USAID issues Broad Agency Announcement for Accelerator to End TB in India

Deadline: 10 May 2019

The United States Agency for International Development (USAID) has issued this Broad Agency Announcement (BAA) to seek participants to co-create, co-design, co-invest, and collaborate on research and development interventions to rapidly demonstrate and rigorously test person-centered, high-impact and novel solutions that can accelerate the Government of India’s (GOI) efforts to eliminate Tuberculosis (TB) by 2025.

Achieving the ambitious goal of ending TB by 2025 necessitates a paradigm shift in approach and strategy. Partnering with the GOI, USAID is calling for groundbreaking approaches to accelerate a reduction in TB, with a special focus on multidrug-resistant/rifampicin resistant TB MDR/RR-TB. USAID will invest in out-of-the-box, but achievable solutions that leapfrog conventional approaches to ensure a person-centered approach to prevent, diagnose and treat TB.

The intent of the BAA is to allow co-creation and co-design to the maximum extent to create high quality, effective partnerships with great efficiency in time and resources. USAID will invite selected for-profit and non-profit, faith-based, public and private organizations, as detailed below, to co-create solutions to the Problem and Challenge Statements stated in this BAA, including those organizations that have ideas, expertise, resources, and/or funding to add to potential solutions.

Problem Statement

Despite a declining Tuberculosis (TB) epidemic, India still has the world’s highest burden of Tuberculosis and multidrug-resistant/rifampicin resistant TB (MDR/RR-TB) — more than 25 percent of the world’s burden. In 2017, there were 2.74 million new TB cases, including 135,000 MDR/RR-TB cases.1 Drug resistance is on the rise, posing significant programmatic and societal challenges. Responding to this epidemic, the Government of India (GOI) has pledged its commitment at the highest levels to eliminate TB by 2025 and launched a bold National Strategic Plan. However, more needs to be done to drastically reduce the TB burden, especially MDR/RR-TB, in India and address key gaps.

  • GAP: Preventing TB
  • GAP: Early and Accurate Diagnosis
  • GAP: Successful Treatment Outcomes
  • GAP: Non-medicalized Response to TB Care

Challenge Statement

USAID/India’s Accelerator to End TB in India BAA wants to rapidly demonstrate and rigorously test person-centered, highimpact and novel solutions that can accelerate GOI efforts to eliminate TB by 2025.

USAID seeks to bring together a diverse set of co-creators and resource partners to enable broader thinking, innovation, a shared vision and a larger resource pool. This BAA recognizes that creating an enabling environment, leveraging digital technology and using innovative financial approaches, may be game changers in facilitating the paradigm shift required for India to reach its TB elimination goals. In particular, they are interested in tapping into local expertise, perspectives, solutions and financing to improve health outcomes over the long term.

Some priority challenge areas are identified below. However, this is not a comprehensive list, and applicants are encouraged to also identify solutions that may fall outside the following categories.

  1. Pillar 1: Strengthening service delivery platforms to deliver high-quality patient-centered TB and MDR/RR-TB services
    • Challenge: This BAA is looking for differentiated solutions that maximize the impact of quality prevention, diagnostic and treatment services in public and private facilities consisting of health care workers with the right knowledge, skills and attitudes, in the right places with the right motivation. Solutions proposed should explain how they would strengthen an institution’s ability to provide differentiated patient-centric care using strategies and approaches generated through state-of-the-art tools and evidence.
  2. Pillar 2: Demonstrating community-led, person-centered prevention, care and support models
    • Challenge: This BAA is looking to test models where communities and families are instrumental in delivering differentiated care for populations that may have unique challenges accessing services. These populations include, but are not limited to: people with MDR/RR-TB, children, people living with HIV, diabetics, tobacco users and alcohol dependents, tribal, pregnant and lactating women, prison inmates, migrants and poor, undernourished and socio-economically vulnerable communities. Although men are more likely to be infected with TB, women are disproportionately more likely to experience significant stigma, discrimination and other barriers in accessing TB services. The impact of community-based activities and associated costs to the patient and the health system remains poorly documented or measured.

Cross-Cutting Areas Challenges

This BAA identifies three challenge areas that cut across both pillars and are strategically important to ensure that investments that strengthen both institutional and community-based TB services are successful and sustainable.

  • Cross-cutting area 1: Create an enabling environment
    • Challenge: USAID is looking for partners that can identify bottlenecks and propose evidence- based solutions that foster an enabling environment. Preference will be given to ideas that take a holistic approach to the needs and environment of people affected by TB including MRD/RR-TB; invest in the long-term vision of a TB-free India; focus on positive interventions that do not further stigmatize or prevent access; acknowledge the importance of positive, inclusive language; and always put the patient at the center of action.
  • Cross-cutting area 2: Deploy effective digital technologies to amplify impact
    • Challenge: This BAA is looking for effective digital solutions that may be used to solve the gaps across any part of the prevention, care and treatment cascade (i.e. the patient, frontline workers, labs, physicians, etc.). Interventions can address concerns around care seeking, screening, diagnostic and notification, treatment initiation, and adherence and treatment support. Solutions could draw inferences and recognize patterns in large volumes of patient histories, medical images, epidemiological statistics, etc. that enhance existing data platforms. Digital solutions that are beyond the initial innovation stage, and have some degree of market readiness are preferred. Solutions may want to consider access in rural and remote areas with limited connectivity and electricity.
  • Cross-cutting area 3: Use innovative financing approaches
    • Challenge: USAID is interested in tapping into the expertise of partners in the financing space who can identify innovative solutions to addressing financing challenges on the patient side as well as the facility side. This BAA is looking for effective approaches that can reduce the financial burden on individuals and families affected with TB, as well as for financing approaches that can improve institutions’ ability to cost-effectively bring state-of-the-art diagnosis, treatment and care to those affected by TB, while focusing more on results and outcomes.

What are they looking for?

Generally, they are looking for expressions of interest that clearly demonstrate the following attributes:

  • Evidence-based ideas, including creativity of the given approach and clear differentiation from existing approaches.
  • Cost-conscious and adaptable for Indian settings, particularly at the sub-national level.
  • Ability to be scaled rapidly and cost effectively in an Indian context.
  • Strong likelihood of achieving a substantial impact.
  • Ability to make significant improvements within the first year of demonstration.

What are they NOT looking for?

  • Research that does not provide a clear path to development and testing of intervention strategies.
  • Solutions that are less efficacious than current technologies or approaches.
  • Proven approaches that are already in use in the field.
  • Basic research, clinical trials or laboratory-intensive research. Basic research is defined as research directed towards fuller knowledge or understanding of the fundamental aspects of phenomena and of observable facts without specific applications toward processes or products in mind.
  • Discovery science, capacity-building-only initiatives, ongoing programmatic funding or infrastructure development.

Award

Awards under this BAA will be made to the Apparently Successful Partner(s) on the basis of their ability to achieve solutions to the Problems/Challenges, as provided herein. The standard clauses or provisions for awards are generally prescribed by law and regulation and will vary considerably by award type. Information regarding clauses and provisions will be offered to the Apparently Successful Partner when the award type is identified.

Eligibility Criteria

Public, private, for-profit, and nonprofit organizations, as well as institutions of higher education, public international organizations, non-governmental organizations, U.S. and non-U.S. governmental organizations, multilateral and international donor organizations are eligible under this BAA. All organizations must be determined to be responsive to the BAA and sufficiently responsible to perform or participate in the final award type.

Additional Considerations

  • Expressions of Interest are not evaluated against other Expressions of Interest, but solely whether USAID believes that the information contained in the EOI indicates that the submitter will be a valuable contributor to the co-creation process. USAID may limit the number of initial submissions selected to move forward based on efficiencies.
  • Concept Papers are not evaluated against other Concept Papers, but solely based on USAID’s determination that the Concept Paper will successfully address the Problem and Challenges set forth herein. USAID may limit the number of Concept Papers selected to move forward based on efficiencies.
  • Decisions regarding USAID’s pursuit of a particular project, technology or relationship are based on all available information, evidence, data, and resulting analysis.

How to Apply

Expression of Interest Information should:

  • Be In English, no more than 2 pages in length, and no smaller than 12 point font;
  • Be submitted electronically at the address given on the website;
  • Contain a header with the following information (included in the page count):
    • Respondent Name/Group and Contact Information;
    • Response Title;
    • BAA Addendum Name/Number;
    • Optional graphic that fits on an 8.5”x11” or A4 piece of paper (included in the page limit);
  • Be in .pdf, .docx, or .odf format.

For more information, please visit this link.

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