USAID’s Systems Strengthening for One Health Activity in Bangladesh

Deadline: 14-Sep-23

The United States Agency for International Development in Bangladesh (USAID/Bangladesh) is seeking applications from qualified US and non-US organizations to implement an activity titled USAID’s Systems Strengthening for One Health Activity.

Purpose

• The purpose of this activity is to enhance Bangladesh’s global health security (GHS) capacity to operate a high functioning and equitable One Health disease detection system that prevents, detects, and responds to new and emerging infectious diseases, while ensuring good One Health governance and reducing risks of irreversible antimicrobial resistance (AMR). This activity will be a cooperative agreement and awarded through a full and open solicitation. The total estimated amount from the Mission is $26 Million, with an expected life of five years.

Results Framework

• Goal: To strengthen the capacity of the Government of Bangladesh (GOB) and the One Health line ministries (Ministry of Health and Family Welfare (MOHFW), Ministry of Environment, Forest, and Climate Change (MOEFCC), and Ministry of Fisheries and Livestock (MOFL)) to operate a high functioning and equitable One Health disease detection system that prevents, detects, and responds to new and emerging infectious diseases, while ensuring good One Health governance and reducing risks of irreversible antimicrobial resistance (AMR). To obtain this goal, this Activity will develop evidence-based and system strengthening interventions to meet the following three objectives.
  • Objective 1: Strengthen systems for better one health governance
    • To effectively prevent, detect, and respond to infectious disease threats with pandemic potential through a One Health approach, it is critical to improve governance systems and relationships between the health, animal (domestic, livestock and wildlife), and environment sectors and relevant GOB line ministries. The MOHFW has the responsibility to ensure the health and wellness of all Bangladeshis. The MOEFCC is responsible for safeguarding the country’s natural environment and wildlife. Even though the wildlife sector is supposed to fall within the animal interface of a One Health approach, in Bangladesh, wildlife efforts are overseen by the MOEFCC.
    • Intermediate result 1. One health coordination platforms strengthened
      • The GOB’s One Health Secretariat (OHS) is designed to oversee, coordinate and advance the national agenda. The MOHFW, MOEFCC, and MOFL are principal members of the GOB’s OHS and the MOHFW’s Institute of Epidemiology, Disease Control, and Research (IEDCR) serves as the current chair. However, the OHS faces governance, financing, leadership, and operational challenges that hamper its effectiveness. Even though the OHS was designed to serve as a governing body to implement the national One Health strategy, the One Health line ministries have not allocated dedicated financial and human resources to ensure its functionality.
      • Strong One Health mechanisms and platforms for multisectoral coordination must address equity when advancing national and local policies to ensure equitable distribution of effort is provided to prevent, detect and respond to pandemic threats across Bangladesh. The applicant is expected to work hand-in-hand with the One Health line ministries, at the national and local levels, to strengthen systems that promote better One Health governance by developing and implementing evidence-based, system strengthening interventions that may include, but are not limited to, the following lines of effort.
        • Operationalize existing national One Health coordination platforms to better advance the national agenda.
        • Support the GOB and One Health line ministries to better plan and budget resources necessary to functionalize the OHS and other One Health coordination platforms, nationally and locally.
        • Collaborate with One Health coordination platforms to improve GOB pandemic preparedness and response plans.
    • Intermediate result 2. One health workforce and networks strengthened
      • Governments are tasked with spearheading national One Health agendas, but they cannot accomplish this on their own. Involving other sectors and organizations with technical skills in the various One Health areas is critical to strengthening national priorities. Some countries benefit from One Health networks composed of the private sector, civil society, and academia. Those networks are designed to collectively advance national One Health agendas, offer technical assistance to governments, serve as implementing entities when needed, and provide critical support to the national workforce interested in working in One Health.
      • The applicant is expected to work hand-in-hand with the One Health line ministries, at the national and local levels, and a diverse set of actors (private sector, academia, civil society, etc.) to strengthen the One Health Network systems and support new and emerging professionals as they enter the One Health workforce. The applicant is to develop and implement evidence based, system strengthening interventions that may include, but are not limited to, the following lines of effort.
        • Conduct a landscape analysis to better understand which local and non-government organizations and institutions are working in the One Health sector.
        • Strengthen the existing One Health network (or build one, if appropriate) that includes, but is not limited to, the private sector, academia, and civil society.
        • Ensure functional linkages between the One Health network and workforce.
  • Objective 2: Strengthen one health disease detection systems
    • To better prevent and detect potential pandemic outbreaks, a country needs to have a high functioning and quality assured disease detection system that is integrated and interoperable among the human, animal, and environment interfaces. A disease detection system should include a versatile surveillance system with the capacity to link and coordinate among human, animal, and environment surveillance and information systems housed within each of the One Health line ministries.
      • Intermediate result 1. One health surveillance systems operationalized
        • Preventing and detecting pandemic threats stems from having a robust, high quality, and interoperable surveillance system with the capacity to perform within the human, animal, and environment interface. A strong surveillance system sets the foundation to improve a country’s GHS architecture, but also advances the One Health approach by ensuring that an interconnected surveillance system exists and operates among the human, animal, and environment interfaces.
        • For this Activity, the applicant is expected to work hand-in-hand with the One Health line ministries, at the national and local levels, to strengthen their disease surveillance system by developing and implementing evidence-based system strengthening interventions that may include, but are not limited to, the following lines of effort.
          • Conduct an equity gap analysis/epidemiological analysis to identify populations in Bangladesh most at risk in the event of infectious disease outbreaks and develop appropriate surveillance plans.
          • Strengthen standalone disease surveillance systems to ensure appropriate and evidence-based surveillance across the human, animal and environment sectors.
          • Ensure connectivity and interoperability among human, animal, and environment sector surveillance systems.
      • Intermediate result 2. One health diagnostic systems strengthened
        • By strengthening the functionality of the quality assured diagnostic networks of the MOHFW, MOEFCC, and MOFL laboratories and testing sites, the GOB will improve its capacity to diagnose diseases within the human, animal, and environment sectors. With a strong surveillance system in place (Objective 2, Intermediate Result 1), ensuring a high functioning and complementary diagnostic network is critical to diagnosing and confirming potential infectious diseases within the One Health interfaces.
        • The applicant is expected to work hand-in-hand with One Health line ministries, at the national and local levels, to strengthen human, animal, and environment diagnostic networks including laboratories and testing sites pertinent to each line ministry, by developing and implementing evidence-based system strengthening interventions that may include, but are not limited to, the following lines of effort.
          • Strengthen national and local human, animal (domestic, livestock, and wildlife animals), and environment diagnostic systems.
          • Ensure interconnectivity, communication, and data sharing across and between human, animal, and environment diagnostic and surveillance systems.
          • Enhance national and local laboratory capacity for pathogen and disease detection across the One Health interfaces.
      • Intermediate result 3. Systems to swiftly respond to infectious disease outbreaks strengthened
        • Strong outbreak response capacities in all One Health interfaces are critical to contain and eliminate diseases and avoid spillover to humans. With robust surveillance and diagnostic systems in place (Objective 2, Intermediate Results 1 and 2), responding to outbreaks will be timely and effective. DGHS has established an Emergency Operations Center (EOC) at IEDCR to serve as the human health response mechanism. However, the EOC lacks financial and human resource capacity and authority to fully operate in this role. For example, during the COVID-19 pandemic, the EOC was slow and weak in its response and many MOHFW units lacked direction in establishing a unified response. Government EOCs tend to only focus on implementing national responses, but local level EOCs are limited in capacity or even nonoperational throughout Bangladesh.
        • The applicant is expected to work hand-in-hand with One Health line ministries, at the national and local levels, to strengthen a coordinated One Health response mechanism by developing and implementing evidence based system strengthening interventions that may include, but are not limited to, the following lines of effort.
          • Strengthen national and local level One Health response mechanisms, methodologies, and capacity to manage human, animal, and environmental disease outbreaks.
          • Support One Health line ministries to conduct outbreak response interventions where resources are severely limited.
          • Functionalize EOCs across the One Health interfaces, ensuring coordination and interconnectivity across them, and establishing dedicated response teams.
  • Objective 3: Reduce Threats of Antimicrobial Resistance (AMR)
    • The World Health Organization (WHO) established an Access, Watch, and Reserve (AWaRE) classification system to monitor the rational use of antimicrobials in humans and reduce the risk of AMR emergence. The World Organization for Animal Health (WOAH) published guidance on prudent uses of antimicrobials in both terrestrial and aquatic animals. Despite global best practices indicating the role of government as stewards in preventing AMR, Bangladesh exhibits limited capacity to serve in that role. For example, 56% of antibiotics consumed in Bangladesh fall into the ‘strict watch’ category, which elevates the risk of AMR for diseases that can be treated with 262 listed access category antibiotic drugs. Bangladesh struggles to implement global standards, practices, and guidelines designed to reduce the risk of AMR among the human, animal, and environment interfaces.
    • Intermediate results 1. National governance systems to regulate and enforce AMR standards strengthened
      • The Directorate General of Drug Administration (DGDA) serves as the national regulatory authority for medicines and medical equipment for humans and animals. Recently, DGDA has published its five-year strategic plan focusing on good governance and regulatory frameworks, which supports the reduction of AMR risk. The DGDA plays a vital role in ensuring that Bangladesh’s national ARM guidelines are aligned with international and evidence-based guidelines. DGHS’s Communicable Disease Control (CDC-DGHS) unit is the AMR focal entity of Bangladesh, both for human and animal sectors and is designed to implement AMR containment activities across the country.
      • The applicant is expected to work hand-in-hand with the One Health line ministries, at the national and local levels, to strengthen national AMR governance systems by developing and implementing evidence-based, system strengthening interventions that may include, but are not limited to, the following lines of effort.
        • Strengthen DGDA’s regulatory and enforcement capacity to uphold AMR and other infection prevention and control standards among the human and animal interfaces.
        • Support the GOB to develop standard treatment guidelines for the use of antibiotics within One Health sectors.
        • Strengthen existing AMR surveillance systems in human and animal interfaces and ensure interconnectivity.
    • Intermediate result 2. AMR standards compliance increased
      • The overall supply and demand for antibiotics is unregulated and indiscriminate across the One Health interfaces. It is critical for consumers and sellers to build their awareness of the threats and dangers of AMR and develop a compliance culture with national guidelines. Further, the GOB needs to strengthen their regulatory oversight of large-scale manufacturers and at the community level to ensure appropriate use of antibiotics. The applicant is to ensure a careful analysis is conducted to better understand the different segments of the population where antibiotics are disproportionately used, and in an indiscriminate or misleading manner.
      • The applicant is expected to work hand-in-hand with the One Health line ministries and other regulatory entities, at national and local levels, to strengthen the GOB’s capacity to ensure compliance and adherence to AMR risk-reduction by developing and implementing evidence-based, system strengthening interventions that may include, but are not limited to, the following lines of effort.
        • Support the GOB to implement standards guidelines at the industrial, community, and individual level, particularly among large scale pharmaceutical industries, and within the human and animal interfaces.
        • Support the GOB to develop social behavior change (SBC) interventions that build awareness and promote the appropriate use of antimicrobials among consumers and sellers. Specifically, this Activity is to work with USAID/Bangladesh’s SBC activity on this specific intervention and avoid duplication of efforts.
        • Support One Health line ministries to better implement guidelines for the rational prescription and use of antimicrobials.

Funding Information

• Subject to funding availability and at the discretion of the Agency, USAID intends to provide twenty-six million dollars ($26 million) in total USAID funding over a Five (5) year period.

Risk and Assumptions

Over the course of this Activity’s implementation cycle, the following assumptions and risks should be considered. This list is not exhaustive.

• Future pandemics that far surpass the GOB’s response capacity.
• Natural disasters derailing efforts to bridge animal, human, and environment interfaces.
• Economic volatility shrinks GOB’s financial capacity to invest in One health priorities.
• Widespread incidents of infectious diseases reaching antimicrobial resistance.
• High-level leaders in the animal, human, and environment systems and relevant ministries do not have sufficient political buy-in/acceptance to coordinate and effectively implement a One Health approach.
• Political and social disruption related to the 2024 national elections might affect implementation.

Intended Beneficiaries

• The intended beneficiaries of this Activity are those individuals, communities, organizations, and governments that work across the One Health interface. Specifically, this Activity is to work with GOB authorities at the national and local level, and with representatives of MOHFW, MOEFCC, and MOFL.
• Through its systems strengthening interventions to improve the One Health workforce, this Activity will also make a concerted effort to closely work with academia and existing and emerging One Health professionals regardless of their demographic, socioeconomic status, gender identity, physical ability, or geographic location. Beyond this, the applicant may identify and propose populations of interest in order to close equity gaps, meet this Activity’s objectives, and maximize USAID impact.

Eligibility Criteria

• This funding opportunity is open to all eligible U.S. and non-U.S. nongovernmental organizations (NGOs) entities (other than those from foreign policy restricted countries), including educational organizations and universities, and public international organizations, etc.
• The non-Federal entity may not earn or keep any profit resulting from Federal financial assistance. While for-profit firms may participate, Prohibition against profit, no funds will be paid as profit to any for-profit entity receiving or administering Federal financial assistance as a recipient or sub-recipient, and as such, for-profit organizations must waive profits and/or fees to be eligible to apply.
• USAID welcomes applications from organizations that have not previously received financial assistance from USAID.
• Individuals are not eligible to apply.

For more information, visit Grants.gov.