Opportunity Information: Apply for CDC RFA GH15 1525
Apply for CDC RFA GH15 1525
- The Centers for Disease Control and Prevention in the health sector is offering a public funding opportunity titled "Building Capacity for a Sustainable, Country led Response to the HIV/AIDS Epidemic in Guyana A Technical Assistance Support Model to the Guyana Ministry of Health (MOH) under the Presidents Emergency Plan for AIDS Relief (PEPFAR)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.067 Global AIDS.
- This funding opportunity was created on Dec 1, 2014 and posted on Dec 1, 2014.
- Applicants must submit their applications by Jan 23, 2015 Electronically submitted applications must be submitted no later than 1159 p.m., ET, on the listed application due date.. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $690,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $3,450,000.00 in funding.
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).
- Ministry of Health, Guyana
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Opportunity Summary:
This CDC cooperative agreement opportunity (Funding Opportunity Number CDC-RFA-GH15-1525) supports Guyana in strengthening a sustainable, country-led HIV response under PEPFAR by providing a structured technical assistance model to the Guyana Ministry of Health (MOH) and key national partners. The overall intent is to improve how HIV services are designed, delivered, monitored, and continuously improved, with a strong emphasis on reaching and effectively serving key populations (KP) such as men who have sex with men (MSM), commercial sex workers (CSW), and transgender (TG) people. A central theme throughout the opportunity is closing the gap between the general population HIV burden and the much higher burden seen in key populations (illustratively noted as general population prevalence around 0.8 to 1.3 versus key population prevalence around 19 to 24), by improving access, uptake, quality of care, and retention outcomes for those most affected.
The approach begins with operational and end-user assessments focused on key population HIV programming. On the operational side, the work involves examining how well MOH program managers and senior staff are adhering to key population implementation requirements and identifying real-world delivery failures such as commodity and material stock-outs, difficulties recruiting and retaining providers, and challenges reaching intended communities using recommended strategies. In parallel, an end-user assessment gathers the perspective of HIV-infected members of key populations to document barriers to accessing clinical services and to capture preferred service delivery options (for example, clinic hours, location, the type of clinical staff clients feel comfortable seeing, and specific service gaps). Findings from these assessments are meant to feed directly into redesigned or revised key population programming and to shape provider training agendas based on what clients and implementers report they need most. The near-term aim is increased access to and uptake of clinical services among key populations, with the longer-term goal of reducing disparities in transmission and clinical outcomes between key populations and the general population.
A major component of the opportunity is improving clinical practice and care delivery across national and regional sites. The program calls for best-practice trainings aligned with international HIV clinical and treatment guidelines, with trainings open not only to MOH staff but also to clinicians from NGOs to encourage consistent standards and shared approaches. These trainings are expected to increase guideline adherence, build provider skills in the clinical management of HIV among key populations, and strengthen collaboration between national clinical treatment centers and civil society organizations involved in care and support. The outcomes emphasized include better quality HIV care and stronger linkage to and retention in care, particularly for MSM and CSW, where attrition and stigma-related barriers can be pronounced.
Quality improvement is treated as a system function rather than a one-time activity. The opportunity describes developing and piloting a single consolidated HIV/AIDS care quality improvement strategy and assessment tool, then integrating it into routine practice at main MOH service delivery sites. The point is to make quality monitoring more efficient and consistent, including streamlining how many administrative areas can be assessed in a visit and how many measures can be reviewed in one chart review process. Expected results include improved quality of care, more reliable documentation (including documentation of linkage to care), and a stronger ability to identify gaps quickly and correct them before they become entrenched.
Strengthening strategic information and patient monitoring is another core pillar. The opportunity includes designing, developing, piloting, and integrating an electronic HIV/AIDS database for patient monitoring, with the intention of improving availability and use of key clinical indicators such as adherence measures, CD4 counts, viral load results, and, where applicable, HIV genotyping and phenotyping. Alongside the database, the program aims to create a patient linking strategy using a single, robust unique identifier across MOH programs. This is meant to improve case tracking across related services such as TB, sexually transmitted infections (STI), and prevention of mother-to-child transmission (PMTCT), reduce fragmentation, and enable more integrated management of HIV alongside comorbid conditions. In practical terms, these changes are supposed to improve both the national-level ability to monitor program performance and the facility-level ability to follow individuals through the continuum of care, ultimately improving documented patient outcomes.
The surveillance and reporting elements focus on improving data quality, reducing duplication, and making data more useful for targeting and decision-making. The opportunity calls for an enhanced surveillance strategy for better linkage of National AIDS Program Secretariat (NAPS) data, aiming to reduce client duplication across multiple indicators used for reporting. Reduced duplication is positioned not only as a data integrity improvement but also as a cost-control measure by avoiding unnecessary procurement and waste (such as excess test kits, drugs, and educational materials driven by inflated counts). It also includes revising case surveillance forms to capture transmission risk, which is intended to increase the volume and quality of strategic information about key populations and other vulnerable groups, strengthen targeting to MSM, CSW, and TG communities, and improve reporting on KP risks and outcomes. To make these changes stick, the program includes data management and analysis trainings to build MOH staff capacity for analysis, increase country ownership of HIV data systems, and strengthen monitoring and evaluation overall.
Clinical outcomes are also addressed through targeted efforts around HIV drug resistance (HIVDR) and retention. The opportunity includes conducting HIVDR testing and reporting HIVDR trends among enrolled patients, with the explicit goal of generating the evidence needed to update treatment guidelines, especially around regimen selection and switching when resistance is suspected or confirmed. This feeds into longer-term goals of reducing acquired drug resistance and lowering HIV-related morbidity and mortality. To address continuity of care, the program promotes open case conferences with NGOs at the National Care and Treatment Center (NCTC) to reduce loss to care, improve re-engagement after clients drop out, and increase overall retention. Complementing that, routine adherence assessments and repeated transmission risk reassessments among patients retained in care are intended to detect adherence challenges earlier, reduce treatment failure, curb the emergence of resistance, improve viral suppression, and reduce opportunistic infections.
Laboratory systems are included as a specific quality improvement domain. The opportunity proposes developing and piloting a laboratory-focused HIV/AIDS quality improvement strategy and assessment tool to produce better performance data, reduce turnaround time for confirmatory testing, and strengthen quality checks for rapid testing using reference standards such as ELISA and Western Blot. These steps are tied to maintaining reliable lab services and safeguarding the blood supply. Relatedly, an HIV drug resistance capacity assessment at the National Public Health Reference Laboratory (NPHRL) is intended to clarify readiness, gaps, and required inputs for initiating or expanding local HIVDR testing, improving decision-making about whether and how to build that capability domestically.
Given the close relationship between HIV and TB in clinical settings, the program also includes monitoring infection control practices at HIV and TB care sites to reduce the risk of nosocomial TB/HIV transmission. The stated outcomes include fewer TB infections among people living with HIV in care and reduced TB/HIV-related morbidity and mortality among co-infected patients. At the national program level, the opportunity calls for developing a clinical cascade for ongoing monitoring and evaluation across the continuum of care, so that managers can quickly see where clients are being lost (testing, linkage, ART initiation, retention, viral suppression) and direct improvement efforts accordingly.
Finally, the opportunity looks beyond Guyana alone by encouraging capacity for Caribbean regional support, including analytical collaboration. This regional emphasis is meant to increase collaboration with peers and technical resources across the Caribbean and to help create a more sustainable technical assistance ecosystem that is not solely dependent on the US government or international multilaterals over the long term.
Administratively, this was posted December 1, 2014 and closed January 23, 2015, with an archive date of February 22, 2015. It was offered as a discretionary cooperative agreement in the health category, CFDA 93.067 (Global AIDS), with an expectation of one award and no cost-sharing or matching requirement. The estimated total funding was listed as $690,000, with an award ceiling of $3,450,000 and a floor of $0. The eligible applicant specified in the notice is the Ministry of Health, Guyana, and the sponsoring agency is the Centers for Disease Control and Prevention (CDC).
Frequently Asked Questions (FAQs)
1) What is the funding opportunity number for this CDC cooperative agreement?
The Funding Opportunity Number (FON) is CDC-RFA-GH15-1525.
2) Who is the sponsoring agency for this opportunity?
The sponsoring agency is the Centers for Disease Control and Prevention (CDC).
3) What type of award is this?
This opportunity is a discretionary cooperative agreement.
4) What is the CFDA number and program name associated with this opportunity?
The CFDA is 93.067, listed as Global AIDS.
5) What is the overall purpose of the cooperative agreement?
The intent is to support Guyana in strengthening a sustainable, country-led HIV response under PEPFAR by providing a structured technical assistance model to the Guyana Ministry of Health (MOH) and key national partners, improving how HIV services are designed, delivered, monitored, and continuously improved.
6) Which populations are emphasized in this opportunity?
The opportunity places strong emphasis on key populations (KP), specifically men who have sex with men (MSM), commercial sex workers (CSW), and transgender (TG) people.
7) Why is there a focus on key populations in Guyana?
A central theme is closing the gap between the HIV burden in the general population and the much higher burden in key populations. The notice illustrates this disparity with general population prevalence around 0.8 to 1.3 versus key population prevalence around 19 to 24. The work aims to improve access, uptake, quality of care, and retention for those most affected.
8) What does the technical assistance approach start with?
The approach begins with operational and end-user assessments focused on key population HIV programming.
9) What is covered in the operational assessment?
The operational assessment examines how well MOH program managers and senior staff adhere to key population implementation requirements and identifies real-world delivery failures, including:
- Commodity and material stock-outs
- Difficulties recruiting and retaining providers
- Challenges reaching intended communities using recommended strategies
10) What is covered in the end-user assessment?
The end-user assessment gathers perspectives from HIV-infected members of key populations to document barriers to accessing clinical services and to capture preferred service delivery options, such as:
- Clinic hours
- Location
- Type of clinical staff clients feel comfortable seeing
- Specific service gaps
11) How are assessment findings expected to be used?
Findings are intended to feed directly into redesigned or revised key population programming and to shape provider training agendas based on what clients and implementers report they need most.
12) What near-term and long-term outcomes are highlighted for key population programming?
The near-term aim is increased access to and uptake of clinical services among key populations. The longer-term goal is reducing disparities in transmission and clinical outcomes between key populations and the general population.
13) What clinical training activities are included?
The program calls for best-practice trainings aligned with international HIV clinical and treatment guidelines. Trainings are open to MOH staff and clinicians from NGOs to encourage consistent standards and shared approaches.
14) What are the expected results of the clinical trainings?
Expected results include increased guideline adherence, stronger provider skills in clinical management of HIV among key populations, and improved collaboration between national clinical treatment centers and civil society organizations involved in care and support.
15) What care outcomes are emphasized in the clinical practice component?
The opportunity emphasizes improved quality of HIV care and stronger linkage to care and retention in care, particularly for MSM and CSW, where attrition and stigma-related barriers may be pronounced.
16) How is quality improvement (QI) described in this opportunity?
Quality improvement is treated as a system function, not a one-time activity. The opportunity describes developing and piloting a single consolidated HIV/AIDS care QI strategy and assessment tool and integrating it into routine practice at main MOH service delivery sites.
17) What efficiencies are expected from the consolidated QI tool?
The tool is intended to make quality monitoring more efficient and consistent by streamlining items such as how many administrative areas can be assessed per visit and how many measures can be reviewed in a single chart review process.
18) What are the anticipated results of the QI work at service delivery sites?
Anticipated results include improved quality of care, more reliable documentation (including documentation of linkage to care), and a stronger ability to identify and correct gaps quickly.
19) What strategic information and patient monitoring upgrades are proposed?
The opportunity includes designing, developing, piloting, and integrating an electronic HIV/AIDS database for patient monitoring to improve availability and use of key clinical indicators, including:
- Adherence measures
- CD4 counts
- Viral load results
- Where applicable, HIV genotyping and phenotyping
20) What is the purpose of a patient linking strategy and unique identifier?
The program aims to create a patient linking strategy using a single robust unique identifier across MOH programs to improve case tracking across related services (TB, STI, PMTCT), reduce fragmentation, and enable more integrated management of HIV and comorbid conditions.
21) How is surveillance and reporting expected to improve?
The opportunity calls for an enhanced surveillance strategy to better link National AIDS Program Secretariat (NAPS) data and reduce client duplication across multiple reporting indicators, improving data quality and usefulness for targeting and decision-making.
22) Why is reducing duplication framed as a cost-control measure?
Reduced duplication is positioned as a way to avoid unnecessary procurement and waste (for example, excess test kits, drugs, and educational materials driven by inflated counts).
23) What changes are proposed for case surveillance forms?
The opportunity includes revising case surveillance forms to capture transmission risk, increasing the volume and quality of strategic information on key populations and other vulnerable groups and improving reporting on KP risks and outcomes.
24) What training is included to strengthen data use and country ownership?
The program includes data management and analysis trainings to build MOH staff capacity for analysis, increase country ownership of HIV data systems, and strengthen monitoring and evaluation.
25) What HIV drug resistance (HIVDR) activities are included?
The opportunity includes conducting HIVDR testing and reporting HIVDR trends among enrolled patients to generate evidence for updating treatment guidelines, especially around regimen selection and switching when resistance is suspected or confirmed.
26) What longer-term outcomes are linked to HIV drug resistance work?
The longer-term goals include reducing acquired drug resistance and lowering HIV-related morbidity and mortality.
27) How does the program address retention and loss to care?
To improve continuity of care, the program promotes open case conferences with NGOs at the National Care and Treatment Center (NCTC) to reduce loss to care, improve re-engagement after clients drop out, and increase overall retention.
28) What routine clinical practices are mentioned to support adherence and prevention?
The opportunity mentions routine adherence assessments and repeated transmission risk reassessments among patients retained in care to detect adherence challenges earlier, reduce treatment failure, curb emergence of resistance, improve viral suppression, and reduce opportunistic infections.
29) What laboratory quality improvement activities are proposed?
The opportunity proposes developing and piloting a laboratory-focused HIV/AIDS QI strategy and assessment tool to:
- Produce better performance data
- Reduce turnaround time for confirmatory testing
- Strengthen quality checks for rapid testing using reference standards such as ELISA and Western Blot
30) How does the opportunity connect laboratory improvements to blood safety?
The lab quality steps are tied to maintaining reliable lab services and safeguarding the blood supply.
31) What is the HIVDR capacity assessment at the National Public Health Reference Laboratory (NPHRL)?
The opportunity includes an HIV drug resistance capacity assessment at the NPHRL to clarify readiness, gaps, and required inputs for initiating or expanding local HIVDR testing and to improve decision-making about building domestic HIVDR testing capability.
32) Are TB and infection control addressed?
Yes. The program includes monitoring infection control practices at HIV and TB care sites to reduce the risk of nosocomial TB/HIV transmission.
33) What outcomes are tied to monitoring infection control practices?
Stated outcomes include fewer TB infections among people living with HIV in care and reduced TB/HIV-related morbidity and mortality among co-infected patients.
34) What is meant by developing a clinical cascade?
The opportunity calls for developing a clinical cascade for ongoing monitoring and evaluation across the continuum of care so managers can see where clients are being lost (testing, linkage, ART initiation, retention, viral suppression) and direct improvement efforts accordingly.
35) Does the opportunity include any regional Caribbean component?
Yes. It encourages capacity for Caribbean regional support, including analytical collaboration, to increase regional collaboration and help create a more sustainable technical assistance ecosystem over the long term.
36) Who is eligible to apply for this funding opportunity?
The eligible applicant specified in the notice is the Ministry of Health, Guyana.
37) How many awards were expected under this announcement?
The opportunity listed an expectation of one award.
38) Is cost-sharing or matching required?
No. The notice states there is no cost-sharing or matching requirement.
39) What was the estimated total funding and the award ceiling/floor?
The estimated total funding was $690,000. The award ceiling was listed as $3,450,000, and the award floor was listed as $0.
40) When was the opportunity posted and when did it close?
It was posted on December 1, 2014 and closed on January 23, 2015. The archive date was February 22, 2015.
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