Opportunity Information: Apply for CDC RFA GH13 13370501SUPP16
Apply for CDC RFA GH13 13370501SUPP16
- The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Program Expansion Supplement: Strengthening the SA National Department of Health to implement and evaluate evidence-based public health program, surveillance and disease control efforts under PEPFAR" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.067.
- This funding opportunity was created on Aug 02, 2016.
- Applicants must submit their applications by Oct 01, 2016 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.)
- Each selected applicant is eligible to receive up to $13,500,000.00 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).
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Opportunity Summary:
This funding opportunity is a CDC cooperative agreement supplement under PEPFAR designed to help South Africa accelerate progress toward HIV epidemic control by strengthening the National Department of Health (NDoH) to implement and evaluate evidence-based public health programming, surveillance, and disease control, with a very specific near-term emphasis on rolling out a "Test and Start" approach in selected districts. It is framed as a practical bridge to national scale-up: South Africa has the worlds largest HIV epidemic (about 6.4 million people living with HIV, with roughly 469,000 new infections annually in cited estimates), and while the country has expanded antiretroviral therapy (ART) and sharply reduced mother-to-child transmission, the grant argues that rapid further expansion of combination prevention and treatment is still urgently needed to meet the national 90-90-90 targets endorsed by the Minister of Health (90 percent diagnosed, 90 percent of those on treatment, and 90 percent of those virally suppressed).
The core strategy is to use PEPFAR-supported priority geographies and platforms to move faster than a full national policy and budgeting cycle would normally allow. PEPFAR identified 27 priority districts for intensified prevention and treatment scale-up, and it is also supporting the DREAMS initiative across five districts in KwaZulu-Natal and Gauteng. DREAMS focuses on reducing HIV risk for adolescent girls and young women through a package that empowers girls and young women, mobilizes communities, strengthens families, and addresses risk among male partners. The opportunity leverages that existing DREAMS infrastructure to implement Test and Start in four of the five DREAMS districts, both to reduce new infections sooner and to generate operational learning about what it takes to run Test and Start effectively before it is expanded nationally.
A major driver for this approach is the shift in global and national guidance. In late 2015, WHO recommended offering ART to all people diagnosed with HIV regardless of CD4 count (Test and Start) and also recommended oral PrEP for HIV-negative individuals at substantial risk. South Africa had already revised its national guidelines to expand ART eligibility (including asymptomatic individuals with CD4 counts below 500) and expressed interest in moving further to Test and Start and to providing PrEP for key populations such as men who have sex with men and HIV-negative female sex workers. The grant positions the supplement as a way to implement Test and Start sooner in targeted areas while policy finalization and full national budgeting catch up.
The award is built around concrete treatment scale-up targets within the four districts. PEPFAR South Africa proposed ART targets of 1,202,939 people on ART by September 2016 and 1,395,146 by September 2017 in those districts, representing a net increase of 261,589 additional patients on ART over two years. The text notes that 70,134 of those net new patients were already part of earlier aggressive scale-up planning (COP15) and were contingent on adoption of new national guidelines, with a planning assumption that a unit cost of 55 per new ART patient (for a technical assistance model with limited differentiated service delivery) would continue to be used in budgeting. In other words, the supplement is not just general support; it is tied to a time-bound expansion in the number of people initiated and maintained on treatment, aligned to PEPFAR planning cycles.
A prominent theme in the opportunity is closing the treatment gap for men, which the announcement treats as a critical barrier to achieving overall coverage and reducing community viral load. While the document notes that gender disparities cannot be fully quantified with the available data, it asserts based on cohort experience that well over half of people living with HIV who are not on treatment are men who are either undiagnosed or diagnosed but not currently on ART. Because of that, the supplement highlights service delivery models designed specifically to find, link, start, and retain men ages 20 to 49. Examples mentioned include mobile testing, after-hours clinic access, male-focused adherence clubs, medication delivery to non-clinical settings, and intensive mapping to choose convenient and acceptable service points for men. The grant also emphasizes the need for rapid assessments of these approaches to identify which models deliver the strongest impact, implying that the supplement is expected to produce usable implementation evidence, not only service outputs.
Financially, the supplement is justified largely by a near-term commodities and laboratory testing gap. The announcement explains that a delay in full national implementation means the South African government has not yet budgeted for the increased demand for commodities that Test and Start will create. To address that, the supplement is intended to fund the purchase of commodities and the laboratory testing required to implement Test and Start in the four districts, with an assumption that commodities would be procured directly by NDoH to take advantage of national tender pricing. The opportunity includes costing assumptions of about 100 per patient for antiretroviral drugs plus 31 per patient for laboratory tests, underscoring that this supplement is meant to cover real incremental costs of treatment expansion, not only technical support.
The performance aim stated for the supplement is ambitious and time-specific: by the end of September 2017, the four-district effort is intended to reach 90 percent of people living with HIV diagnosed and 80 percent of people living with HIV on ART, using Test and Start as the mechanism to remove eligibility barriers and speed initiation. For men specifically within these districts, the stated goals are 65 percent of males with HIV in care and on ART by September 2016 and 80 percent by September 2017, with DREAMS activities helping identify and reach male partners and address male norms using evidence-based interventions.
In terms of administrative details, this is a discretionary CDC funding opportunity (CDC RFA GH13-13370501SUPP16) under CFDA 93.067, offered as a cooperative agreement, which usually indicates substantial federal involvement and ongoing technical collaboration rather than a hands-off grant. The opportunity was posted August 2, 2016, with an application deadline of October 1, 2016 (11:59 p.m. ET for electronic submissions). The award ceiling is $13.5 million, and the expected number of awards is one, suggesting a single, focused implementing partner arrangement closely aligned with NDoH and PEPFAR South Africa priorities.
Overall, the grant is essentially a targeted infusion of funds to rapidly operationalize Test and Start in four high-priority districts by paying for the tangible inputs (drugs and labs) and supporting service delivery models and evaluation learning, with a strong emphasis on reaching men and leveraging the DREAMS platform. The intent is to deliver immediate gains in treatment coverage and prevention impact while producing practical evidence and implementation experience that can inform South Africas eventual national roll-out of Test and Start and related interventions.
Frequently Asked Questions (FAQs)
1) What is this funding opportunity?
This opportunity is a CDC cooperative agreement supplement under PEPFAR. It is designed to help South Africa accelerate progress toward HIV epidemic control by strengthening the National Department of Health (NDoH) to implement and evaluate evidence-based public health programming, surveillance, and disease control, with a specific near-term emphasis on rolling out a "Test and Start" approach in selected districts.
2) What is the main goal of the supplement?
The main goal is to rapidly operationalize "Test and Start" in four priority districts (within the DREAMS-supported districts) by covering key incremental needs like HIV treatment commodities and laboratory testing, while also supporting service delivery models and generating practical implementation learning to inform national scale-up.
3) What does "Test and Start" mean in this opportunity?
"Test and Start" refers to offering antiretroviral therapy (ART) to all people diagnosed with HIV regardless of CD4 count. The supplement emphasizes using this approach to remove eligibility barriers and speed initiation onto treatment in the selected districts.
4) Why is this supplement being pursued now?
The opportunity is framed as a practical bridge to national scale-up. It is intended to move faster in targeted geographies than a full national policy and budgeting cycle would normally allow, especially given the increased commodities and laboratory demand expected under Test and Start.
5) Which country and epidemic context does this address?
This supplement is focused on South Africa, which is described as having the world's largest HIV epidemic (about 6.4 million people living with HIV, with roughly 469,000 new infections annually in cited estimates). The opportunity notes progress in ART expansion and reductions in mother-to-child transmission, while emphasizing that rapid additional combination prevention and treatment expansion is still urgently needed.
6) How does this opportunity connect to the 90-90-90 targets?
The supplement is aligned with South Africa's national 90-90-90 targets endorsed by the Minister of Health: 90 percent of people living with HIV diagnosed, 90 percent of those diagnosed on treatment, and 90 percent of those on treatment virally suppressed. The four-district effort also includes specific aims related to diagnosis and ART coverage by September 2017.
7) What geographic areas are targeted?
The strategy leverages PEPFAR-supported priority geographies. PEPFAR identified 27 priority districts for intensified prevention and treatment scale-up, and the supplement specifically leverages the DREAMS platform to implement Test and Start in four of the five DREAMS districts across KwaZulu-Natal and Gauteng.
8) What is DREAMS and how is it used in this grant?
DREAMS is a PEPFAR-supported initiative focused on reducing HIV risk for adolescent girls and young women through a package that empowers girls and young women, mobilizes communities, strengthens families, and addresses risk among male partners. This opportunity leverages existing DREAMS infrastructure to implement Test and Start in four DREAMS districts to reduce new infections sooner and generate operational learning for eventual national expansion.
9) What shift in guidance is this opportunity responding to?
The opportunity responds to late-2015 WHO guidance recommending ART for all people diagnosed with HIV regardless of CD4 count (Test and Start), and recommending oral PrEP for HIV-negative individuals at substantial risk. The opportunity notes South Africa had already expanded national ART eligibility (including asymptomatic individuals with CD4 counts below 500) and expressed interest in moving further to Test and Start and to PrEP for key populations.
10) Is PrEP being funded or implemented through this supplement?
The opportunity references WHO guidance on oral PrEP and notes South Africa's interest in PrEP for key populations (such as men who have sex with men and HIV-negative female sex workers). However, the specific near-term emphasis described for this supplement is rolling out Test and Start in selected districts, with funding justified primarily by commodities and laboratory testing needed to implement Test and Start.
11) What are the ART scale-up targets mentioned for the four districts?
PEPFAR South Africa proposed targets of 1,202,939 people on ART by September 2016 and 1,395,146 by September 2017 in the four districts, representing a net increase of 261,589 additional patients on ART over two years.
12) How do these targets relate to PEPFAR planning cycles?
The supplement is explicitly tied to time-bound expansion aligned to PEPFAR planning cycles. The opportunity notes that 70,134 of the net new patients were already part of earlier aggressive scale-up planning (COP15) and were contingent on adoption of new national guidelines.
13) Why is there a special emphasis on reaching men?
Closing the treatment gap for men is presented as a critical barrier to achieving overall coverage and reducing community viral load. The opportunity asserts, based on cohort experience, that well over half of people living with HIV who are not on treatment are men who are undiagnosed or diagnosed but not currently on ART.
14) What age group of men is specifically prioritized?
The supplement highlights models designed specifically to find, link, start, and retain men ages 20 to 49 in HIV services and treatment.
15) What service delivery approaches for men are mentioned?
Examples include mobile testing, after-hours clinic access, male-focused adherence clubs, medication delivery to non-clinical settings, and intensive mapping to choose convenient and acceptable service points for men.
16) Does the opportunity expect evaluation or learning activities?
Yes. The opportunity emphasizes rapid assessments of the approaches used (including those focused on men) to identify which models deliver the strongest impact. The supplement is positioned as expected to produce usable implementation evidence, not only service outputs.
17) What is the primary funding gap this supplement is intended to fill?
The supplement is justified largely by a near-term commodities and laboratory testing gap. The announcement explains that delays in full national implementation mean the South African government has not yet budgeted for the increased demand for commodities that Test and Start will create in the targeted districts.
18) What types of costs does the supplement intend to cover?
The supplement is intended to fund the purchase of commodities and the laboratory testing required to implement Test and Start in the four districts. It includes costing assumptions of about 100 per patient for antiretroviral drugs plus 31 per patient for laboratory tests, indicating coverage of real incremental treatment expansion costs.
19) Who is expected to procure the commodities?
The opportunity assumes that commodities would be procured directly by the NDoH to take advantage of national tender pricing.
20) What performance aims are stated for September 2017?
By the end of September 2017, the four-district effort is intended to reach 90 percent of people living with HIV diagnosed and 80 percent of people living with HIV on ART, using Test and Start to remove eligibility barriers and speed initiation.
21) What goals are stated specifically for men in the four districts?
For men, the stated goals are 65 percent of males with HIV in care and on ART by September 2016 and 80 percent by September 2017. DREAMS activities are described as helping identify and reach male partners and address male norms using evidence-based interventions.
22) What kind of award mechanism is this?
This is a discretionary CDC funding opportunity offered as a cooperative agreement supplement. A cooperative agreement typically implies substantial federal involvement and ongoing technical collaboration rather than a hands-off grant.
23) What is the opportunity identifier and CFDA number?
The opportunity is identified as CDC RFA GH13-13370501SUPP16 under CFDA 93.067.
24) When was the opportunity posted and when was the application deadline?
The opportunity was posted on August 2, 2016. The application deadline was October 1, 2016 (11:59 p.m. ET for electronic submissions).
25) What is the funding ceiling and how many awards are expected?
The award ceiling is $13.5 million, and the expected number of awards is one, indicating a single, focused implementing partner arrangement closely aligned with NDoH and PEPFAR South Africa priorities.
26) Is this supplement described as national scale-up funding?
No. It is framed as a targeted, near-term infusion focused on four districts, intended to deliver immediate gains and to generate operational evidence and implementation experience that can inform eventual national roll-out.
27) What broader HIV prevention and treatment strategy does the opportunity describe?
The opportunity emphasizes rapid expansion of combination prevention and treatment, leveraging PEPFAR priority districts and the DREAMS platform, and aligning implementation with evolving WHO and national guidelines to accelerate progress toward epidemic control.
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