This Is an Amendment to Funding Opportunity Announcement

This is an amendment to Funding Opportunity Announcement

CDC-RFA-PS10-1030

Page 4: In an effort to ensure maximum cost efficiencies and program effectiveness, HHS/CDC also supports coordination with and among partners and integration of activities that promote Global Health Initiative principles. As such, grantees may be requested to participate in programmatic activities that include the following activities:

· Implement a woman- and girl-centered approach;

· Increase impact through strategic coordination and integration;

· Strengthen and leverage key multilateral organizations, global health partnerships and private sector engagement;

· Encourage country ownership and invest in country-led plans;

· Build sustainability through investments in health systems;

· Improve metrics, monitoring and evaluation; and

· Promote research, development and innovation.

Pages 19 and 46: Anticipated Award Date: September 30, 2010.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS)

Centers for Disease Control and Prevention (CDC)

Expansion of HIV/AIDS Prevention and Care Interventions Among Rural Populations in the Republic of Côte d’Ivoire

Under the President’s Emergency Plan for AIDS Relief (PEPFAR)

I. Authorization of Intent

Announcement Type: New

Funding Opportunity Number: CDC-RFA-PS10-1030

Catalog of Federal Domestic Assistance Number: 93.067

Application Deadline: March 26, 2010

Key Dates:

Note: Application submission is not concluded until successful completion of the validation process.

After submission of your application package, applicants will receive a “submission receipt” email generated by Grants.gov. Grants.gov will then generate a second e-mail message to applicants which will either validate or reject their submitted application package. This validation process may take as long as two (2) business days. Applicants are strongly encouraged check the status of their application to ensure submission of their application package is complete and no submission errors exists. To guarantee that you comply with the application deadline published in the Funding Opportunity Announcement, applicants are also strongly encouraged to allocate additional days prior to the published deadline to file their application. Non-validated applications will not be accepted after the published application deadline date.

Authority:

This program is authorized under Public Law 108-25 (the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003) [22 U.S.C. 7601, et seq.] and Public Law 110-293 (the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008).

Background:

The President’s Emergency Plan for AIDS Relief (PEPFAR) has called for immediate, comprehensive and evidence based action to turn the tide of global HIV/AIDS. As called for by the PEPFAR Reauthorization Act of 2008, initiative goals over the period of 2009 through 2013 are to treat at least three million HIV infected people with effective combination anti-retroviral therapy (ART); care for twelve million HIV infected and affected persons, including five million orphans and vulnerable children; and prevent twelve million infections worldwide (3,12,12). To meet these goals and build sustainable local capacity, PEPFAR will support training of at least 140,000 new health care workers in HIV/AIDS prevention, treatment and care. The Emergency Plan Five-Year Strategy for the initial five year period, 2003 - 2008 is available at the following Internet address: http://www.pepfar.gov.

Purpose:

Under the leadership of the U.S. Global AIDS Coordinator, as part of the President's Emergency Plan, the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention (HHS/CDC) works with host countries and other key partners to assess the needs of each country and design a customized program of assistance that fits within the host nation's strategic plan and partnership framework.

HHS/CDC focuses primarily on two or three major program areas in each country. Goals and priorities include the following:

· Achieving primary prevention of HIV infection through activities such as expanding confidential counseling and testing programs linked with evidence based behavioral change and building programs to reduce mother-to-child transmission;

· Improving the care and treatment of HIV/AIDS, sexually transmitted infections (STIs) and related opportunistic infections by improving STI management; enhancing laboratory diagnostic capacity and the care and treatment of opportunistic infections, interventions for intercurrent diseases impacting HIV infected patients including tuberculosis (TB); and initiating programs to provide anti-retroviral therapy (ART);

· Strengthening the capacity of countries to collect and use surveillance data and manage national HIV/AIDS programs by expanding HIV/STI/TB surveillance programs and strengthening laboratory support for surveillance, diagnosis, treatment, disease monitoring and HIV screening for blood safety.

In an effort to ensure maximum cost efficiencies and program effectiveness, HHS/CDC also supports coordination with and among partners and integration of activities that promote Global Health Initiative principles. As such, grantees may be requested to participate in programmatic activities that include the following activities:

· Implement a woman- and girl-centered approach;

· Increase impact through strategic coordination and integration;

· Strengthen and leverage key multilateral organizations, global health partnerships and private sector engagement;

· Encourage country ownership and invest in country-led plans;

· Build sustainability through investments in health systems;

· Improve metrics, monitoring and evaluation; and

· Promote research, development and innovation.

The purpose of this program is to continue to build a sustainable local response to the HIV epidemic among rural populations in Côte d’Ivoire through the rapid expansion of evidence-based HIV/AIDS prevention, counseling, testing, and care interventions with improved linkages to HIV treatment services. Specifically, the recipient of this award will oversee targeted, coordinated behavior-change communication (BCC) activities reaching rural areas in all regions of Cote d’Ivoire to promote HIV testing and counseling (TC), prevention of mother-to-child transmission (PMTCT), and HIV risk awareness and reduction through safer sexual behaviors including abstinence and fidelity. For populations engaged in high-risk behaviors, BCC activities will also include HIV prevention through correct and consistent condom use. In selected higher-prevalence areas, the awardee will increase the provision of HIV testing and care services, including care of orphans and vulnerable children (OVC), as well as uptake of care and treatment services through a strong referral network. Activities will pay particular attention to the role of gender in HIV transmission and vulnerability reduction.

A secondary purpose of this program is to engage and sustain community involvement and build local capacity to implement and monitor evidence-based and gender-sensitive HIV prevention and care and support interventions. Monitoring and evaluation of all interventions, including baseline and impact assessments, will be essential in measuring the success of these activities.

Measurable outcomes of the program will be in alignment with one (or more) of the following performance goal(s):

Abstinence (A) and Be Faithful (B) and Condoms and Other Prevention (C)

• At least 548,000 individuals reached over five years with individual/small group interventions focused on HIV prevention through abstinence and being faithful;

• At least 658,200 individuals reached over five years with individual/small group interventions focused on HIV prevention through correct and consistent condom use and other sexual-prevention methods beyond abstinence and fidelity;

• Fifty (50) broadcast events held per targeted health district per year to promote HIV prevention and/or PMTCT/CT;

• Twelve million five hundred thousand (12,500,000) broadcast “impressions” [defined as the viewing or hearing of a broadcast (e.g. advertisement or program) by individuals, to be counted by estimating and summing the audiences of all broadcast events] promoting HIV prevention and/or PMTCT/TC services;

• Three hundred (300) village groups (e.g. radio listening groups) established by year five that participate in regular HIV prevention activities;

• Two thousand five hundred (2,500) individuals trained over five years to provide HIV prevention interventions promoting abstinence, faithfulness, and/or correct and consistent condom use; and

• Two hundred (200) condom service outlets supported.

Prevention: Gender

• At least 329,000 people reached over five years by an individual, small-group, or community-level intervention or service that explicitly addresses norms about masculinity related to HIV/AIDS, gender-based violence and coercion related to HIV/AIDS, and/or the legal rights and protection of women and girls impacted by HIV/AIDS; and

• One thousand (1,000) people reached over five years by an individual, small group, or community-level intervention or service that explicitly aims to increase access to income and productive resources of women and girls impacted by HIV/AIDS.

Prevention of Mother to Child Transmission of HIV

• At least 54,850 women ages 15-49 reached over five years with PMTCT messages through individual or small-group interventions;

• At least 27,425 pregnant women or 50 percent of pregnant women reached referred for HIV counseling and testing; and

• At least 21,940 pregnant women or 80 percent of pregnant women referred for CT tested for HIV and provided with their results.

Confidential Counseling and testing (CT) for HIV

• One hundred and fifty thousand (150,000) people over five years provided with HIV counseling and testing and their test results;

• Eighty percent (80%) of health-facility clients, in villages with project-supported HIV testing and care activities, provided with HIV testing and their test results by year five;

• Ninety percent (90%) of identified PLWHA provided with home-based follow-up, in villages with project-supported HIV testing and care activities, including HIV testing for partners and children by year five; and

• One thousand (1000) people trained over five years in providing confidential counseling and testing.

Basic Health Care and Support

• One thousand (1000) community health care workers who successfully completed a pre-service training program over five years;

• Five thousand (5,000) eligible adults and 15,000 eligible OVC provided with a minimum of one support service by year five;

• Ten thousand (10,000) eligible OVC provided with at least three types of support services by year five;

• Five thousand (5,000) PLWHA provided with Prevention with Positives services, including HIV prevention services and testing promotion for household members, by year five;

• Ninety percent (90%) of followed clients provided with ART adherence counseling, in villages with project-supported HIV testing and care activities, by year five;

• Eighty percent (80%) of followed clients regularly accessing cotrimoxazole, in villages with project-supported HIV testing and care activities, by year five;

• Seventy-five percent (75%) of followed HIV-infected households provided with bed nets and safe-water supplies, in villages with project-supported HIV testing and care activities, by year five;

• One hundred (100%) of followed HIV-infected households provided with TB screening, in villages with project-supported HIV testing and care activities, by year five;

• Five hundred (500) eligible adults and 3,000 eligible OVC provided with food and/or nutrition services in accordance with PEPFAR food and nutrition guidelines by year five; and

• One hundred percent (100%) of villages with project-supported HIV testing and care activities have active people living with HIV/AIDS (PLWHA) support groups by year five.

Expanded Indigenous Sustainable Response

Project-specific quantifiable milestones to measure indigenous capacity-building and

progress toward sustainability, including:

· Number of locally organized and supported HIV/AIDS activities increased by 10% annually and improved in quality;

· Performance by local entities (such as health committees, women's associations, etc.) improved based on regular (at least annual) standardized assessments of organizational and technical capacities;

· Measurable progress toward integration of HIV/AIDS activities into routine, non-project-funded activities; and

· Quantifiable progress on implementation of a sustainability plan to be developed by year two.

This announcement is intended for non-research activities supported by the Centers for Disease Control and Prevention within HHS (HHS/CDC). If an applicant proposes research activities, HHS/CDC will not review the application. For the definition of “research,” please see the HHS/CDC Web site at the following Internet address: http://www.cdc.gov/od/science/regs/hrpp/researchdefinition.htm

II. Program Implementation

Activities:

Partners receiving HHS/CDC funding must place a clear emphasis on developing local indigenous capacity to deliver HIV/AIDS related services to the Ivorian population and must also coordinate with activities supported by Ivorian, international or USG agencies to avoid duplication. Partners receiving HHS/CDC funding must collaborate across program areas whenever appropriate or necessary to improve service delivery.

The selected applicant(s) (grantee) of these funds is responsible for activities in multiple program areas.

The recipient will implement activities both directly and, where applicable, through sub-grantees; the recipient will, however, retain overall financial and programmatic management under the oversight of HHS/CDC and the strategic direction of the Office of the U.S. Global AIDS Coordinator. The recipient must show measurable progressive reinforcement of the capacity of health facilities to respond to the national HIV epidemic as well as progress towards the sustainability of activities.

Applicants should describe activities in detail that reflect the policies and goals outlined in the Five-Year Strategy for the President’s Emergency Plan and the Partnership Framework for Cote d'Ivoire. The grantee will produce an annual operational plan, which the U.S. Government Emergency Plan team on the ground in Cote d'Ivoire will review as part of the annual Emergency Plan review-and-approval process managed by the Office of the U.S. Global AIDS Coordinator.

The grantee may work on some of the activities listed below in the first year and in subsequent years, and then progressively add others from the list to achieve all of the Emergency Plan performance goals as cited in the previous section. HHS/CDC, under the guidance of the U.S. Global AIDS Coordinator, will approve funds for activities on an annual basis, based on availability of funding and USG priorities, and based on documented performance toward achieving Emergency Plan goals, as part of the annual Emergency Plan for AIDS Relief Country Operational Plan review-and-approval process.

Grantee activities for this program are as follows:

1. Operationalize and implement a national communications strategy for HIV prevention education, TC mobilization, and PMTCT promotion in rural areas. This communications strategy will promote the coordinated use of rural radio stations and networks, listening groups, and other community-based activities involving key spokespeople (such as health-care providers, teachers, and religious, traditional, youth, and male/female community leaders). In collaboration with other PEPFAR partners, the awardee will identify and implement targeted behavior-change communication tools and strategies, using both mass media (radio) and individual or small-group (proximity) approaches, to: 1) promote delay of sexual debut; 2) reduce multiple partnerships, transactional and intergenerational sex; 3) encourage condom use (Abstainance, Be Faithful, Condom approach); 4) diminish HIV stigma and gender-based violence; and 5) increase uptake of TC and PMTCT services. Interventions will provide clearly defined content for each selected target sub-population (such as young women, out-of-school youth, etc.) as well as standard tools for measuring outputs and outcomes.