U.S. Department of Health and Human Services (Hhs)

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

Centers for Disease Control and Prevention (CDC)

Behavioral Interventions (BI) for the General Population, Youth, and Most-at-Risk Population (MARP) in Ethiopia

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

I. Authorization of Intent

Announcement Type: New

Funding Opportunity Number: CDC-RFA-PS10-10112

Health Impact Number: 2979

Catalog of Federal Domestic Assistance Number: 93.067

Application Deadline: April 19, 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.

In the event that you do not receive a “validation” email within two (2) business days of application submission, please contact Grants.gov. Refer to the email message generated at the time of application submission for instructions on how to track your application or the Application User Guide, Version 3.0 page 57.

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 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 partnersand integration of activitiesthat promoteGlobal 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, monitoringandevaluation; and

·  Promote research, developmentand innovation.

The purpose of this program is to support behavioral interventions through the provision of a comprehensive prevention service package to the general population, youth and most-at-risk population (MARP). The interventions will include design, development and dissemination of culturally-appropriate messaging using a multi-channel approach that is comprised of mass media programs for youth and People Living with HIV (PLHIV), peer outreach that involves organizing listening/reading discussion groups, promotion of HIV testing and counseling, ART and early diagnosis and treatment of sexually transmitted infections (STIs) services. The purpose of the ART communication is to implement a comprehensive communication program to create a demand for quality HIV/AIDS service provision and to increase self management and self efficacy for the ART and adherence. The interventions will also support the strengthening of referral linkages with services addressing alcohol and substance abuse, and strengthening knowledge management skills, information technology clearinghouse, local capacity building through capacity assessment, training, mentorship and secondment as deemed necessary.

Technical assistance for behavioral interventions will include support to local government and CDC/PEPFAR partners in the development of high quality, evidence- based behavior change communication (BCC) for HIV/AIDS prevention, and care and treatment. The use of BCC will result in a significant change/improvement in behaviors and attitudes that contribute to the sexual transmission of HIV, which will ultimately contribute to preventing new HIV infections as well as improved HIV/AIDS services utilization by the general population, youth, and MARP in high HIV prevalent cities and towns in Ethiopia.

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

1. Number of the targeted populations reached with individual and/or small group level preventive interventions that are based on evidence and/or meet the minimum standards required:450,000 individualswill be reached with individual counseling, small group outreach activity and/or peer education.

2. Technical assistance will be provided to develop 1,000,000 copies of print, audio visual and electronic HIV/AIDS, STI and TB materials to 20 stakeholders.

3. 11 regional HIV/AIDS Prevention and Control Offices (HAPCOs) will be qualified to manage the respective regional AIDS Resource Centers (ARCs).

4. 22 regional ARCs will be fully functional and managed by regional HAPCOs.

5. High quality,research based information, education, communication/behavioral change communication (IEC/BCC) materials on relevant HIV/AIDS topic such as VCT, PMTCT, ART, living positively, and care and support, as well as STI’s and TB will be developed.

6. Number of the targeted populations reached with individual and/or small group level preventive interventions that are primarily focused on abstinence and/or being faithful, and are based on evidence and/or meet the minimum standards required:

a) 440,000 high school students will be reached with individual and/ or small group prevention intervention activities like peer education, training and listening and discussion groups focusing

b) 50,000 individuals will be reachedwith individual and/or small group prevention intervention activities like peer education, training and individual counseling, focusing on abstinence and/orbeing faithful.

7. Number of MARP reached with individual and/or small group level interventions that are based on evidence and/or meet the minimum standards required: 110,000 commercial sex workers will be reached withpeer education, listening and discussion group, training and individual counseling on HIV prevention.

8. 22 regional ARCs will be linked with Anti-AIDS Associations to reach youth and commercial sex workers.

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/CDCfunding must place a clear emphasis on developing local indigenous capacity to deliver HIV/AIDS related services to deliver HIV/AIDS related services to the Ethiopian population and must also coordinate with activities supported by Ethiopia, international or United State Government agenciesto 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 Ethiopia. The grantee will produce an annual operational plan, which the U.S. Government Emergency Plan team on the ground in Ethiopia 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.  Assess, develop, pre-test, produce and disseminate locally relevant IEC/BCC multi-media materials that include print and electronics to specific populations. These materials will include behavioral intervention components for preventing new HIV infections using the abstinence, faithfulness, reduction of sexual partners, and correct and consistent condom use strategy.

2.  Assess capacity among host government structure and design, and implement a capacity assessment strategy that ensures ownership and sustainability.

3.  Design and disseminate youth media programs and people living with HIV/AIDS ( PLWHA) radio programs that will be linked with smaller group discussions. Organize listening and discussion groups.

1. Develop communication materials targeted toward PLWHA, their caregivers, health providers, and community leaders.
2. Undertake four national and regional public awareness campaigns using national and local media, mini-media, and other forms of promotional activities. Use various local languages to generate awareness among the general public. Increase adherence to and uptake of ART among PLWHA, and increase the quality of ART services in Ethiopia.
3. Collaborate with PLWHA associations to strengthen the communication and counseling skills of PLWHA community workers in home-based care, ART adherence support, and provision of peer-to-peer psychosocial support.
4. Develop a pediatrics communication strategy that will address the issues of HIV-positive children, their caregivers, service providers, and communities encounter in the provision of pediatric ART as well as training needs in communication to support HAPCOs pediatrics ART plans.
5. Provide technical support to Ministry of Health (MoH), HAPCO, US universities and other implementing partners to strengthen ART activities in hospitals and assist treatment-adherence initiatives.

9.  Support World AIDS Day and HTC Day in close collaboration with the local government, specifically MoH and HAPCOs.

1. Support the Multi-targeted ARC website and virtual information center, ICT infrastructure and connectivity support to National and Regional ARCs and maintain IEC/BCC Materials Clearinghouse.

11.  Design and implement appropriate interventions on alcohol and substance abuse in relation to HIV/AIDS prevention.

12.  Work with relevant partners to enhance the role of mass media against HIV/AIDS through capacity building, training and development of job aids and standards.

13.  Work very closely with the MoE and Regional Health Bureaus (RHBs) to use the school net program for behavioral interventions and sexual prevention.

14.  Provide technical assistance to 20 previously established and new regional ARCs, to build their capacity to reach the general population and youth groups through Anti-AIDS Clubs (AACs), and MARPs through facilitated small peer group discussions. These discussions will be conducted on a regular basis with drop-in interactive trainings integrated with outreach to support mainstreaming in sector offices, factories and other workplaces. This will also result in supporting an enabling environment and strengthening the multi-sectoral response to HIV/AIDS. Management and ownership will remain with regional HAPCOs. All ARCs are sharing internet connections and educational materials from the current national ARC.

15.  Create referral networks and linkages with HIV/AIDS services.

16.  Mainstream monitoring and evaluation plans and procedures in line with the HHS/CDC requirements.

17.  Work very closely with the HAPCOs and Health Promotion and Disease Prevention Directorate under the MOH to ensure "The Three Ones."

18.  Produce national and regional levels campaign materials (campaign toolkits, posters, flyers, radio/TV spots, and newspaper advertisements).

19.  Organize and coordinate media coverage, street shows, music, and theater community events. Provide information through its Wegen Talkline and Warm Line for service providers.

20.  Work Closely with MOH, HAPCO and other partners to market HIV Testing Day and use the event to promote HIV Testing and counseling (HTC) services.

21.  Design and apply a workable strategy to promote HTC service among MARPs.

CDC Activities:

The selected applicant (grantee) of this funding competition must comply with all HHS/CDC management requirements for meeting participation and progress and financial reporting for this cooperative agreement (See HHS/CDC Activities and Reporting sections below for details), and comply with all policy directives established by the Office of the U.S. Global AIDS Coordinator.