DFOP0017890 Advancing Global Health APS Round 1 Q&A Amended as Highlighted 4-30-2026.pdf

APS, Round 1 Q&A

Formatting Clarifications The Department of State has received numerous questions regarding formatting requirements for Statements of Interest (SOIs). The following clarifications are provided to ensure consistent interpretation of the instructions outlined in Section D: Application Contents and Format of the APS.

• Page Limit and Narrative Content As stated in the APS, SOI submissions should be no more than five (5) pages in length for the narrative portion. This page limit applies to the core narrative content only. Submissions will only be reviewed up to the specified page limit and no further.

• Table of Critical Details (Cover Page) The required “Table Listing of Critical Details” (Section D.1.a) does not count toward the five-page narrative limit. Applicants may include this table as a cover page to their submission.

• Tables, Charts, and Visual Elements As specified in the APS, tables and charts are not included in the five-page narrative limit. Applicants may include relevant tables and charts either within the narrative or as annexes. For the purposes of this guidance, diagrams, conceptual frameworks, and other visual representations may be treated as charts and are therefore also excluded from the page limit. Given the nature of tables and charts, font sizes as small as 10-point are acceptable for these elements.

• Annexes Applicants may include annexes containing supporting tables, charts, or other visual materials. To ensure a fair and efficient review process, the Department will review up to four (4) annexes per submission, and each annex should be no more than one (1) page. Annexes should be used to supplement, not replace, the narrative.

Reviewers will primarily evaluate the five-page narrative submission in accordance with the APS review criteria.

• General Guidance Applicants are encouraged to present information clearly and concisely within the five-page narrative, using annexes only where they add value or clarity. Submissions that exceed these parameters may not be fully reviewed.

Process and Timeline Clarifications The Department of State has received a number of questions regarding the anticipated timeline for review, selection, and award under the Advancing Global Health APS. The following clarifications are provided to outline the general process while preserving necessary flexibility.

• Review Timing and Process All SOIs submitted within a given quarterly window are reviewed after the submission deadline for that window has passed. Following the close of the submission window, the Department conducts a multi-step review process, including:

o Technical Eligibility Review o Merit Review Panel evaluation o Internal clearance and selection decision-making The Department aims to complete initial review and communicate outcomes in a timely manner following the close of the window. However, timelines may vary based on the volume of submissions and operational considerations.

• Notification of Results Organizations who have submitted an SOI will be notified of one of the following outcomes, consistent with the APS:

o Not selected for continued review o Recommended for consultative program design o Recommended to proceed to Phase 2 (full application)

Due to the anticipated volume of submissions, the Department does not anticipate being able to provide individualized feedback to unsuccessful applicants.

• Consultative Program Design (if applicable) For organizations selected for consultative program design, this stage is intended to be a structured, time-bound process to refine proposed concepts in collaboration with the Department of State. In general, this process is expected to occur over a defined and relatively short period and may include virtual, in-person, or hybrid engagement.

As this is a new approach being implemented on a pilot basis, the Department retains flexibility in how consultative program design is conducted.

• Phase 2 (Full Application) and Awards Organizations invited to submit a full application will receive additional guidance, including submission requirements and timelines, at that stage. The timing of full application review and award issuance will depend on a range of factors, including:

o Complexity of proposed programs o Availability of funding o Completion of required reviews and approvals

• General Guidance The Department of State is committed to conducting a fair, transparent, and efficient review process. At the same time, applicants should anticipate that the full process (from SOI submission to potential award) may take several months. Organizations are encouraged to plan accordingly and monitor official communications for updates.

Submission Platform Clarifications (Grants.gov and MyGrants) The Department of State has received a number of questions regarding submission requirements across Grants.gov and MyGrants, particularly related to required forms at the SOI stage.

• SOI Submission Requirements As stated in the APS, the only required submission at Phase 1 is the SOI. Standard federal assistance forms (e.g., SF-424, SF-424A, SF-424B) are not required at the SOI stage and are not part of the merit review. SOIs will be accepted on grants.gov (now requires an active sam.gov registration to apply) or MyGrants (does not require an active sam.gov registration to apply)

• Grants.gov System Requirements The Department is aware that, due to Grants.gov system functionality, certain forms (including the SF-424) may appear as required fields in order to complete a submission through that platform. At this time, these system requirements cannot be modified or bypassed. Applicants who choose to submit via Grants.gov may therefore complete and upload the required forms for the purpose of satisfying system submission requirements only.

• Review Process Any SF-424 or related forms submitted as part of a Grants.gov package at the SOI stage will not be reviewed or evaluated. The Department will assess only the SOI document in accordance with the evaluation criteria outlined in the APS.

• Alternative Submission Platform Applicants may also submit SOIs via MyGrants, which does not require completion of these forms at the SOI stage.

• Troubleshooting Help Desk o For assistance with Grants.gov accounts and technical issues related to using the system, please call the Contact Center at +1 (800) 518-4726 or email support@grants.gov. The Contact Center is available 24 hours a day, seven days a week, except federal holidays.

o For assistance with MyGrants accounts and technical issues related to the system, please contact the ILMS help desk by phone at +1 (888) 313-4567 (toll charges apply for international callers) or through the Self Service online portal that can be accessed from https://afsitsm.servicenowservices.com/ilms. Customer support is available 24/7.

MOU Alignment and Country Priorities Clarifications The Department of State received several questions regarding how applicants should align proposed activities with bilateral Memoranda of Understanding (MOUs) and whether these documents are publicly available. As stated in the APS, bilateral MOUs are a central element of the America First Global Health Strategy (AFGHS) and serve as a framework for partnership, reinforcing shared commitments between the U.S. government and recipient governments to sustain health gains and advance health systems performance and integration. The overarching goals are to save lives, strengthen health systems, and advance U.S. interests by fostering country self-reliance, reducing dependency on U.S.

funding, and improving global health security to protect U.S. and global populations.

MOUs will be implemented through multiple mechanisms, including government-to-government (G2G) agreements and APS-funded activities. The APS is designed to support projects that support the implementation of the MOUs as well projects that complement the MOUs. For example, some APS addenda will be for specific countries and will be used to implement MOU priorities with MOU funding. Other APS addendum will be for specific services that could compliment MOUs and would be funded with non-MOU funding.

SOIs should be responsive to the priorities outlined in the specific Addendum to which they are applying. For general context on U.S. global health priorities and the strategic framework underpinning this APS, applicants may refer to the publicly available U.S.

Department of State America First Global Health Strategy: https://www.state.gov/america-first-global-health-strategy/. This resource provides high-level information on the goals of the strategy. Organizations should focus on developing clear, feasible, and impactful concepts that respond directly to Addendum priorities. Detailed knowledge of specific mailto:support@grants.gov https://afsitsm.servicenowservices.com/ilms https://www.state.gov/america-first-global-health-strategy/

MOUs is not required to submit a competitive SOI.

Addendum A: Child Protection

1. We are trying to apply for funding for a grant to help implement a mental health program amongst school children, incorporating teachers, parents, and community/religious leader using schools as the hub for the transformation we seek.

Reduction of bullying, depression, and anxiety, and building resilience through the provision of psychosocial support. Could you please confirm if it aligns with your goals and that we can go ahead and apply?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

2. Our organization is currently preparing a Statement of Interest in response to the 'Child Development, Care and Protection' Addendum. Since the main APS highlights the importance of bilateral Memoranda of Understanding (MOUs) as a framework for implementation, we would like to inquire if such an agreement has already been established, or is currently being negotiated, with the government of Colombia.

The scope of this Addendum reflects the direction of the AFGHS, especially in areas such as supporting frontline workers who provide lifesaving support to children and increasing government ownership and financing. While activities to support the health and well-being of vulnerable children complement key efforts in the Memorandums of Understanding (MOUs), proposed activities under this Addendum are not limited to countries where there is an existing MOU.

3. Could you clarify whether the U.S. Department of State is only considering projects that take place in one of the 26 countries where bilateral global health MOUs have been signed? Or will proposals for activities in other countries also be eligible for consideration?

While activities to support the health and well-being of vulnerable children complement key efforts in the MOUs, proposed activities under this Addendum are not limited to countries where there is an existing MOU.

4. What is the anticipated size and number of awards for the Child Protection Addendum? Does GHSD intend to fund one large award or multiple smaller awards?

Is there a recommended or average award size range that applicants should target?

The available funding and maximum number of awards are specified in the APS Addendum. Final size and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

5. Could you please confirm whether applicants are expected to address all three objectives within a single proposal, or whether it is acceptable to focus on only one of these objectives? Context- The addendum outlines three primary objectives related to: strengthening child protection systems, preventing malnutrition and supporting early childhood development, and preventing child-family separation and promoting family-based care.

SOIs do not need to address all three Addendum objectives; it is acceptable to focus on only one.

6. Is the focus specifically on children ages 0–5, or can programming target older children and adolescents?

Outside of Objective 2, which centers on comprehensive programs to prevent malnutrition and poor development during the critical first 1,000 days (conception to age two), the Addendum scope applies to all children ages 0-17.

7. Is this opportunity primarily oriented toward international development/system strengthening, or does it also support humanitarian approaches?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

8. When comparing the Advancing Global Health (AGH) APS and the Child Development, Care and Protection (CDCP) APS Addendum, is it correct that the CDCP APS Addendum will go through multiple quarterly windows as described in the AGH APS? For example, will applicants have the opportunity to apply for the CDCP APS Addendum opportunity during Window 1: March 5 - May 31st, Window 2: June 1 - August 14th, Window 3: August 15 - November 14, AND Window 4:

November 15 - February 14? Or will applications only be accepted for the CDCP APS Addendum until May 31, 2026?

As of now, this is the only window for the CDCP APS. SOIs will only be accepted for this Addendum until May 31, 2026.

9. A Detailed Budget is not listed as a submission requirement at the SOI or Full Application stage. Will that be a requirement at some point in the application process?

Detailed instructions regarding the full application submission process will be provided to those applicants that move to Phase 2.

10. Regarding the “Child Development, Care, and Protection” APS Addendum, does the consultative design process result in a revised SOI and re-submission of the SOI, or something else?

The results of the consultative program design process may or may not result in a recommendation for funding and movement to phase 2. The Department of State reserves the right to make this final determination. Organizations that have moved either directly to Phase 2 or subsequent to consultative program design, will be directed to an announcement available via MyGrants to submit a full application based on their approved concept.

11. Regarding the “Child Development, Care, and Protection” APS Addendum, does GHSD intend to give priority to certain countries for this funding opportunity? If so, will GHSD share a list of those countries?

There are no priority countries specified in this Addendum.

12. Regarding the “Child Development, Care, and Protection” APS Addendum, would GHSD prefer projects that are multi-country or single country focused?

There is no minimum or maximum number of countries that may be included in SOIs.

13. Regarding the “Child Development, Care, and Protection” APS Addendum, can GHSD clarify the number of applications that an applicant is allowed to submit, and how that applies to a prime applicant versus a sub applicant?

Organizations may submit as many SOIs as they like, either as a prime implementer or a sub-implementer.

14. Does the Department anticipate issuing bilateral Child Protection programs under future waves of this APS?

In anticipation of the quarterly windows, the State Department will amend the APS to include Addenda indicating specific areas in which the U.S. government plans to invest.

15. Could you please confirm which countries have signed MOUs and have also signed an addendum for Child Protection, or where that information can be found?

Information on existing MOUs can be found on the DOS website. While activities to support the health and well-being of vulnerable children complement key efforts in the Memorandums of Understanding (MOUs), proposed activities under this Addendum are not limited to countries where there is an existing MOU.

16. The Addendum highlights a focus on prevention during the first 1,000 days. Should nutrition interventions be limited to pregnancy and children under age two, or may activities involving older children (ie. children ages 2-5 and school-age children) be included where they are clearly linked to child protection, family stability, or prevention objectives?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Outside of Objective 2, which centers on comprehensive programs to prevent malnutrition and poor development during the critical first 1,000 days (conception to age two), the Addendum scope applies to all children ages 0-17.

17. The Child Protection Addendum references alignment with "global best practices" and evidence-based interventions. Are there specific models, frameworks, or prior State Department-funded programs that applicants should explicitly build upon or demonstrate awareness of in their SOIs?

Organizations submitting SOIs should refer to the information outlined in the APS instructions and the Addendum in identifying specific outcomes and results that the proposed approach/activities seek to achieve and defining “success.”

18. For Objective 3 (preventing child-family separation and reducing residential care), will GHSD consider SOIs that focus primarily on system-level policy reform and workforce development as sufficiently responsive, or is a direct services delivery component required?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

19. Given the wide award range ($500K–$250M) in the umbrella APS and available funding for Child Protection addendum (up to 5 awards with ceiling of $52.6M), is there a preferred or anticipated budget band per award that applicants should target to remain competitive during merit review?

The available funding and maximum number of awards are specified in this Addendum. Final size and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

20. Will the CP Addendum be a grant or cooperative agreement?

Final size, number, and type of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

21. What is the Bureau of GHSD's approach to the involvement of local grassroots organizations in the development of a full proposal application?

Instructions for the full application process will be shared with applicants that have moved either directly to Phase 2 or subsequent to consultative program design, based on their approved concept.

22. What is the Bureau of GHSD's approach to project co-design involving groups with lived experience, to ensure a child centered approach to project design and implementation?

Organizations should present SOIs that follow the APS instructions and address the technical scope of the Addendum. Outcomes and results should aim to save lives, strengthen systems, enhance efficiency, foster self-reliance and ensure investments directly benefit American safety, strength, and prosperity.

23. With regards to the theme on "Child Development, Care, and Protection":

We have implemented in the past some USAID projects that included specific activities related to "Orphan and Vulnerable Children (OVC)". Would this opportunity include some themes that may be covered in the MoU signed between the USA and DRC governments?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. While activities to support the health and well-being of vulnerable children complement key efforts in the MOUs, proposed activities under this Addendum are not limited to countries where there is an existing MOU.

24. Are there budgetary limitations or ceiling per project on submitting of the SOI?

The available funding and maximum number of awards are specified in the APS Addendum. Final size and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

25. Regarding the Child Protection Addendum, are there any preferred child vulnerability subpopulations for this addendum, such as children without parental care, children at risk of separation, trafficked children, children facing online exploitation, children with disabilities, or very young children in the first 1,000 days?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

26. The APS emphasizes that AGH investments should support implementation gaps, sequencing challenges, or transitional needs connected to bilateral MOUs/G2G efforts. For the child protection addendum, should applicants explicitly frame the proposed work as gap-filling around existing government efforts, or are broader child protection system-strengthening concepts also welcome?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

27. Does GHSD expect applicants to propose direct service delivery, technical assistance, systems strengthening, policy reform, workforce development, or some combination of these approaches?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

28. The Child Protection Addendum refers to supporting government partners and local organizations to develop the social service workforce. Is there an expectation that SOIs include formal government partnership or endorsement at Phase 1, or is that only expected later in Phase 2 or co-design?

Organizations submitting SOIs should refer to the information outlined in the APS instructions and the Addendum.

29. The Child Protection Addendum stresses capacity building and sustainability with local and national partners. Is there any preference for local prime applicants, local subrecipients, or a minimum level of local partner leadership expected under this addendum?

Eligible applicants are listed on page 4 of the APS. Organizations submitting SOIs should refer to the information outlined in the APS instructions and the Addendum.

30. The APS requires outcomes/results that “directly benefit American safety, strength, and prosperity.” Can GHSD provide examples of how applicants should articulate that linkage in a child protection SOI? This point seems especially important but is not operationalized in the addendum.

Organizations submitting SOIs should refer to the information outlined in the APS instructions and the Addendum in identifying specific outcomes and results the proposed approach/activities seek to achieve and defining “success.”

31. For the addendum on child protection/1000 days, there are three stated objectives -can we apply for one of these or is the expectation that our proposal would need to address all three objectives? We noted that the surveillance addendum clearly states that applying for only one objective is permissible, but the other addendum does not explicitly state that SOIs do not need to address all three Addendum objectives; it is acceptable to focus on only one.

32. Could the Department clarify how “extremely vulnerable children and families” should be defined for the purposes of this opportunity? For example, should applicants prioritise specific categories (such as children at risk of family separation, children with disabilities, or children outside of family care), or propose context-specific definitions aligned with country-level data?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

33. What are the age limits for a child in the Annual Program Statement Addendum of Child Development, Care, and Protection?

Outside of Objective 2, which centers on comprehensive programs to prevent malnutrition and poor development during the critical first 1,000 days (conception to age two), the Addendum scope applies to all children ages 0-17.

34. The Annual Program Statement Addendum of Child Development, Care, and Protection anticipates to award up to five awards. Are these global, regional or country specific?

Final size, scope and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

35. In the event that the Annual Program Statement Addendum of Child Development, Care, and Protection is global, does the U.S Department of State Bureau of Global Health and Security and Diplomacy (GHSD) intend to issue country-specific APS addenda?

In anticipation of the quarterly windows, the State Department will amend the APS to include Addenda indicating specific areas in which the U.S. government plans to invest.

36. Are applicants to the Annual Program Statement Addendum of Child Development, Care, and Protection required to respond to all the objectives of the APS or to some of them?

SOIs do not need to address all three Addendum objectives; it is acceptable to focus on only one.

37. For Objective 2 of the Child Development, Care, and Protection Addendum, does GHSD intend for nutrition-related activities to span the full continuum of prevention and early childhood development (e.g., within the first 1,000 days), or to focus more narrowly on acute malnutrition and emergency response interventions?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

38. What is the specified upper age range for "children" in the APS? Does it extend to 18 or 24 to accommodate youth development programming?

Outside of Objective 2, which centers on comprehensive programs to prevent malnutrition and poor development during the critical first 1,000 days (conception to age two), the Addendum scope applies to all children ages 0-17.

39. The Rapid Outbreak Response addendum states that proposed projects may focus on a single objective or address multiple objectives. Does this flexibility also apply to the Child Development, Care, and Protection addendum?

SOIs do not need to address all three Addendum objectives; it is acceptable to focus on only one.

40. There are countries with no signed bilateral health MOUs in which critical gaps exist in child care, development, and protection. Does this addendum accommodate proposals for countries that do not have a signed MOU at the time of application?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. While activities to support the health and well-being of vulnerable children complement key efforts in the MOUs, proposed activities under this Addendum are not limited to countries where there is an existing MOU.

41. The addendum states that a total of five awards will be made. Is there a funding ceiling for each individual award?

The available funding and maximum number of awards are specified in the APS Addendum. Final size and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

42. Are there particular research methodologies or approaches that are preferred or expected?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

43. Is there any preferences or expectations on policy or systems-strengthening research, and direct service delivery or pilot implementation?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

44. Should health MOUs between the USG and country governments mention child protection for the country to be considered for implementation?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. While activities to support the health and well-being of vulnerable children complement key efforts in the MOUs, proposed activities under this Addendum are not limited to countries where there is an existing MOU.

45. Is Objective 2 intended to include procurement of nutrition supplements?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

46. Will State allow teams to incorporate implementation science frameworks and methods into the monitoring and evaluation strategy?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

47. Are there specific criteria that will determine whether awards are grants v.

cooperative agreements?

The available funding and maximum number of awards are specified in the APS Addendum. Final size, number and type of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

48. Is it possible that only 1 award will be made under this addendum?

The available funding and maximum number of awards are specified in the APS Addendum. Final size and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

49. How do you anticipate that up to 5 awards will be determined – will the split be by objective or by country/region of focus for example Final size, scope and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

50. Can programs funded under this Addendum include WASH activities that prevent maternal, newborn, and child death and/or support early childhood development, nurturing care, and nutrition outcomes?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

51. Are stand-alone WASH programs that advance child well-being and nurturing care eligible for funding under this Addendum, or must programs be integrated?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

52. Should applicants propose their own M&E frameworks, or align with existing USG/PEPFAR indicators?

Please refer to Section D (“Application Contents and Format”) of the APS for instructions on the SOIs. Detailed instructions regarding the full application submission process will be provided to those applicants that move to Phase 2.

53. To what extent should proposals integrate HIV/AIDS prevention and treatment services with child development and protection activities?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

54. Number of anticipated awards [listed in the Child Protection Addendum] is up to 5, how do you intend to distribute the awards across continents/countries? Is there a set minimum allocation say for Africa, Asia, Americas etc.

Final size, scope and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

55. Are community-based and kinship care models (including informal family support systems) considered acceptable approaches to family-based care?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations submitting SOIs should refer to the information outlined in the APS instructions and the Addendum in identifying specific outcomes and results the proposed approach/activities seek to achieve and defining “success.”

56. What types of investments in the social service workforce are prioritized (training, recruitment, supervision systems, or case management strengthening)?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

57. Will GHSD accept SOIs that designate a non-health ministry as the primary government counterpart where that reflects the appropriate institutional architecture for child protection programming? How should SOIs address coordination between social welfare and health ministries where both are engaged?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations submitting SOIs should refer to the information outlined in the APS instructions and the Addendum in identifying specific outcomes and results the proposed approach/activities seek to achieve and defining “success.”

58. Child Health Information Systems as Eligible Programmatic Activity - Does GHSD consider the design and implementation of an integrated child health information system - enabling continuity of care across facilities, universal access to a child's medical history for trained providers regardless of the clinic visited, and tracking of treatment completion and medication adherence - an eligible programmatic cost under this Addendum? Given that pediatric medication non-adherence contributes to antimicrobial resistance (AMR), a documented threat to American biosecurity, how does GHSD view AMR-prevention through health data system design within the America First Global Health Strategy framework Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

59. Can a monitoring and evaluation design include prospective assignment of child protection workers or children if more than one intervention or delivery mode will be deployed?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

60. Can you please clarify whether the following countries where the USG has previously supported health, development, and/or humanitarian collaborations are eligible for funding under this APS Addendum due to:

• The high priority for global health, such as Tanzania, Zambia, Philippines?

• The need for system innovation and adaptation to protect children and youth, and the strategic importance for regional stability, such as Jordan?

• The urgency of threats to child protection and family separation due to conflict, such as Ukraine?

There are no priority countries specified in this APS Addendum. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. While activities to support the health and well-being of vulnerable children complement key efforts in the MOUs, proposed activities under this Addendum are not limited to countries where there is an existing MOU.

61. Please confirm: that sickle cell disease is considered a priority condition responsive to both the Rapid Outbreak Response and Child Development, Care and Protection Addenda?

62. Should applicants focus on one objective only, or are proposals expected to address multiple objectives across child protection systems, early childhood development/nutrition, and care reform/family strengthening?

SOIs do not need to address all three Addendum objectives; it is acceptable to focus on only one.

63. Does the operational definition of "evidence-based family strengthening" require a program already field-tested as a complete unit, or can it be a program built upon existing, validated evidence (e.g., the "Ad Gen 3" strategy)?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

64. Is a focus on family strengthening and prevention of family separation sufficient to address this objective?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

65. Would GHSD prefer concepts focused primarily on systems strengthening, with limited targeted service delivery only where needed?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

66. Does GHSD expect applicants to address residential care reform, or is a focus on preventing unnecessary separation and expanding family-based alternatives sufficient?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

67. Is there a specific limit or preference regarding the percentage of funding allocated to direct service delivery (e.g., nutritional supplements, kits) versus technical assistance and system strengthening?

There is no specified limit. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

68. At the SOI stage, is it sufficient to name "types" of local partners (e.g., "Local NGO in Kenya"), or must the specific legal entities be identified?

Please refer to Section D.1.d (“List of Partner Roles and Responsibilities (if applicable)”) of the APS.

69. For countries with bilateral MOUs focused mainly on HIV/AIDS or other disease priorities, would GHSD view child protection, family strengthening, and early childhood development concepts as responsive where they address systemic vulnerabilities affecting vulnerable children and families, even if they are not framed as disease-specific interventions?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. While activities to support the health and well-being of vulnerable children complement key efforts in the MOUs, proposed activities under this Addendum are not limited to countries where there is an existing MOU.

70. Should SOIs under this Addendum be explicitly anchored to countries with existing GHSD bilateral health MOUs, or will GHSD also consider SOIs in countries where no bilateral MOU has yet been publicly announced?

outlined in the Addendum. While activities to support the health and well-being of vulnerable children complement key efforts in the MOUs, proposed activities under this Addendum are not limited to countries where there is an existing MOU.

71. For Objective 1, does GHSD consider anti-child trafficking and child labor programming as responsive to the violence, exploitation, abuse and neglect framing of this Addendum? What minimum level of existing child protection systems expertise or track record is expected from the prime applicant versus being fulfilled through a specialist sub-partner?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Refer to Section D (“Application Contents and Format”) of the APS for instructions on the SOI. Detailed instructions regarding the full application submission process will be provided to those applicants that move to Phase 2.

72. Will proposals that incorporate an Early Childhood Development model — using the child as the central nucleus for integrated nutrition, health, protection, and community penetration interventions — be considered favorably under this Addendum?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

73. Given that formal social services infrastructure is minimal or absent in several of the anticipated target countries, how does DOS expect applicants to address Objective 3's reference to 'connecting vulnerable families to social services' in contexts where those services do not exist at scale?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations submitting SOIs should refer to the information outlined in the APS instructions and the Addendum in identifying specific outcomes and results the proposed approach/activities seek to achieve and defining “success.”

74. Is a comprehensive baseline and situational analysis study (proposed as a Year 1 deliverable) an acceptable and valued component of the project design, or does the donor expect in-depth situational analysis to be completed prior to SOI or full proposal submission?

Please refer to Section D (“Application Contents and Format”) of the APS for instructions on the Statements of Interest. Detailed instructions regarding the full application submission process will be provided to those applicants that move to Phase 2.

75. What is the expected level of government engagement in the SOI? Must Ministries of Health, Social Services, or Education be named partners at SOI stage, or can this be confirmed at the co-creation or full proposal stage?

Please refer to Section D (“Application Contents and Format”) of the APS for instructions on the Statements of Interest. Detailed instructions regarding the full application submission process will be provided to those applicants that move to Phase 2.

76. Objective 3 emphasizes reducing reliance on residential care and expanding family-based alternatives. In country contexts where residential care is not prevalent or de-institutionalization is already advanced, how should applicants approach Objective 3?

outlined in the Addendum, and are not required to address all three Objectives.

77. Concerning the "social service workforce". Does this include training and capacity building for private pediatricians and community health workers managed by private entities?

Addendum B: Rapid Outbreak Response

1. May a single SOI propose activities that span both immediate outbreak surge response

(Objectives 1–3) and longer-term investment in domestic manufacturing capacity for essential diagnostic medical countermeasures under Objective 4 (System Reinforcement and Transition)? Or would these be better submitted as separate SOIs?

SOIs can focus on one Objective or several.

2. Under Objective 4, does the Department consider private-sector investment in domestic rapid diagnostic test (RDT) manufacturing infrastructure within a partner country as an eligible activity, provided such investment demonstrably contributes to national outbreak detection and response capacity and reduces long-term dependence on imported diagnostic supplies?

Investments that achieve the objectives and are aligned with the overall APS are eligible for consideration.

3. The Addendum notes that proposed projects can focus on one Objective or cover several.

Within a single Objective, does the Department envision awards that focus on a specific technical domain (for example, diagnostic supply chain deployment and surveillance data generation), or does the Department prefer proposals that address the full range of activities listed under each Objective?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum and should explain in the SOIs how their proposed work will achieve the objective(s) outlined in the Addendum.

4. The addendum emphasizes early detection and rapid response. Would projects focused on operational early-warning systems and outbreak intelligence platforms, for example, integrating clinical, environmental, and animal surveillance data to support the seven-day detection goal, be considered within scope?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum and should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

5. To what extent are ROR projects expected to include direct surge response capabilities (e.g., deployable response teams or operational response support) versus systems that enable rapid detection, risk assessment, and decision support for containment?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum and should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum

6. Could you please clarify whether the call allows for implementation science research to generate evidence that can inform cultural appropriateness and scalability? Context- The Annual program Statement Addendum Rapid Outbreak response, under program description paragraph 2, last sentence states that activities under the ROR projects are expected to be time-bound, surge-oriented, culturally adapted, and scalable, allowing partners to adapt interventions as outbreak dynamics evolve.

ROR SOIs are invited that are in line with Pillar 1 of the America First Global Health Strategy Goal 1: Enable detection of an outbreak with epidemic potential within seven days of its emergence and Goal 2: Contain outbreaks that originate outside of the United States rapidly at their source. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

7. Can an institution apply independently without formal partners, provided it demonstrates how it will support government and its existing frameworks respond to outbreaks Context- The Addendum indicates that ROR efforts will capitalize on existing country capacities and partnerships to support swift activation of outbreak response activities, complementing national leadership and established response frameworks. Projects supported under this addendum will prioritize speed, operational readiness, and flexibility, enabling countries to respond rapidly to evolving epidemiological threats, while maintaining coordination across national, regional, and international actors.

The following organizations are eligible to apply: U.S. and foreign private for-profit enterprises; U.S. and foreign public and private institutions of higher education; U.S and foreign organizations, including faith-based organizations; and Public International Organizations (PIOs) and governmental institutions. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum and should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

8. For emergency outbreak responses, are applicants permitted to propose activities outside their country of primary operation?

Applicants are permitted to propose activities outside of their country of primary operation.

9. Are there certain countries (among the existing list of bilateral MOUs signed with the US govt) that are prioritized for global outbreak response? Or are all bilateral agreement countries of equal interest?

There are no priority countries specified in this APS Addendum. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

10. Will proposals be considered if the geographic scope does not cover an entire country, or is nationwide coverage required for each country included in the proposal?

Nationwide scope is not required for proposals. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum, without limitations on coverage of an entire country.

11. Under the Rapid Outbreak Response addendum, are SOIs limited to countries with signed bilateral global health MOUs, and if so, can GHSD confirm the countries currently eligible for submission?

Proposed activities under this Addendum are not limited to countries where there is an existing health MOU.

12. Does this call also include Animal (Livestock) disease outbreaks?

As recognized by the American First Global Health Strategy's Goal (AFGHS), zoonotic diseases present a significant outbreak risk. Work proposed in the SOI should focus primarily on GHS, and organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

13. Funding Cap (India): Is there a cap on funding for Rapid Outbreak Response applications from India? If yes, what is the maximum award amount?

The available funding and maximum number of awards are specified in this Addendum. Final size, scope and number of awards are subject to the results of the SOI review process and Phase 2 (request for full applications).

14. Under the Outbreak Response Goal 2 (page 15, paragraph 2), the America First Health Strategy describes the Field Epidemiology Training Program (FETP) as one of “our highest returns on investments in this area.” Will the FETP program be positioned under the GHS&D Bureau, or will this remain under HHS?

The U.S. Centers for Disease Control and Prevention created and continues to run the Field Epidemiology Training Program (FETP).

15. The Addendum states “Projects supported under this addendum will prioritize speed, operational readiness, and flexibility, enabling countries to respond rapidly to evolving epidemiological threats.....” (page 2, paragraph 1). Many emerging and re-emerging threats are zoonotic in nature, please confirm that proposals may include the animal health sector for outbreak response

There are no priority pathogens specified in this APS Addendum. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum and should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

16. The Addendum states “Projects supported under the Rapid Outbreak Response (ROR) Addendum will be guided by the principles outlined in the America First Global Health Strategy, emphasizing targeted, results-driven investments that protect the health and security of the American people while strengthening partner countries’ ability to prevent, detect, respond to, and recover from infectious disease threats.” (page 3, paragraph 3), are there specific definitions or prioritizations of these threats? Can bacterial pathogens, especially MDR, XDR or PDR bugs be included?

There are no priority pathogens are specified in this APS Addendum. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum and should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

17. Speed is given as one of the guiding principles for outbreak response, (page 3, paragraph 4), can organizations recommend/endorse any specific model such as 7-1-7 or leave it to the implementing entities and/or beneficiary countries to decide what model they look to adopt?

ROR SOIs are invited that are in line with Pillar 1 of the America First Global Health Strategy Goal 1: Enable detection of an outbreak with epidemic potential within seven days of its emergence and Goal 2: Contain outbreaks that originate outside of the United States rapidly at their source. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

18. The Rapid Outbreak Response (ROR) addendum includes four objectives and describes the core components of outbreak response. Given the role that CDC has historically played as the lead agency for international outbreak response (per Congressional mandate to protect the homeland), is the expectation that these awards partner with CDC in that capacity? Or is CDC no longer expected to lead or support international outbreak response?

The ROR addendum is designed to solicit proposals for funding by…