Amendment 08, N00244-19-S-F001.pdf

AMENDMENT 0008

FUNDING OPPORTUNITY ANNOUNCEMENT (FOA)

Number N00244-19-S-F001

“FY19 – FY20 Department of Defense HIV/AIDS Prevention Program:

Military Specific HIV/AIDS Prevention, Care, and Treatment Program for non-PEPFAR (President’s Emergency Plan for AIDS Relief)

Funded Countries”

The purpose of this Amendment 0008 is to incorporate the following:

DHAPP is accepting “Concept Papers” for Colombia through 01 July 2020 as described below.

NOTE: Each narrative is a standalone effort and should not be combined with another narrative and all the program elements (tasks) in each specific narrative must be addressed in that concept paper submission.

E-mail address for submission of Concept Papers: dha.ncr.pub-health.list.dhapp-operations-team@mail.mil

The full solicitation is available at: http://www.grants.gov/

Eligible Applicants are requested to submit Concept Papers following the guidelines and format provided in the N00244-19-S-F001, Section II, D.

All respondents must demonstrate the active support of the in-country military and the DoD representative in the corresponding U.S. Embassy in the planning and execution of their proposals. The selected Grantee is the Implementing Partner and will be referred to as IP in this document.

mailto:dha.ncr.pub-health.list.dhapp-operations-team@mail.mil mailto:dha.ncr.pub-health.list.dhapp-operations-team@mail.mil http://www.grants.gov/

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment Program for non-PEPFAR Funded Countries)

Colombia DHAPP FFMM Partnership for Sustainable HIV Epidemic Control

Introduction

The HIV/AIDS epidemic has been devastating and negatively affected many militaries and other uniformed organizations worldwide by reducing military readiness, limiting deployments, causing physical and emotional decline in infected individuals and their families, posing risks to military personnel and their extended communities, and impeding peacekeeping activities. As HIV management improves, many of these impacts are disappearing; however, militaries now need to sustain life-long HIV treatment for their HIV-infected beneficiaries in addition to other long-term chronic disease management issues.

The US Government has a long history of international collaboration and partnerships in the fight against HIV/AIDS, providing funding, technical assistance, and program support. These collaborations are all contributing to HIV epidemic control.

Over the years, the United States Department of Defense (DoD) HIV/AIDS Prevention Program (DHAPP) has successfully engaged over 80 countries in an effort to control the HIV epidemic among their respective military services. DHAPP is the DoD implementing agency collaborating with the US Department of State, the Health Resources and Services Administration, Peace Corps, US Agency for International Development (USAID), and the Centers for Disease Control and Prevention (CDC), in the US President’s Emergency Plan for AIDS Relief (PEPFAR).

DHAPP receives funding for its programs from two sources: a congressional plus-up to the Defense Health Program (DHP) and funding transfers from the Department of State for PEPFAR. Working closely with DoD, U.S. Unified Combatant Commanders, Joint United Nations Programme on HIV/AIDS (UNAIDS), university collaborators, and other nongovernmental organizations (NGOs), DHAPP’s mission is to build capable military partners through military-specific, culturally focused, HIV/AIDS cooperation and assistance.

In the Defense Security Cooperation Agency guidance, the US Secretary of Defense has identified HIV/AIDS in foreign militaries as a national security issue. Pursuing HIV/AIDS activities with foreign militaries is clearly tied to security interests, regional stability, humanitarian concerns, counterterrorism, and peacekeeping efforts due to the impact of HIV/AIDS as a destabilizing factor in developing societies. DHAPP employs an integrated bilateral and regional strategy for HIV/AIDS cooperation and security assistance. DHAPP implements bilateral and regional strategies in coordination with respective Combatant Commands (COCOMs) and Country Support Teams to offer military-to-military HIV/AIDS program assistance using country priorities set by the US Under Secretary of Defense for Policy and by the Office of the Global AIDS Coordinator. DHAPP provides strategic information and supports defense forces in HIV prevention, care, and treatment for HIV-infected individuals and their families.

On October 1, 2013, DoD established the Defense Health Agency (DHA) as part of the U.S.

Military Health System governance reform. DHA is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force and ready medical force to COCOMs in both peacetime and wartime. In July 2014, the Deputy Secretary of Defense approved the realignment of medical Executive Agent organizations to DHA, including DHAPP. The transition to DHA from the Secretary of the Navy was completed

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment on August 20, 2017. DHAPP is now a division under the Research and Development (J-9) Directorate and continues to be cornerstone of the global health engagement portfolio delivering solutions to COCOMs. The DHAPP headquarters office remains at Naval Base Point Loma in San Diego, California.

In 2014, PEPFAR moved from an “emergency” response to a strategy focused on sustainable control of the HIV epidemic. In doing so, PEPFAR adopted the United Nations Programme on HIV/AIDS (UNAIDS) global 90-90-90 goals that state by 2020: 90% of people with HIV are diagnosed, 90% of them are on ART and 90% of them are virally suppressed. DHAPP shifted with PEPFAR in how Monitoring, Evaluation, and Reporting (MER) indicators are collected and reported to efficiently use data to drive decision-making and focus HIV programming in the right geographic areas. DHAPP collects MER indicator results on a quarterly and semi-annual basis, and data is reported at the site level. This data allows DHAPP to understand the gaps in programming and needs for shifts to reach our shared goals. Due to security sensitivities regarding military site locations and troop movement, all site-level data is analyzed at DHAPP headquarters and summary data is collected by the Office of the Global AIDS Coordinator so each USG country team can review military program results at the national level.

In fiscal year (FY) 2017, DHAPP supported 56 national HIV programs, mainly through direct military-to-military cooperation in addition to support from contracting external organizations and academic institutions to assist with specific aspects of proposed programs. Partners in FY17 included 54 NGOs and universities working in 55 countries.

Budget

Phase 1 Phase 2 Phase 3 Phase 4 Total Care & Treatment $76,000 $76,000 $76,000 $76,000 $304,000 HVCT- HIV Testing Services

HVTB- TB/HIV

HTXS- Adult Treatment

$36,000

$40,000

$36,000

$40,000

$36,000

$40,000

$36,000

$40,000

Prevention $20,000 $20,000 $20,000 $20,000 $80,000

HVOP – Other Sexual Prevention

$20,000

Health Systems Strengthening

$40,000 $40,000 $40,000 $40,000 $160,000

OHSS- Health Systems Strengthening HVSI- Strategic Information

$20,000

$20,000

$20,000

$20,000

$20,000

$20,000

TOTAL $136,000 $136,000 $136,000 $136,000 $544,000

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment

Approaches to Reaching Sustainable Epidemic Control

Proposals are requested to support the Colombian Armed Forces (FFMM de Colombia) to reach sustainable control of the HIV/AIDS epidemic through the pillars of transparency, accountability, and impact.

The TBD partner’s program should emphasize capacity building across all activities and technical areas. All proposals should detail how the partner will engage the partner military leadership as well as personnel at all levels in this work; and, specifically how the partner will utilize the organizational structure of the military to strengthen the internal capacity of the military to conduct these activities. Within the proposal the partner will need to demonstrate transition of programmatic capabilities and capacity to the military over the life of the grant.

Accompanying the proposal, applicants should include a letter of support from the Colombian FFMM, indicating willingness to work together with the applicant if their proposal is awarded.

The partner must work in complete coordination with the partner militaries’ HIV prevention and health services, as well as the DHAPP/DoD Program Manager based at the US Embassies in these countries, the DOD adult and pediatric treatment program manager based at the Military Health Department, other DHAPP supported implementing partners working in these countries, other bilateral and multilateral agencies with similar objectives and the DHAPP Headquarters Team. The Grantee is the Implementing Partner and will be referred to as IP in this document.

Targets

Progress towards epidemic control will be successfully measured, in part, through an effective strategic information framework that not only monitors program outputs, but also key outcomes and programmatic impact.

Collection and use of disaggregated data that characterizes the populations served in the lowest geographic areas where HIV services are being provided is critical in understanding current program performance and planning for future performance. Consequently, the Monitoring, Evaluation, and Reporting (MER) indicators continue to evolve in order to reflect the progression of U.S. government (USG) support and global HIV response guidelines. Measuring the impact of support at national and regional above-site levels down to direct services at the site-level is paramount to DHAPP’s program implementation and monitoring approach.

MER indicators are not an exhaustive list of all metrics that should be monitored by DHAPP-supported programs. These programs should continually monitor and assess any acute programmatic issues and collect additional data to inform program improvement.

The indicators listed below strives to drive program monitoring to a more patient-centered approach. Per the 2017 WHO Consolidated Guidelines on Person-Centred HIV Patient Monitoring and Case Surveillance, person-centered monitoring refers to a shift from monitoring measuring services (e.g., the number of individuals tested or people on treatment) to monitoring people at the center of their access to linked HIV and health services. In essence, this marks a

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment shift to better support the clients accessing services by focusing more on their individual health outcomes.

The proposal will address approaches to reaching the following targets for military and civilian populations.

Prevention

Technical Area Targets, Year 1

Indicator Label Military Only Civilian

PP_PREV

Number of priority populations (PP) reached with the standardized, evidence-based intervention(s) required that are designed to promote the adoption of HIV prevention behaviors and service uptake

Testing

HTS_INDEX

HTS_TST

TB_STAT

Number of individuals who were identified and tested using Index testing services and received their results

Number of individuals who received HIV Testing Services (HTS) and received their test results

Percentage of new and relapse TB cases with documented HIV status

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment

Treatment

TB_ART

TX_CURR

TX_NEW

TX_TB

Proportion of HIV-positive new and relapsed TB cases on ART during TB treatment

Number of adults and children currently receiving antiretroviral therapy (ART)

Number of adults and children newly enrolled on antiretroviral therapy

(ART)

Proportion of ART patients screened for TB in the semiannual reporting period who start TB treatment.

Viral Suppression

Only Civilian

TX_PVLS Percentage of ART patients with a suppressed viral load (VL) result (<1000 copies/ml) documented in the medical or laboratory records/laboratory information systems (LIS) within the past 12 months

553 502

Technical Narrative

The IP will address the technical approach to each area. The IP will be responsible for providing the following in close collaboration with other DHAPP-funded implementing partners and the host military.

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment

HIV Prevention The IP will ensure that the partner military is providing standardized, evidence-based interventions that are designed to promote the adoption of HIV prevention behaviors and service uptake for all military and other uniformed services as well as other priority populations served by the military health services. These priority populations (PP) should include men that have sex with men (MSM), sex workers and their clients, mobile populations, HIV discordant couples, adolescent girls and young women and illicit drug users.

The IP will ensure that the following interventions for adults and youth include:

• Targeted promotion of relevant adult and youth friendly prevention and clinical services and demand creation to increase awareness, acceptability, and uptake of these services within the STI and HIV testing facilities.

• Condom procurement (175,000), supplying and distribution for HIV/STI patients, Condom and lubricant (where feasible) promotion, skills building, and facilitated access to condoms and lubricant (where feasible) through direct provision or linkages to social marketing and/or other service outlets.

Pre-exposure Prophylaxis (PrEP) Oral pre-exposure prophylaxis with oral tenofovir or tenofovir-containing regimens has been shown to reduce the risk of HIV acquisition among numerous populations. WHO guidelines recommend offering oral PrEP to those at substantial risk of HIV infection, defined as an incidence rate of or exceeding 3 per 100 persons per year. This level of risk has been seen among sero-discordant couples with inconsistent condom use when the partner living with HIV is not virally suppressed, MSM, transgender women, sex workers (SW) of all genders, people who inject drugs (PWID), and older adolescent girls and young women (AGYW) in many parts of sub-Saharan Africa. DHAPP supports WHO guidelines on the use of PrEP as part of a package of comprehensive prevention services that includes risk reduction education and counselling, condom promotion, VMMC, and structural interventions to reduce vulnerability to HIV infection.

• The IP should work with the partner military to identify priority groups, set targets, and plan for PrEP implementation and implementation as well as identify PrEP supply chain through local channels.

• IPs should engage with partner militaries to advance “above-site” PrEP readiness and implementation. These activities may include: developing national policies;

implementation and operational guidelines; product registration; supporting awareness-building and demand-creation efforts; testing integrated PrEP service delivery models;

and exploring private sector engagement. Communication efforts will be needed to educate potential PrEP clients and to train health care providers on PrEP benefits, risks, and procedures. Civil society groups already working with the key and other vulnerable populations should be engaged to assist in outreach. High-quality PrEP materials can be found at the following links:

o Implementation tools: http://www.who.int/hiv/pub/prep/prep-implementation-tool/en/ o Readiness materials, training materials, monitoring and evaluation (M&E) materials, advocacy materials, and demand creation materials including communications tools: www.prepwatch.org http://www.prepwatch.org/

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment o Training materials and M&E tools in several languages (English, French, Spanish, and Portuguese): http://icap.columbia.edu/resources/PrEP-kit

HIV Testing Services Finding the remaining persons who are living with HIV infection is the first priority for reaching HIV epidemic control. Current epidemiology shows us that most of those who do not yet know about their infection are men. The FFMM HIV/AIDS program is strategically placed to reach men; therefore, the IP will work closely with the FFMM on HIV Testing Services (HTS), particularly index testing and self-testing, in an effort to achieve the “first 90” for military personnel: 90% of all FFMM personnel living with HIV know their status.

HTS will focus primarily on index testing to provide high yield testing to those most at risk for infection. The local epidemiology and situational analysis should guide the use of other testing methodologies to identify those who are living with HIV.

Where possible, a rapid test for recent infection (RTRI) should be conducted for all of those found to be newly positive. Those who test positive are classified as “probable recent HIV infections” until results of viral load are available. The index testing of these persons should receive high priority and robust efforts should be made to reach all contacts.

Provider-Initiated Testing and Counseling (PITC) will continue in the fixed sites for both the military and civilian cohorts. PITC should focus in clinical areas that have shown a high yield such as TB and STI clinics.

Ensuring that any positives identified are linked to HIV care and treatment is essential to the success of the FFMM program. The IP should work to achieve 100% linkage of HIV+ individuals identified. The IP will monitor HIV testing yield; modifying strategies or locations that are not identifying and/or linking significant numbers of HIV positive persons to HIV care and treatment.

The IP will be responsible for technical assistance at 6 sites to support the FFMM in the following:

o HTS to military bases and facilities Diagnosing 448 PLHIV with 90% of those diagnosed linked to HIV care and treatment services Index-case testing for all sexual partners of HIV-infected military personnel and civilians Index-case testing for all children under 15 years of age with HIV-infected mothers.

o Index clients should also be offered self-testing (where available) for partners if they do not volunteer for partner notification.

o The IP will provide refresher/updated training and mentoring for KP-friendly, stigma free HTS service delivery to 9621 individuals across modalities in the Colombian Military HIV/STI and TB clinics utilizing trainers previously trained in 3 sites in Bogota, and expanding to 3 additional sites in 2 new cities outside the Capital, ensuring that all of those diagnosed are linked to HIV treatment services and receive same day initiation of ART.

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment o Self-testing should be made available for military personnel, adolescent girls and young women (AGYW) and their partners, male partners of ANC clients, sex workers, MSM and other key and priority populations (young men and at risk males) that face high levels of stigma and discrimination. Following self-testing, facility referral and the regular diagnostic algorithm can be used according to national standards. It is vital to engage community groups to advocate for, design, implement, and analyze the success of HIVST.

o The IP will provide follow-up training for and monitor the roll-out of Index- Case testing and active partner notification in the three main hospitals and one Private Health Provider (EPS) were most military PLHIV are receiving medical care as well as continue to improve linkage to care o Quality improvement and quality assurance for all FFMM HTS including continuous training and mentoring and supervision visits, at least quarterly o Conducting proficiency testing for all HTS sites and individuals o Support of virtual course for HTS services and KP friendly, stigma free service delivery including mentoring in order to strength sustainability and military ownership of training for HTS providers, especially in high-rotation positions.

o Tracking PLHIV from HTS to clinical care and treatment services.

o Monitoring HIV testing yield; modifying strategies or locations that are not identifying and/or linking significant numbers of HIV positive persons to HIV care and treatment

HIV Treatment Support for treatment of HIV is an essential component of this FOA. These activities will address the 2nd 95 in the WHO UNAIDS goals (95% of diagnosed PLWHIV on ART treatment).

The IP will achieve this through supporting the FFMM through training and mentoring in same-day ART initiation for newly-diagnosed PLHIV, return to care for PLHIV who are not on ART , retention and adherence programming, linkage services and continuing education in comprehensive care support including PHDP and Case Reviews.

The following issues should be considered in supporting the treatment of PLHIV in military populations:

Dolutegravir (DTG)-containing regimens are the preferred first-line antiretroviral therapies (ART) due to superior efficacy, tolerability and higher threshold for resistance compared to efavirenz (EFV)-containing regimens. The fixed dose combination (FDC) of tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) is currently priced as the least expensive FDC, and it is expected that prices will go down as generic manufacturing scales up. For these reasons, DHAPP now recommends TLD as the preferred option for ART, and further recommends that DHAPP-supported programs switch over to TLD as soon as possible in a coordinated fashion as supply becomes available.

Programs should carefully assess the risk and benefit of TLD in child-bearing age women. See published updated from PEPFAR to further understand the high benefits in the face of a potential NTD signal.

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment

Children (< 30kg) are not expected to be included in the initial roll-out of TLD. Development of pediatric DTG formulations and evaluation of appropriate DTG dosing in infants and children are underway.

A priority of HIV programs is to find, diagnose and treat people with tuberculosis (TB) disease and ensure that they become non-infectious. For all those who do not have active TB, prevention of TB is a priority.

TB preventive therapy (TPT) must be scaled up for all PLHIVs as an integral part of the clinical care package. DHAPP-supported care and treatment programs need to catalyze the introduction and scale-up of TPT. IPs are expected to increase the use of TB diagnostic testing within DHAPP-supported HIV care and treatment facilities and promote the use of TPT as a routine part of HIV care. As a consequence, programs should have clear policies and/or guidelines for the use of TPT, and should plan for programmatic and clinical trainings, procurement and supply management, adequate diagnostic capacity (including specimen transportation) and development of appropriate data collection systems. In Global Fund high-impact countries implementing joint TB/HIV grants, IPs should also seek opportunities to support effective joint program implementation. Additionally, IPs should implement TB infection prevention and control activities to minimize the risk of TB transmission and provide safe health seeking environment. This is critical in DHAPP-supported settings where clients at high risk for TB and HIV often co-mingle. It also puts the health care workers at the highest risk of contracting TB disease. Activities aimed at preventing transmission at facility-level include administrative and environmental controls, and the availability and use of personal protective equipment. Infection prevention and control basics will also be important for ART adherence clubs and other community clinical work.

Viral Suppression

Viral load, a complex molecular test is primarily performed at centralized laboratories located at the national or regional levels of the tiered laboratory network. This requires robust laboratory systems including an efficient sample referral network for transportation of specimens from various clinics or treatment sites.

The IP should ensure the partner military has access to VL testing and that capacity exists to test at least 95% of persons currently on ART annually. To ensure this capacity the appropriate use of both plasma and dried blood spots (DBS) should be considered to increase access to routine viral load monitoring.

DBS are easy to collect and store under field conditions, no phlebotomist required, easy to transport to centralized laboratories, reduced cost associated with collection materials and transportation under ambient temperature. The DBS technology is applicable to both adult and pediatric populations and the small volume of blood required for preparing DBS makes it suitable for pediatric populations.

The IP will ensure that VL results are made available in a reasonable amount of time to both the health care provider and the client. These results should be used to ensure that those who are not virally suppressed are linked to adherence support and close follow-up leading to either

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment suppression or ART modification as needed. Those who are suppressed should be encouraged to stay suppressed and should be offered multi-month supplies of ART and fast-tracking as an incentive and given the message that undetectable equals untransmittable (U=U).

Site Improvement through Monitoring System (SIMS) and Data Use

The purpose of SIMS is to provide a standardized approach and set of tools for monitoring program quality at DHAPP-supported sites and entities that guide and support service delivery.

SIMS assessment results are used to strengthen alignment with global and national standards and facilitate program improvement as a component of an overall quality management strategy.

SIMS is also used to identify performance issues that may impact patient outcomes or the integrity of reporting for MER targets or disaggregates. Low final scores (reds and yellows) from these core essential elements (CEEs) highlight potential issues with service delivery, site performance or oversight, and/or documentation of patient results. Site-level triangulation of MER and SIMS data can be used to contextualize performance and could be useful to determine if performance challenges at a site are due to issues related to the underlying quality of service provision.

Site Improvement through Monitoring System (SIMS) aims to: (1) facilitate improvement in the quality of DHAPP-supported services and technical assistance, (2) ensure accountability of U.S.

government investments, and (3) maximize impact on the HIV epidemic.

SIMS assessment results confirm compliance to minimum quality assurance standards and identify areas where improvements in DHAPP-supported programs can be made.

Programs should conduct SIMS assessments in accordance with DHAPP guidance and implementing partners are responsible for taking corrective action for items within the IP SOW and per discussion with DHAPP USG staff.

In addition to adhering to SIMS requirements for monitoring of IP activities. The IP will provide support to the ongoing application of the SIMS tool by the FFMM to their own contracted providers. This initiative addresses barriers to monitoring identified within the Colombian FFMM’s unique healthcare system, which relies heavily on contracted services. Continued support required by the FFMM to maintain success of this program includestraining and monitoring of SIMS implementation by a team of healthcare administrators previously trained on the use of SIMS the 3 main HIV clinics in Bogota and in six sites, outside of the capital city. In addition one above site (DIGSA). This is in addition to the DHAPP-led SIMS evaluations described in the previous section

Data Monitoring

Successful tracking of patient level data is critical to the success of the partner military HIV program’s ability to monitor progress towards epidemic control. The Grantee will work with the respective partner military to support the collection of patient-level data, the clinical and programmatic use of data, and the reporting of site-level data to DHAPP HQ and the partner military leadership.

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment

In addition to collecting required site-level data for targets at each supported site as described above, the IP will provide support to the FFMM DIGSA (Health Command) in analysis and use of data collected from all sites with HIV data, regardless of their receipt of direct site-level support from the IP. The purpose of this support is to equip the FFMM, especially military health leadership, with improved capabilities for complex data review, and generation of meaningful graphics to inform decision making and program planning.

The IP will be responsible for:

• Staffing support and mentoring of existing partner military staff for data entry

• Ensuring confidentiality and security of data, in line with MOD, MOH, and national guidelines

• Timely, accurate reporting of all indicators required by the partner military and DHAPP.

• Securing all patient-level and site-level data from dissemination outside of the partner military and DHAPP without prior approval from the partner military.

• Support for data entry, cleaning, reporting, and use.

• Assisting the FFMM in generating a regularly updated and reviewed workbook of interactive graphics to be utilized for improved decision making and communication with MoD leadership

Data Quality

Measuring the success of HIV/AIDS initiatives requires strong monitoring and evaluation (M&E) systems that produce high quality data. Efforts to ensure data quality, therefore, are not singular events occurring randomly. Rather, these processes need to become institutionalized as part routine data management processes. Once achieved, data quality helps to ensure that limited resources are used effectively, progress toward established goals are accurately monitored, and that decisions are based on strong evidence. Attention to data quality ensures that target-setting and results reporting are informed by valid and sensitive information, and that all partners are thinking about and collecting and organizing this information in the same manner. In this way, attention to data quality leads to improved program performance and to more efficient resource management.

Data quality has always been a focus of global HIV monitoring and reporting efforts.

Specifically, all countries conducting programming supported by DHAPP are expected to have a data quality strategy in place. For example, data quality assessments should be conducted routinely and action should be taken as a result of these DQAs. If errors are identified in data, these should be remediated at the point of service delivery as well as in the DHAPP and host-country reporting systems as soon as possible. Standard operating procedures for routine data quality review should also be in place. Data should be routinely reviewed for errors before submission to ensure that the data passes the data quality checks outlined within the guidance and the Data Review Tool available in DATIM.

Amendment #0008, Number N00244-19-S-F001 (FY19 – FY20 DHAPP: Military Specific HIV/AIDS Prevention, Care, and Treatment

Work Plans

The Grantee must submit annual, programmatic and financial, work plans to the DHAPP Program Manager and DHAPP HQ (budget breakdown per activity and for program management is required). Work plans should include an activities implementation timeline as well as monitoring and evaluation timeline.

Reporting

• Quarterly Fiscal Reports: The grantee must submit quarterly programmatic and financial reports to DHAPP in order to monitor expenditures according to the program budget codes. The report template will be provided by DHAPP. Submit data within 30 calendar days following each reporting period (3/31, 6/30, 9/30, and 12/31).

• Interim Progress/Monitoring, Evaluation, and Reporting (MER) Report: This report shall summarize progress in relation to the approved work plan as well as monitor grant deliverables. The Grantee shall submit quarterly indicator reports in accordance with the format provided by the Program Office within 45 calendar days following the end of the reporting period: 12/31, 3/31, 6/30 and 9/30. The Grantee shall provide reports in accordance with the template provided by DHAPP

• Reports will follow DHAPP Headquarters and Country Team Templates