Sol_72062119R00001_-_Amendment_No._02.pdf

Issuance Date: April 4, 2019 Deadline for Questions: April 11, 2019 at 0700 East Africa Time Deadline for Receipt of Past performance Information: April 22, 2019 at 1700 East Africa Time Key Personnel Annex: April 22, 2019 at 1700 East Africa Time Deadline for Receipt of Proposal: May 6, 2019 at 0700 East Africa Time

Subject: Request for Proposals (RFP) No. SOL_72062119R00001 – Amendment No. 2

Dear Prospective Offerors:

The United States Agency for International Development (USAID) Mission in Tanzania is seeking proposals from responsible organizations interested in identifying and implementing proven, evidence-based vector control approaches in Tanzania. The proposed activity is aimed at reducing the burden of malaria and moving towards the long-term goal of malaria elimination as detailed in Section C of the RFP.

USAID/Tanzania anticipates awarding one hybrid Firm-Fixed-Price and Cost Plus Fixed-Fee Completion form contract from this solicitation. The estimated cost of the CPFF portion of the contract is between $1,500,000 and $7,500,000 (between $500,000 and $2,500,000 for objectives 3 and 5 and between $1,000,000 and $5,000,000 for optional service). The maximum total amount of possible financial incentives is $250,000 over the life of the project. The anticipated period of performance is five years, subject to availability of funds.

This procurement is being conducted through full and open competition, pursuant to Part 15 of the Federal Acquisition Regulation (FAR). All types of organizations are eligible to compete and local, Tanzanian organizations are encouraged to submit offers. All organizations responding to this solicitation, must submit their proposal in accordance with Section L of this RFP. Proposals must be submitted electronically to the USAID Tanzania contracting office mailbox at usaidtzco@usaid.gov. Late proposals will be handled in accordance with FAR 52.215-1, Alternate I.

The Request for Proposals (RFP), once issued, and subsequent amendments thereto, can be downloaded from the Federal Business Opportunities (“FBO”) web site at: http://www.fbo.gov. An Interested Vendor List is not included in this solicitation. Offerors can register and use the Interested Vendor List (IVL) on the FBO website. This is a useful tool so that firms can contact one another for consideration of teaming arrangements and/or small business subcontracting opportunities in response to this solicitation.

If substantive questions are received which affect the response to the solicitation, or if changes are made to the closing date and time, as well as other aspects of the RFP, this solicitation will be amended. Any amendments to this solicitation will be issued and posted on the FBO website. It is the Offeror’s responsibility to check this site periodically for official updates and amendments to the solicitation.

mailto:usaidtzco@usaid.gov http://www.fbo.gov/

SECTION B – SERVICES/PRICES

B.1 PURPOSE

B.2 CONTRACT TYPE

B.3 CONTRACT LINE ITEM NUMBER (CLIN 001) – COST PLUS FIXED FEE OBJECTIVES

B.4 CLIN 002 FIRM FIXED PRICE OBJECTIVES

B.5 PERFORMANCE INCENTIVES

B.6 INDIRECT COSTS

B.7 MULTI-YEAR CONTRACT

SECTION C – DESCRIPTION/SPECIFICATIONS

SECTION D – PACKAGING AND MARKING

D.1 AIDAR 752.7009 MARKING (JAN 1993)

D.2 BRANDING POLICY

D.3 BRANDING STRATEGY

SECTION E – INSPECTION AND ACCEPTANCE

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

E.2 INSPECTION AND ACCEPTANCE

SECTION F – DELIVERIES OR PERFORMANCE

F.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

F.2 PLACE OF PERFORMANCE

F.3 PERIOD OF PERFORMANCE

F.4 REPORTS, DELIVERABLES, AND OUTPUTS

SECTION G – CONTRACT ADMINISTRATION DATA

G.1 DOCUMENTATION FOR PAYMENT, AIDAR 752.7003 (NOV 1998)

G.2 CONTRACTING OFFICER’S AUTHORITY

G.3 CONTRACTING OFFICER’S REPRESENTATIVE

G.4 ADMINISTRATIVE CONTRACTING OFFICE

G.5 PAYING OFFICE

G.6 ACCOUNTING AND APPROPRIATION DATA

G.7 TECHNICAL DIRECTIONS/RELATIONSHIP WITH USAID

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1 AUTHORIZED GEOGRAPHIC CODE

H.2 KEY PERSONNEL

H.3 USAID-FINANCED THIRD-PARTY WEB SITES (NOVEMBER 2017)

H.4 GOVERNMENT FURNISHED FACILITIES OR PROPERTY

H.5 INSURANCE AND SERVICES

H.6 LOGISTICAL SUPPORT

H.7 ENVIRONMENTAL COMPLIANCE

H.8 FOREIGN GOVERNMENT DELEGATIONS TO INTERNATIONAL CONFERENCES (JUNE 2012)

H.9 ACTIVITY INTEGRATION

H.10 ELECTRONIC PAYMENTS SYSTEM

H.11 SALARY APPROVALS FOR LONG-TERM AND SHORT-TERM TECHNICAL ASSISTANCE TO BE APPLIED

TO THE COST REIMBURSEMENT LINE ITEMS

H.12 SUBMISSION OF DATASETS TO THE DEVELOPMENT DATA LIBRARY (DDL) (October 2014)

H.13 OPTION FOR ADDITIONAL SERVICES – SEPARATELY PRICED

H.14 (Class Deviation No. M-OAA-DEVFAR-18-1c) INCORPORATION OF CONTRACT CLAUSES APPLICABLE TO

COMMERCIAL ITEMS

H.15 INFORMATION TECHNOLOGY APPROVAL (APRIL 2018) (DEVIATION NO. M/OAA-DEV-FAR-18-2c)

SECTION I – CONTRACT CLAUSES

I.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

I.2 FAR CLAUSES INCORPORATED BY REFERENCE

I.3 AIDAR 752.252-1 SOLICITATION PROVISION INCORPORATED BY REFERENCE (MARCH 2015) . 60

I.4 AIDAR CLAUSES INCORPORATED BY REFERENCE

I.5 FAR 52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS

OR STATEMENTS (JAN 2017)

I.6 FAR 52.204-1 APPROVAL OF CONTRACT (DEC 1989)

I.7 FAR 52.222-35 EQUAL OPPORTUNITY FOR VETERANS (OCTOBER 2015)

I.8 FAR 52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES (JULY 2014)

I.9 FAR 52.245-1 GOVERNMENT PROPERTY (JAN 2017)

I.10 AIDAR 752.245-70 GOVERNMENT PROPERTY -- USAID REPORTING REQUIREMENTS (OCT 2017)

I.11 FAR 52.247-1 -- COMMERCIAL BILL OF LADING NOTATIONS (FEB 2006)

I.12 FAR 52.249-2 – TERMINATION FOR CONVENIENCE OF THE GOVERNMENT (FIXED-PRICE) (APR 2012) .. 76

I.13 AIDAR 752.222-70 USAID DISABILITY POLICY (DECEMBER 2004)

I.14 AIDAR 752.222-71 NONDISCRIMINATION (JUNE 2012)

I.15 AIDAR 752.228-7 INSURANCE -- LIABILITY TO THIRD PERSONS (JULY 1997)

I.16 AIDAR 752.229-71 REPORTING OF FOREIGN TAXES (JULY 2007)

I.17 AIDAR 752.225-70 SOURCE AND NATIONALITY REQUIREMENTS (FEB 2012)

I.18 AIDAR 752.7005 SUBMISSION REQUIREMENTS FOR DEVELOPMENT EXPERIENCE DOCUMENTS (SEP

2013) I.19 AIDAR 752.7013 CONTRACTOR-MISSION RELATIONSHIPS (JUNE 2018) (Class Deviation No. M/OAA-DEV-

AIDAR-18-03)

I.20 AIDAR 752.7027 PERSONNEL (DEC 1990)

I.21 AIDAR 752.7032 INTERNATIONAL TRAVEL APPROVAL AND NOTIFICATION REQUIREMENTS (APR

2014)

I.22 AIDAR 752.7034 ACKNOWLEDGEMENT AND DISCLAIMER (DEC 1991)

SECTION J – LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

SECTION K – REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF BIDDERS

K.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

K.2 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (DEC 2018)

K.3 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2018)

K.4 FAR 52.209-13 VIOLATION OF ARMS CONTROL TREATIES OR AGREEMENT-CERTIFICATION (JUN 2018)

K.5 FAR 52.222-22 PREVIUOS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999)

K.6 FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (FEB 1999)

K.7 FAR 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATIONS (OCT 2015)

K.8 FAR 52.230-7 PROPOSAL DISCLOSURE COST ACCOUNTING PRACTICE CHANGES (APR 2005)

K.9) FAR 52.209-11 REPRESENTATION BY CORPORATION REGARDING A DELINQUENT TAX LIABILITY OR A FELONY CRIMINAL (Deviation OAA-DEV-14-02c) CONVICTION (FEB 2016)

K.10 DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER

K.11 AUTHORIZED NEGOTIATORS

K.12 SIGNATURE

K.13 AIDAR 752.252-70 PROVISIONS AND CLAUSES TO BE COMPLETED BY THE OFFEROR (MAR 2015)

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

L.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

L.2 FAR 52.216-1 TYPE OF CONTRACT (APR 1984)

L.3 FAR 52.222-56 CERTIFICATION REGARDING TRAFFICKING IN PERSONS COMPLIANCE PLAN (MAR 2015) 100

L.4 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

L.5 GENERAL INSTRUCTIONS TO OFFERORS

L.6 DELIVERY INSTRUCTIONS

L.7 TECHNICAL PROPOSAL INSTRUCTIONS

L.8 COST PROPOSAL

L.9 BRANDING IMPLEMENTATION AND MARKING PLAN

L.10 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

L.11 COMPETITIVE RANGE NEGOTIATIONS

SECTION M – EVALUATION FACTORS FOR AWARD

M.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

M.2 GENERAL INFORMATION

M.3 TECHNICAL EVALUATION FACTORS

M.4 COST EVALUATION

M.5 EVALUATIONOF PROPOSAL ON MULTI-YEAR CONTRACT CANCELLATION CEILINGS

ATTACHMENTS

Attachment J.1: Government Furnished Property for Contract Performance Attachment J.2: International Travel related to Visa Renewal Attachment J.3: Past Performance Information Data Sheet Attachment J.4: Initial Environmental Evaluation Attachment J.5. Mission Local Compensation Plan Attachment J.6. Immigration Tips Attachment J.7. Value Added Tax Guidance

SECTION B – SERVICES/PRICES

B.1 PURPOSE

The purpose of the Tanzania Vector Control (TVC) acquisition is to identify and implement proven, evidence-based vector control approaches in Tanzania aimed at reducing the burden of malaria and moving towards the long-term goal of malaria elimination as detailed in Section C.

B.2 CONTRACT TYPE

The U.S. Government represented by the United States Agency for International Development Mission in Tanzania intends to award a hybrid Firm-Fixed-Price and Cost Plus Fixed-Fee Completion form contract type with performance - based incentives.

B.3 CONTRACT LINE ITEM NUMBER (CLIN 001) – COST PLUS FIXED FEE

OBJECTIVES

B. 3. 1 ESTIMATED COST PLUS FIXED FEE (OBJECTIVES THREE & FIVE)

(a) The total estimated cost plus fixed fee for the performance of services related to

Objectives Three (3) and Five (5) is between $500,000.00 and $2,500,000.00. The final negotiated amounts will be entered in the table below at the time of award:

Total Estimated Cost: $ Fixed Fee: $ Total Estimated Cost Plus Fixed Fee: $

(b) The total estimated cost plus fixed fee for the performance of the mass distribution campaign optional service is between $1,000,000.00 and $5,000,000.00

Total Estimated Cost: $ Fixed Fee: $ Total Estimated Cost Plus Fixed Fee: $

(c) The total estimated cost for the performance of the work required hereunder, including the optional service and exclusive of fixed fee, is $[to be inserted by CO at time of award].

(d) Within the estimated cost plus fixed fee specified in paragraphs (a) and (b) above, the amount currently obligated and available for reimbursement of allowable costs incurred by the Contractor for performance hereunder is $[to be inserted by CO at time of award].

B.3.2 COST PLUS FIXED FEE BUDGET

The following budget tables capture the final negotiated budget for the performance of the work required to achieve Objective Three (3), Objective Five (5), and the Optional Service for Mass Distribution Campaign(s) hereunder. The budget for the work to be performed to achieve Objectives Three & Five is fungible and purposely not delineated by objective.:

Objectives Three and Five

Cost Element Amount Program Implementation $ Subcontracts $ Total Estimated Cost $ Fixed Fee $ Total Estimated Cost Plus Fixed Fee $

Optional Services Mass Distribution Campaign as described in Section C.5

Cost Element Amount Program Implementation $ Subcontracts $ Total Estimated Cost $ Fixed Fee $ Total Estimated Cost Plus Fixed Fee $

* Program Implementation will be equal to the sum of all direct costs and indirect costs with the exception of subcontracts.*

B.3.3 REIMBURSEMENT OF COSTS AND PAYMENT OF FIXED FEE

(a) Allowable costs shall be limited to reasonable, allocable and necessary costs determined in accordance with FAR clause 52.216-7, Allowable Cost and Payment and AIDAR clause 752.7003, Documentation for Payment.

(b) Pursuant to FAR 52.216-8, Fixed Fee, payment of fixed fee shall be allocated based upon the achievement of performance standards associated with Objectives Three (3) and Five (5) as outlined in Section C, the approval of required deliverables listed in Section F, the proportion of allowable and allocable costs incurred to achieve the performance standards and complete deliverables.

B.4 CLIN 002 FIRM FIXED PRICE OBJECTIVES

B.4.1. TOTAL FIRM FIXED PRICE (OBJECTIVES ONE, TWO, AND FOUR)

Expected Outcomes Milestone(s) Schedule in terms of

Project Year/Month Price

1.1 ITN coverage of the

targeted populations using data from surveys

Specific Milestone(s) to be inserted by CO at time of Award.

1. Specific schedule to be inserted by CO at time of

1. TBD The final number of milestones managed under this contract and/or through data from large scale household surveys conducted by other entities determined annually award. and price per milestone has will depend on the outcome of negotiations with the successful offeror

Total Price for Expected Outcome 1.1:

$TBD

1.2 Using the latest available

data on ITN coverage, ITN needs for distribution through the RCH and School Net Program (SNP) in targeted areas of Mainland Tanzania and for distribution through RCH and the Community-based approach in Zanzibar quantified annually.

Specific Milestone(s) to be inserted by CO at time of Award.

1. Specific schedule to be inserted by CO at time of award.

1. $TBD The final number of milestones and price per milestone has will depend on the outcome of negotiations with the successful offeror

Outcome 1.2:

$TBD

2.1 The quantity of ITNs

needed to maintain at least 80% population access among targeted populations delivered in a timely and effective manner.

Specific Milestone(s) to be inserted by CO at time of Award.

1. Specific schedule to be inserted by CO at time of award.

Specific unit price to be inserted by CO at time of award.

Period of Performance Maximum amount of ITNs:

Outcome 2.1:

4.1 Annual reviews of the

effectiveness of vector control interventions implemented in the previous year in Tanzania.

1. Effectiveness of Vector Control Interventions in Tanzania Annual Review Written Report Approved by

COR

Specific schedule to be inserted by CO at time of award.

TBD The final number of milestones and price per milestone has will depend on the outcome of negotiations with the

2. Effectiveness of Vector Control Interventions in Tanzania Annual Review Presented to GOT & PMI stakeholders successful offeror

Outcome 4.1:

Total Firm Fixed Price for

CLIN 002:

$TBD

B.5 PERFORMANCE INCENTIVES

Separate from the negotiated price and estimated cost plus fixed fee stated in B.3 and B.6 the Contractor is eligible to earn performance incentives in accordance with the incentive schedule set forth below.

The Contracting Officer will determine the Contractor’s eligibility for performance incentives 30 days after quarterly performance reports and/or annual reports documenting the achievement of applicable performance standards as approved by the Contracting Officer’s Representative (COR).

Performance Incentive Payment Schedule

Expected Outcome Performance Standard Amount Maximum Frequency

1.1 ITN coverage of the

targeted populations using data from surveys managed under this contract and/or through data from large scale household surveys conducted by other entities determined annually

1. Completed by the 90th calendar day after the final ITN distribution through the SNP.

2. Accuracy of coverage is estimated to be at least 95% confidence interval

$10,000 Annually

1.2 Using the latest

available data on ITN coverage, ITN needs for distribution through the RCH and School Net Program (SNP) in targeted areas of Mainland Tanzania and for distribution through RCH and the Community-based approach in Zanzibar quantified annually.

1. ITN needs to maintain a minimum of 60% and a maximum of 80% population access for the 14 regions of Mainland Tanzania quantified annually by the 105th calendar day after the final ITN distribution through the SNP to allow time to procure ITNs for the next SNP distribution.

2. ITN needs to maintain a minimum of 60% and a maximum of 80% population access for Zanzibar quantified annually by November 30th to allow time to procure ITNs.

$15,000 Annually

2.1 The quantity of ITNs

needed to maintain at least 80% population access among targeted populations delivered in a timely and effective manner.

1. 100% of ITNs necessary to maintain at least 60% population coverage delivered to schools and health facilities correctly in terms of ITN quantities needed at each designated location.

2. 100% of deliveries of ITNs necessary to maintain at least 60% population access to health facilities for RCH distribution arrive within 7 days of planned quarterly distribution

$15,000 Annually

5.2 As appropriate, new

vector control approaches are implemented in Tanzania

Rollout plan drafted within 30 calendar days of go ahead from the

COR

$10,000 Annually

B.6 INDIRECT COSTS

Prime:

Description Rate Base Type Period

TBD TBD 1/ 1/ 1/

TBD TBD 2/ 2/ 2/

1/ Base of Application: TBD

Type of Rate: TBD Period: TBD

2/ Base of Application: TBD

Type of Rate: TBD Period: TBD

The Contractor is allowed to recover applicable indirect costs (i.e. overhead, G&A, etc.) on other direct costs (ODCs), if it is part of the Contractor’s usual accounting procedures, consistent with FAR Part 31, and the Negotiated Indirect Cost Rate Agreement (NICRA).

B.7 MULTI-YEAR CONTRACT

Outcomes Three (3) and Five (5) are considered non-severable and the Government only has funding for two years and is therefore a multi-year contract as defined in FAR 17.103. Therefore, this contract is subject to the requirements of FAR 17.106.

Cancellation Dates:

Contract Year 3: 2021 Contract Year 4: 2022

Contract Year 5: 2023

Cancellation Ceiling:

This is a CPFF type contract where the contractor is authorized to be reimbursed for all costs which are allowable in accordance with FAR 52.216-7, “Allowable Costs and Payment.” The contractor will not incur any costs which would have been amortized over the life of the contract should the contract be cancelled in accordance with FAR 52.217-2. Therefore, the cancellation ceiling for each cancellation date is $[negotiated amount] for Contract Year 3, beginning June 1, 2021; $[negotiated amount] for Contract Year 4, beginning June 1, 2022; and $[negotiated amount] for Contract Year 5, beginning June 1, 2022.

The total proposed cancellation ceiling for this contract is $[to be inserted by Offeror].

Contract Year Date Cancellation Ceilings 3 Date, 2021 $ 4 Date, 2022 $ 5 Date, 2023 $

[END OF SECTION B]

SECTION C – DESCRIPTION/SPECIFICATIONS

Performance Work Statement

ABBREVIATIONS and ACRONYMS

ACT Artemisinin-based combination therapy ALU Artemether-lumefantrine ANC Antenatal care CDC U.S. Centers for Disease Control and Prevention CDCS Country Development Cooperation Strategy DHIS2 District Health Information System 2 CHSD Comprehensive Health Service Delivery DO Development Objectives DQA Data quality audit eIDSR Electronic Infectious Disease Surveillance and Response eLMIS Electronic Logistics Management Information System EPI Expanded Program on Immunizations FY Fiscal year Global Fund Global Fund to Fight AIDS, Tuberculosis and Malaria GoT Government of Tanzania HMIS Health Management Information System IDSR Infectious Disease Surveillance and Response IR Intermediate Result IRS Indoor residual spraying ITN Insecticide-treated mosquito net MCN Malaria case notification MEEDS Malaria Epidemic Early Detection System MIS Malaria Indicator Survey MOHCDGEC Ministry of Health, Community Development, Gender, Elderly and

Children MOEVT Ministry of Education and Vocational Training MOP Malaria Operational Plan mRDT malaria Rapid Diagnostic Test NMCP National Malaria Control Program PAD Project Appraisal Document PMI President’s Malaria Initiative PO-RALG President’s Office– Regional Administration and Local Government QA/QC Quality assurance/quality control RCH Reproductive and child health SBCC Social and Behavior Change Communication SNP School net program TBD To be determined TDHS Tanzania Demographic and Health Survey TES Therapeutic Efficacy Study THMIS Tanzania HIV and Malaria Indicator Survey TVC Tanzania Vector Control TWG Technical Working Group UCC Universal Coverage Campaign (of ITNs) USAID United States Agency for International Development USG United States Government WHO World Health Organization ZAMEP Zanzibar Malaria Elimination Program

C.1 BACKGROUND

C.1.1 Country Contexts

The epidemiology of malaria in Mainland and in Zanzibar differs. The Mainland and Zanzibar have separate ministries of health and malaria control programs: the National Malaria Control Program (NMCP) and the Zanzibar Malaria Elimination Program (ZAMEP).

Ninety-three percent of the population in the Mainland and the entire population of Zanzibar live in areas where malaria is transmitted. Unstable seasonal malaria transmission occurs in approximately 20% of the country, while stable malaria with seasonal variation occurs in another 20% of the country. The remaining malaria endemic areas in Tanzania (60%) are characterized as stable perennial transmission. Plasmodium falciparum accounts for 96% of malaria infection in Tanzania, with the remaining 4% due to P. malariae and P. ovale.

The principal malaria vectors in Tanzania are mosquitoes of the Anopheles gambiae complex, which accounted for 94% of all anopheline mosquitoes collected in a 2016 survey carried out in the Lake Zone. An. funestus accounted for the remaining 6%. The An. gambiae population in Lake Zone was comprised of 90% An. arabiensis and 10% An. gambiae s.s. Similarly, in Zanzibar, high coverage of insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS) has resulted in a shift in the malaria vector population from An. gambiae s.s. to predominantly An. arabiensis. This is reflected in the predominant outdoor biting pattern observed on Pemba and Unguja.

Figure 1 - Malaria Prevalence in Children Age 6-59 Months by Region (Source: 2015-2016 Tanzania

Demographic Health Survey and Malaria Indicator Survey

[TDHS-MIS])

The 2017 Tanzania DHS-MIS household survey reported malaria prevalence in Mainland Tanzania of 7% in children under five years of age. Prevalence varied by region from <1% in the highlands of Arusha to 24% in Kigoma (Figure 1). In Zanzibar, the malaria prevalence was 0%. In the Mainland, more than 26% of all outpatient visits are attributed to malaria, resulting in an estimated 7.7 million confirmed and clinical outpatient malaria cases annually, 3.4 million cases of under-five and 4.3 million cases of five and older.

Childhood mortality rates in Tanzania continue to decline, from an all-cause under-five mortality of 147/1000 in 1999 to 67/1000 in 2015. A trend analysis of 1999-2012 demographic surveys shows the under-five mortality decline was greater in rural areas than urban areas and greater in medium- to high-risk than low-risk malaria areas. These findings indicate malaria control is contributing to reductions in under-five mortality in Tanzania (January 2012 Roll Back Malaria report Progress and Impact series: Focus on Mainland Tanzania available at http://www.rollbackmalaria.org/microsites/wmd2014/report10.html ; and June 2012 Evaluation of the Impact of Malaria Interventions on Mortality in Children in Mainland Tanzania available at http://www.pmi.gov/docs/default-source/default-document-library/tools-curricula/tanzania_ie_report.pdf)

Key programmatic interventions contributing to the dramatic reductions in cases in Tanzania include:

1. Vector control

a. Indoor Residual Spraying:

In Tanzania, IRS has evolved from blanket to targeted applications. IRS is a tool to mitigate mosquito resistance to pyrethoids in high transmission areas. To date IRS has been limited to the Lake Zone. The principal criteria for spraying, in accordance with WHO guidelines, are: 1) overall malaria positivity rates, 2) incidence, according to health facility reports and census data, 3) insecticide resistance, and 4) results from school surveys.

Because of low malaria prevalence and reliable surveillance and entomological monitoring, Zanzibar has been conducting only focal spraying since 2014. Malaria incidence at village levels is the criteria for using IRS. In 2017, Zanzibar used focal spraying to reach all villages (shehias) with malaria incidence of more than 4.1 cases per 1,000 population over the previous 12 months. Following a second universal coverage campaign for ITNs in Zanzibar in 2016, IRS is used only for hot spots.

b. Insecticide-treated nets (ITNs)

Universal coverage campaign (UCC): The universal coverage campaign in 2015-2016 delivered 27.1 million ITNs, one ITN for every two people, across 22 of the 25 regions in the Mainland. In mid- 2016, Zanzibar completed a UCC delivering over 700,000 ITNs to achieve coverage of one ITN for every two people.

ITN distribution through ANC and vaccination clinics: In June 2016, the NMCP with PMI support began the rollout of distribution of ITNs free of charge to pregnant women at their first ANC visit and to children at their first measles vaccination visit in two regions. This Reproductive and Child Health (RCH) channel was launched in Zanzibar in June 2014 and as of June 2016 had delivered over 65,000 ITNs through antenatal clinics (ANCs) and more than 60,000 through vaccination clinics.

School-based net distribution program: Beginning in 2013, ITNs were distributed at schools in three regions in the Mainland to supplement distribution at ANC and vaccination clinics. Results of evaluations of that program indicated that the combination of these channels was sufficient to maintain ITN coverage at sufficiently high levels over time, eliminating the need for future UCCs.

This approach has now been expanded to 14 regions with the highest malaria prevalence in Tanzania.

Community-based distribution program: As part of the Zanzibar continuous distribution approach, ZAMEP with PMI support launched a community-based approach to supplement the delivery through ANC and vaccination clinics. Between June 2014 and December 2015, 160,000 ITNs were delivered through this channel. Results from an evaluation of the community-based approach indicate http://www.rollbackmalaria.org/microsites/wmd2014/report10.html http://www.pmi.gov/docs/default-source/default-document-library/tools-curricula/tanzania_ie_report.pdf http://www.pmi.gov/docs/default-source/default-document-library/tools-curricula/tanzania_ie_report.pdf that with minor improvements, including greater community buy-in, the combination of this community approach with RCH will maintain high ITN coverage and eliminate the need for future campaigns.

2. Surveillance

In the Mainland, the routine malaria surveillance system is the Health Management Information System (HMIS)/District Health Information System II (DHIS2), which is supplemented by the electronic Integrated Disease Surveillance and Response (eIDSR) system. Historically, the majority of malaria cases reported were the result of clinical diagnoses, usually non-specific fever. This is changing as Tanzania continues to increase use of mRDT at health facilities. HMIS information is reported monthly with an annual roll up of results through Council Health Management Teams and the Health Statistics Abstract.

The eIDSR captures data on notifiable and epidemic-prone diseases, which are reported on a daily, weekly or monthly basis, depending on the disease. Three malaria data variables are captured in the eIDSR– total tested (mRDT/microscopy), total positive, and total treated clinically. Data submissions to the eIDSR are moving to a mobile phone platform in the future.

Zanzibar’s surveillance system is comprised of the Malaria Early Epidemic Detection System (MEEDS) for passive surveillance through health facility reporting and the Malaria Case Notification (MCN) system for active malaria case notification and follow-up. The MEEDS system collects data on three indicators from outpatient clinics: total visits, confirmed malaria-positive cases, and confirmed malaria-negative cases. Weekly aggregated data, stratified by two age categories (< 5 and ≥ 5 years of age), are sent from each health facility using a customized cell phone menu.

The MCN system employs a follow up household investigation of every confirmed case of malaria infection within 24 hours of notification from the health facility where the case was first detected. All occupants of the household are tested using a mRDT and those positive are treated on site. The ZAMEP disseminates surveillance data to the districts via quarterly reports. Using data from the MCN, the ZAMEP has initiated village mapping to highlight foci of transmission (hotspots) in relation to implementation of interventions.

Because of very low rates of asymptomatic parasitemia detected during large-scale reactive case detection in prior years, the ZAMEP has revised epidemic response guidelines. In addition to the reactive case detection at household level for every malaria case reported (household screening and treatment), ZAMEP currently uses a focal screen and treat approach for an entire village where ≥ five cases are detected in a village within a week, and conducts screen and treat at the shehia level where ≥ 10 cases are detected in a shehia within a week.

3. Monitoring

a. Entomological monitoring

In the Mainland, insecticide resistance monitoring takes place across 23 sentinel sites. Data collected at sentinel sites includes phenotypic assays of insecticide resistance and molecular characterization of mechanisms of resistance. Longitudinal entomological monitoring is done at a subset of sites in IRS regions in the Lake Victoria basin, including Mara, Mwanza, Geita and Kagera. Samples are collected from indoor light traps and outdoor clay-pot traps and analyzed for species identification and detection of malaria parasites. In addition, cone wall bioassays are conducted to monitor residual insecticide activity of the IRS insecticide.

In Zanzibar, monitoring occurs in areas of persistent malaria transmission, providing data on vector species and density, human blood feeding index, and malaria infection rates. ZAMEP conducts on-site entomological laboratory assays for molecular mosquito species identification, detection of target site mutations of insecticide resistance mechanisms (kdr), and malaria infectivity rates in mosquitoes.

b. Therapeutic efficacy monitoring

In recent years, therapeutic efficacy monitoring supported by PMI has been conducted annually in Tanzania to evaluate the clinical and parasitological efficacy, and safety, of the first line anti-malarial drug, artemether/lumefantrine (ALu), for the treatment of uncomplicated malaria in children aged six months to 10 years. Monitoring is designed to analyze primary early treatment failures, late clinical failures, late parasitological failures, adequate clinical and parasitological response, and adverse outcomes. The NIMR, Tanga Station, conducts on-site laboratory assays by polymerase chain reaction to differentiate recrudescent from new malaria infections, and detect markers associated with resistance to ALu, including Pfmdr1, Pfmdr1 copy number, and Kelche propeller polymorphisms (k- 13). Monitoring alternates annually between a total of eight sites and have closely adhered to the WHO standard protocol for monitoring therapeutic efficacy and have used WHO tools for analyzing TES results.

Following NMCP guidance, the TES is conducted annually in a subset of the eight sites with management of field activities shifting over time between coalitions of local entities. Laboratory support for TES is not shifted.

C.1.2 National Policy Context

The results and activities carried out in this TVC activity are guided by and must be consistent with the following Tanzania strategy documents that can be found at the Ministry of Health, Community Development, Gender, Elderly, and Children (MOHCDGEC):

a) Health Sector Strategic Plan IV (HSSP IV) (2015-2020) and any successive plan

b) National Malaria Strategic Plan (2015-2020) and any successive plan

c) Zanzibar Malaria Strategic Plan (2018-2022)

d) Communication Strategy for Malaria Control Interventions (2015-2020) and any successive plan

e) Zanzibar Malaria Communication Strategy (2018-2022)

f) Malaria Surveillance, Monitoring and Evaluation Plan (2015-2020) and any successive plan

The principal partners of the TVC are Government of Tanzania (GOT) agencies, including:

● Ministry of Health, Community Development, Gender, Elderly, and Children (MOHCDGEC)

● National Malaria Control Program (NMCP)

● Zanzibar Malaria Elimination Program (ZAMEP)

● Ministry of Education and Vocational Training (MOEVT)

● President’s Office Regional and Local Government (PO-RALG)

C.1.3 PMI/USAID’s Response in Tanzania

PMI’s Overall Support for Tanzania

When it was launched in 2005, the goal of the President’s Malaria Initiative (PMI) was to reduce malaria-related mortality by 50% across 15 high-burden countries in sub-Saharan Africa through a rapid scale-up of four proven and highly effective malaria prevention and treatment measures:

insecticide-treated mosquito nets (ITNs); indoor residual spraying (IRS); accurate diagnosis and prompt treatment with artemisinin-based combination therapies (ACTs); and intermittent preventive treatment of pregnant women (IPTp). With the passage of the Tom Lantos and Henry J. Hyde Global Leadership against HIV/AIDS, Tuberculosis, and Malaria Act in 2008, PMI developed a U.S.

Government Malaria Strategy for 2009–2014. This strategy included a long-term vision for malaria control in which sustained high coverage with malaria prevention and treatment interventions would progressively lead to malaria-free zones in Africa, with the ultimate goal of worldwide malaria eradication by 2040-2050. Consistent with this strategy and the increase in annual appropriations supporting PMI, four new sub-Saharan African countries and one regional program in the Greater Mekong Subregion of Southeast Asia were added in 2011. The contributions of PMI, together with those of other partners, have led to dramatic improvements in the coverage of malaria control interventions in PMI-supported countries, and all 15 original countries have documented substantial declines in all-cause mortality rates among children under five years of age.

In 2015, PMI launched the next six-year strategy, setting forth bold and ambitious goals and objectives. The PMI Strategy for 2015-2020 takes into account the progress over the past decade and the new challenges that have arisen. Malaria prevention and control remains a major U.S. foreign assistance objective and PMI’s Strategy fully aligns with the U.S. Government’s vision of ending preventable child and maternal deaths and ending extreme poverty. It is also in line with the goals articulated in the RBM Partnership’s second generation global malaria action plan, Action and Investment to defeat Malaria (AIM) 2016-2030: for a Malaria-Free World and WHO’s updated Global Technical Strategy: 2016-2030. Under the PMI Strategy 2015-2020, the U.S. Government’s goal is to work with PMI-supported countries and partners to further reduce malaria deaths and substantially decrease malaria morbidity, towards the long-term goal of elimination.

Tanzania was selected as a PMI focus country in FY 2006. The Malaria Operational Plan (MOP) presents a detailed implementation plan for Tanzania based on the strategies of PMI and the National Malaria Control Program (NMCP) and the Zanzibar Malaria Elimination Program (ZAMEP) strategy. MOPs are developed in consultation with the NMCP, ZAMEP, and with the participation of national and international partners involved in malaria prevention and control in the country. The activities that PMI is proposing to support fit in well with the National Malaria Control strategy and plan and build on investments made by PMI and other partners to improve and expand malaria-related services, including the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) malaria grants.

Since FY 2006 PMI has continuously supported Tanzania (both Mainland and Zanzibar) on the following interventions: Entomologic monitoring and insecticide resistance management;

Insecticide-treated nets; Indoor residual spraying; Malaria in pregnancy;

Case management; Health systems strengthening and capacity building; Social and behavior change communication; Surveillance, monitoring and evaluation; and Operational research.

PMI’s Support for the Tanzania ITN delivery strategy

Tanzania with assistance from Global Fund and PMI is providing ITNs free of charge through all public health facilities nationwide to pregnant women at the first antenatal care clinic visit and to infants at the first measles vaccination, called the Reproductive and Child Health (RCH) channels for delivery. In addition, on Mainland Tanzania, ITNs are delivered annually to primary school children in selected grades in all public schools in 14 regions of the country that were reported to have a malaria prevalence >10% in the Tanzania Demographic Health Survey 2015/16. In Zanzibar, in addition to the RCH delivery, there is a community-based delivery component. The goal of delivery through these channels on an annual basis is to maintain population access at greater than 70%.

Sustaining this level of population coverage has the advantage of providing more continuous protection to the population following mass campaigns. Also, if high coverage with ITNs can be maintained, it can eliminate the need for additional campaigns. In both the Mainland and Zanzibar, the projected needs of combined delivery through RCH plus either SNP or community-based deliveries respectively are calculated using models based on NetCALC. Using this approach, the quantities of ITNs delivered through schools on the Mainland can be adjusted by targeting only selected grades in primary schools, reducing or expanding as needed from year to year. Similar adjustments can be made in Zanzibar by adjusting the quantities of ITNs provided for community-based delivery.

The remaining 12 regions of Mainland Tanzania, where malaria prevalence is low, will receive ITNs only through RCH channels and eleven of those regions are targeted for a Global Fund supported mass campaign in 2019, with only Dar es Salaam not receiving ITNs through a mass campaign.

In close agreement with the National Malaria Control Program, in 2018 PMI will support the delivery of ITNs in the 14 highest prevalence regions on Mainland Tanzania through RCH and SNP delivery.

The total quantity of ITNs planned for delivery in 2018 is about 6.9 million, 4.1 million through RCH channels (procured by Global Fund), and 2.7 million through SNP channels (procured by PMI).

Similarly, in 2018 PMI will provide assistance to Zanzibar for delivery of about 320,000 ITNs.

PMI has also supported activities to revive the commercial sector for ITNs in line with the Tanzania National Malaria Strategic Plan 2015-2020, which notes that the only sustainable approach to continuous ITN distribution is the reestablishment of a viable commercial market, at least in urban and peri-urban settings.

C.1.4 USAID Health Projects in Tanzania

The TVC activity is authorized under USAID/Tanzania’s Comprehensive Health Service Delivery (CHSD) Project Appraisal Document (PAD) and is critical to the achievement of USAID/Tanzania’s Country Development Cooperation Strategy (CDCS) for 2014-2019. The three Development Objectives (DOs) of the CDCS address the needs of women and youth, strengthen local governments, build health and education systems, and promote economic growth. The CDCS Results Framework is available at https://www.usaid.gov/documents/1860/usaid-tanzania-cdcs-final

The CDCS posits that if Tanzania empowers its women and youth, sustains inclusive broad-based growth, and makes governance more effective, its socio-economic transformation toward middle-income status by 2025 will be significantly advanced. DO 1- Tanzanian women and youth empowered, DO 2-Inclusive broad-based economic growth sustained, and DO 3- Effective democratic governance improved are the development objectives that support this hypothesis. The intermediate result (IR), Data-driven decision-making, planning and implementation improved, cuts across all three DOs and across the Mission’s portfolio.

Three IRs must be met to achieve DO 1: IR 1.1 Gender equality increased; IR 1.2 Health status improved; and IR 1.3 Lifelong learning skills improved. The TVC activity will empower Tanzanian women and youth through improved health status as a result of national level reductions in malaria.

The TVC Contractor will also build capacity of government staff in vector control and prevention, thus contributing to DO3, Effective democratic governance improved through its impact on IR 3.2, Government delivery of services improved.

The USAID CHSD Project Goal is Tanzanian health status improved (IR 1.2) and the TVC Activity https://www.usaid.gov/documents/1860/usaid-tanzania-cdcs-final https://www.usaid.gov/documents/1860/usaid-tanzania-cdcs-final

Purpose is Access to quality integrated services, with a focus on maternal, neonatal, and child health (MNCH) increased (Sub-IR 1.2.1). The TVC Contractor will help achieve this Sub-IR 1.2.1 through interventions that will strengthen malaria prevention and monitoring, leading to decreases in maternal and child morbidity and mortality.

C.2 SCOPE

The purpose of the TVCA is to identify and implement proven, evidence-based vector control approaches in Tanzania. This activity does not include indoor residual spraying (IRS). The TVC focuses on insecticide treated bednets (ITNs) that includes determining the quantity of ITNs needed annually to maintain high population access and implementing delivery of ITNs. The TVC Contractor provides the Government of Tanzania and malaria partners with state of the art reviews and advice concerning new developments in vector control, and as appropriate, develops plans for implementation of modified or new vector control approaches in Tanzania.

Through the Tanzania Vector Control activity, technical, material, and logistical assistance is provided to the Government of Tanzania to:

Objective 1: Determine the ITN population access among targeted populations and the quantity of ITNs needed in the coming year to maintain high population access to ITNs Objective 2: Deliver Insecticide Treated Nets to targeted populations Objective 3: Undertake activities to create an enabling environment to revive the commercial market for ITNs Objective 4: Provide annual guidance on effectiveness of vector control interventions used in Tanzania Objective 5: Provide guidance on new evidence-based vector control approaches that show potential for successful outcomes in Tanzania and, when appropriate, assist with implementation of proven approaches

The target population for this activity includes residents living in high malaria endemic regions of Mainland Tanzania and the entire population of Zanzibar.

Geographical Scope by Objective

Objective 1: Determine the ITN population access among targeted populations and the quantity of ITNs needed in the coming year to maintain high population access to ITNs

Objective 2: Deliver Insecticide Treated Nets to targeted populations

Two pillars in Tanzania for maintaining high coverage through continuous distribution approach on

Figure SEQ Figure \* ARABIC 1 - Intermediate Result 1.2 of USAID/Tanzania CDCS the Mainland are the SNP and RCH channels and on Zanzibar the community-based and RCH channels. The NMCP and malaria partners determined that on the Mainland the full package of continuous distribution would be rolled out in the 14 regions with the highest malaria prevalence (2015-16 TDHS/MIS). The remaining regions would receive ITNs only through RCH, with most of those regions also receiving universal coverage campaigns. The geographical scope of the TVC for Objectives 1 and 2 will be those 14 regions on the Mainland targeted for continuous distribution. For Zanzibar, the TVC will support continuous distribution of ITNs though the community-based and RCH channels across all of Unguja and Pemba Islands. The geographic scope for this contract may be adjusted to align with changes in criteria for focus areas made by NMCP, ZAMEP, and/or PMI.

Objective 3: Undertake activities to create an enabling environment to revive the commercial market for ITNs Objective 4: Provide annual guidance on effectiveness of vector control interventions used in Tanzania Objective 5: Provide guidance on new evidence-based vector control approaches that show potential for successful outcomes in Tanzania and when appropriate, assist with implementation of proven approaches

Activities undertaken to complete Objectives 3, 4, and 5 will be principally conducted at central level, yet the policies, guidance, and/or novel interventions resulting from these may have impact at regional, zonal, or national levels. The geographical scope of the implementation of any vector control approach will be based on the Government of Tanzania and PMI priorities.

C.3 PROJECT OBJECTIVES AND OUTCOMES

Objective 1: Determine the ITN population access among targeted populations and the quantity of ITNs needed in the coming year to maintain high population access to ITNs

Expected Outcomes:

Outcome 1.1: ITN coverage of the targeted populations using data from surveys managed under this contract and/or through data from large scale household surveys conducted by other entities determined annually.

Outcome 1.2: Using the latest available data on ITN coverage, ITN needs for distribution through the RCH and School Net Program (SNP) in targeted areas of Mainland Tanzania and for distribution through RCH and the Community-based approach in Zanzibar quantified annually.

Because the approach of providing ITNs on an annual basis through RCH and SNP channels at levels designed to maintain high population access is relatively new, ITN population access must be determined each year using sound survey approaches. Survey results are used to determine ITN inputs needed to maintain high population access for the following year.

Outcome 2.1: The quantity of ITNs needed to maintain at least 60% population access among targeted populations delivered in a timely and effective manner.

In 2019 the Contractor must assume responsibility for ensuring distribution of ITNs through schools and health facilities in 14 regions of the Mainland and delivery through community-based and health facilities in Zanzibar. The target for population access laid out in the National Malaria Strategic Plan is 80% population access. This is also the target for coverage for the TVC activity.

For the SNP this must include delivery of an estimated 3.1 million ITNs to primary schools in 14 regions of mainland Tanzania with the highest prevalence of malaria, currently: Kagera, Geita, Mwanza, Simiyu, Mara, Kigoma, Katavi, Tabora, Singida, Morogoro, Pwani, Lindi, Mtwara, and Ruvuma. This is an annual exercise in the 14 regions of mainland Tanzania with the highest prevalence of malaria based on guidance from NMCP, and PMI/Tanzania. The target date for completion of the 2019 SNP distribution is September 2019.

For delivery through RCH channels in Mainland Tanzania, the Contractor must assume responsibility for the ongoing delivery of Global Fund - procured ITNs to those same 14 regions by July 2019. This includes delivery from the level of the Medical Stores Department (MSD) Zonal Warehouses to all public health facilities on a quarterly basis. The quantity of ITNs planned for distribution through RCH to the 14 regions in 2019 is about 3 million ITNs. The quantity delivered quarterly to each health facility is determined by following MoHCDGEC and MSD agreed upon criteria and procedures and may vary over the course of the year as needed. In addition, the Contractor must store ITNs for those MSD Zonal Warehouses that lack adequate storage space. All RCH ITNs on the Mainland are handled as an MSD managed commodity and the receiving and dispensing for all RCH ITNs are recorded in the MSD system.

For community-based delivery in Zanzibar, the Contractor must provide technical assistance as needed to ZAMEP and the Central Medical Stores. In Zanzibar, the Central Medical Stores is responsible for storage and distribution of RCH ITNs through their requisition and delivery system to all public health facilities.

Objective 3: Undertake activities to create an enabling environment to revive the commercial market for ITNs

Expected Outcome:

Outcome 3.1: The bednet market dynamics in Mainland Tanzania reviewed annually.

Outcome 3.2: Mitigating actions taken to improve the enabling environment of the commercial market for long-lasting ITNs reviewed annually.

Objective 4: Provide annual guidance on effectiveness of vector control interventions used in Tanzania

Outcome 4.1: Reviews based on the most current entomological, epidemiological, and other relevant data prepared annually, an overview of the effectiveness of the ongoing vector control interventions in Mainland Tanzania and Zanzibar synthesized annually.

Objective 5: The Government of Tanzania and stakeholders are well informed of new promising, evidence-based vector control approaches that may be appropriate for the epidemiological, ecological, and human behavior settings in Tanzania.

Expected outcomes:

Outcome 5.1: NMCP and ZAMEP knowledgeable of analytically sound and comprehensive reports on the possible use of new vector control approaches in Tanzania.

Outcome 5.2: New WHO vector control approaches approved by the Government of Tanzania and PMI are implemented in Tanzania.

C.4 PERFORMANCE STANDARDS

Objective 1: Determine the ITN population access among targeted populations and determine the quantity of ITNs needed in the coming year to achieve and maintain high population access to ITNs

Expected Outcomes Performance Std. Quality Assurance Plan

1.1 ITN coverage of the targeted

populations using data from surveys managed under this contract and/or through data from large scale household surveys conducted by other entities determined annually

● Completed by the 120th calendar day after the final ITN distribution through the

SNP

● Accuracy of coverage estimates for targeted regions of Mainland Tanzania measured to achieve minimum precision of 90%.

● Results published in at least one peer-reviewed publication.

Plan for monitoring the progress toward meeting performance standards and to be proposed by the Offeror.

TBD at time of award

1.2…