SBU - CONTRACTING AND ACQUISITIONS

The Laboratory Sample Transportation (LST) and distribution from central to provincial/intermediate level is currently implemented by the project Global Health Supply Chain

– Procurement and Supply Management (GHSC-PSM) and is expected to end on March 31, 2027.

These activities are proposed to start on/around November 1,2026 to avoid disruption of services which would allow for 2-4 months to ensure a smooth transition from GHSC-PSM to CHEGAR.

This is a request to approve a non-competitive increase in contract funding and scope of work for contract number 72065621C00001 with Africa Global Logistics (AGL), in support of the Commodities for Health Guaranteed Access and Reliability (CHEGAR) and the President’s Emergency Plan for AIDS (PEPFAR) programs to transition the LST and central distribution activities from (GHSC-PSM)

The CHEGAR project plays a pivotal role in transportation and distribution of healthcare commodities to the last mile in Mozambique through strategic engagement with the private sector. Operating across eleven provinces and around 1900 delivery sites, the program improves the availability of prevention, testing, and treatment commodities, ensuring the accessibility of healthcare commodities nationwide, particularly in underserved and hard-to-reach areas. These efforts are critical to achieving lasting health outcomes and supporting national HIV, Malaria, MCHN and TB programs. CHEGAR is implemented by AGL which has proven experience in the distribution and sample transport activities.

A modification to increase the funding and scope of work to the CHEGAR contract will solidify the transport activities oversight from USAID to the Department of State (DOS), which has already been effectively implemented. This adjustment will ensure the program’s continued effectiveness and sustainability, preserving a mature, robust, and functional initiative that aligns with the U.S. Government’s commitments to PEPFAR and the national HIV and TB response.

The increase will maintain essential services such as antiretrovirals (ARVs), malaria treatments, rapid diagnostics tests for HIV and malaria, maternal and child health supplies, surgical materials, laboratory commodities, vaccines, laboratory sample transportation and distribution from central level to the provincial/intermediate level

The current contract expires on April 01, 2028.

This action is critical to prevent a lapse in services that would pose an immediate risk to public health and human life in Mozambique.

SECTION 3: DESCRIPTION OF SUPPLIES/SERVICES REQUIRED TO MEET THE AGENCY’S NEEDS

Mozambique carries a high burden of HIV and tuberculosis (TB), with a national HIV prevalence of 12.5% and one of the highest rates of multidrug-resistant TB globally. Timely, accurate, and accessible diagnostic services are critical to achieving epidemic control and improving health outcomes for affected populations.

In response to these challenges, the Ministry of Health (MISAU), in collaboration with the United States Government (USG)—primarily through PEPFAR—has made significant investments to expand and strengthen the country's diagnostic infrastructure. The USG currently allocates nearly $400 million annually to Mozambique’s health sector, with approximately $50 million dedicated specifically to HIV and TB diagnostic efforts.

These investments have yielded notable gains, including increased access to viral load (VL) and early infant diagnosis (EID) testing, and the broader deployment of GeneXpert platforms across the country. However, persistent challenges continue to hinder the diagnostic network’s effectiveness. These include inefficiencies in sample transport, shortages of skilled personnel, inadequate cold chain systems, and prolonged turnaround times for test results. Rural and hard-to-reach areas remain especially underserved.

The LST was being implemented by AGL through a USAID contract, under the project name AMOSTRA (Adapting and Modifying Optimized Sample Transport Routes for Achieving Impact), which was terminated during the Stop Work Order in March of 2025, and transitioned under the management of GHSC-PSM with the current name Laboratory Sample Transportation (LST). During this process AGL was shifted to a subcontractor but is still providing overall management of the activity. Transitioning this activity back to AGL would therefore create minimal disruption. This activity will be operated under the supervision of the GRM and will aim at increasing access to diagnostic testing while improving the timeliness of diagnostic test results by ensuring shortened turnaround times between specimen collection, drop-offs, and return of results. The activity will also assure the quality of diagnostic testing through proper handling of specimens and through support of a national platform for specimen transport reporting, monitoring and coordination that leads to continuous quality improvement of specimen transport.

In addition to the LST, GHSC-PSM also implements the distribution from central to provincial/intermediate, which involves distribution of commodities funded by the USG (ARVs, malaria treatment, laboratory consumables and Rapid Diagnostic Tests, as well as TB commodities when space is available) from central to provincial/intermediate level.

CHEGAR is well positioned to take on these distribution activities, given their current role in the last mile distribution (provincial/intermediate to health facility level) and overall expertise in transportation services

The Commodities for Health Ensuring Guaranteed Access and Reliability (CHEGAR) activity is designed to establish a reliable and efficient transportation system for medical commodities in Mozambique. Through strategic engagement with the private sector, CHEGAR provides both transportation services and transportation management solutions, supporting the consistent delivery of health commodities to service delivery points.

By improving the availability of prevention, testing, and treatment commodities, CHEGAR directly strengthens health service delivery across the country, particularly in underserved and hard-to-reach areas.

The current GHSC-PSM contract expires on March 31, 2027. With the ongoing transition of HIV programming from USAID to the Department of State, any lapse in this service would create an immediate risk to public health and patient outcomes in Mozambique. Because of the timing and complexity of the transition, no alternative contract or implementing mechanism will be in place to ensure continuity. The proposed increase in scope of work and funds to accommodate the LST and central distribution is essential to avoid disruption of life-saving services and to uphold the integrity of U.S. foreign assistance.

It will ensure the continuity of critical HIV/AIDS interventions, maintain program stability, and reinforce the U.S. Government’s commitment to supporting Mozambique’s efforts to achieve epidemic control.

This action will authorize an updated scope of work of contract 72065621C00001, with an estimated value for the proposed for distribution from central to provincial/intermediate level and for LST, with a total estimated increased cost of

Total Estimated Value:

Current Ceiling:

The EPP specifically authorizes the use of AIDAR 706.302-70(b)(3)(ii) for contract actions, stating:

"You have the authority to extend the EPP under the following: for contracts, Section 706.302-70(b)(3)(ii) of USAID’s Acquisition Regulation (AIDAR), Impairment of Foreign Aid Programs; for assistance awards, ADS Chapter 303.3.6.5, Restrictions to Eligibility; and for the source-and-nationality waiver, Section 228.31 of Title 22 of the Code of Federal Regulations (CFR)."

The current EPP is effective from January 1, 2025, through December 31, 2029, and was approved by the USAID Administrator.

Although the EPP is specific to USAID, a memorandum of understanding between USAID and the Department of State delegates authority to DOS to carry out applicable PEPFAR programming under USAID procedures and regulations. Accordingly, this justification relies on AIDAR 706.302-70 as the basis for limiting competition, as proceeding with full and open competition at this stage would risk impairing the effective implementation of a critical foreign assistance program.

SECTION 5: DEMONSTRATION THAT THE PROPOSED CONTRACTOR’S

UNIQUE QUALIFICATIONS OR THE NATURE OF THE ACQUISITION REQUIRES

USE OF THE AUTHORITY CITED

Africa Global Logistics (AGL) is the current contractor with the qualifications needed to execute this scope of work increase. As the incumbent, AGL is already operating in Mozambique with a complete technical, logistical, and administrative platform for both distribution and LST activities that would be a challenge for another firm to replicate within the required timeline.

The continuation of the activity Commodities for Health Guaranteed Access and Reliability (CHEGAR) will ensure the availability of medical commodities where needed for prevention, testing and treatment. This model is fully adapted to conditions in Mozambique and is deeply tied to local systems and established relationships with national and provincial health authorities.

In addition, the LST activity will provide an efficient and effective transportation system for samples to ensure access to diagnostic testing which is critical to reducing the HIV epidemic.

level to the last mile where the needs for primary health commodities are more acute and will avoid gaps in the availability of critical lifesaving HIV commodities and other essential medicines in health facilities as well as lab sample transport activities following the completed transition of program oversight from USAID to the Department of State (DOS). It aligns directly with PEPFAR’s 95-95-95 targets and DOS’s commitment to evidence-based, patient-centered programming. Maintaining program stability during this period is essential to protect health outcomes and uphold the credibility of U.S. foreign assistance.

The increase in funding and scope of work also provides DOS with the necessary time to consolidate institutional capacity and deepen its understanding of this multifaceted program. It establishes a stable foundation for effectively managing HIV programming under the DOS-led development model, including strengthening strategic partnerships with the Government of Mozambique. In summary, this extension is vital to ensuring continuity in lifesaving HIV services while enabling DOS to implement a sustainable, long-term strategy that supports epidemic control and advances U.S. foreign assistance objectives.

Currently, the Ministry of Health relies on donor support for the distribution of commodities and laboratory sample transport. This approach is not sustainable for the government due to limited funding, which also diminishes suppliers’ willingness to engage with the partner government. To mitigate the current situation, the Government of Mozambique has requested support from partners to conduct a market transport cost assessment and to prepare a concept note. These documents will inform decisions on the most effective approach for distributing commodities through the Central Medical Store, utilizing its human resources with donor funding support. The options under consideration include: (1) using the Central Medical Store’s own fleet for direct client distribution; (2) serving as a fourth-party logistics provider (4PL) for last-mile delivery;

and (3) acting as a third-party logistics provider (3PL) for first-mile distribution. The assessment results are expected to be presented to partners and donors in 2026 with further refinement and planning needed for future implementation.

The ongoing assessment supports the need for an extension of the current contract to protect critical transport distribution services and ensure commodities’ availability for stable program performance.

SECTION 10. LISTING OF THE SOURCES, IF ANY, THAT EXPRESSED, IN

WRITING, AN INTEREST IN THE ACQUISITION

CONTRACTING OFFICER CERTIFICATION (FAR 6.303-2(a)(12)) I certify that this submission is accurate to the best of my knowledge, and that it contains complete information necessary to enable other officials to make an informed recommendation for approval or disapproval.

SIGNATURE:

Contracting Officer Department of State

DIVISION DIRECTOR

SIGNATURE:

Kelly Wagner Date Division Director Department of State

Signature and Approval Note:

The Competition Advocate and Head of the Contracting Activity are not required to sign EPP J&As, as stated in Attachment 1. This differs from standard J&A approval requirements. EPP operates under a unique authority, and signature authority has been delegated to the Contracting Officer. The Contracting Officer requested the Division Director’s signature for operational awareness. The Contracting Officer is also required to notify the GA front office, and that notification has been completed.

J&A Attachments:

1. Attachment 1: Tab 1 of the HIV/AIDS EPP, entitled “Authorization for the Use of Other

Than Full and Open Competition in the Award or Modification of Contracts Funded Under the President’s Emergency Plan for AIDS Relief,” is the Determination and Findings (D&F).

CAI MEMORY 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