RFI 72067424RFI00005 Gauteng Provincial Care and Treatment.pdf

Request FOR INFORMATION (RFI)

RFI Number: 72067424RFI00005

Date of Issue: March 12, 2024

Closing Date for Responses: April 12, 2024

(09:00AM Pretoria, South Africa Time)

Responses to be submitted to: pretoriaapplications@usaid.gov

Subject: USAID Gauteng Provincial Care and Treatment Activity

To: All Interested Respondents/Parties/Organizations:

The United States Government, represented by the United States Agency for International

Development (USAID) at its Mission in Southern Africa through the Bilateral Health Office (BHO) is publishing this Request for Information to obtain information and input from all interested entities, US and non-US organizations, on its potential future Gauteng Provincial Care and Treatment

Activity. The information will be used to help make planning decisions and may inform activity design to improve future development outcomes.

This Request for Information (RFI) is issued solely for information gathering purposes and is published in accordance with FAR Part 10 and FAR 15.201(e).

Specifically, through this Request for Information (RFI), issued to collect expert industry inputs solely for information-gathering and planning purposes, USAID seeks to enhance the design of the subject Activity. This RFI does not constitute a Notice of Funding Opportunity (NOFO) or a

Request for Proposals (RFP). Responses to this RFI are not applications or official proposals and will in no way be deemed to form any binding agreement with the RFI issuing authority. Please do not submit applications, proposals, resumes or promotional materials, as they will be discarded.

Proprietary information should not be sent. USAID may use any information provided without incurring any obligation. USAID reserves the right to, or not to incorporate any, some, or none of the comments received from this RFI into any subsequent solicitations or design documents.

Anticipated Term: TBD

Proposed Mechanism(s) Type: TBD

Responses to this RFI should be submitted to USAID via email to pretoriaapplications@usaid.gov with subject line “72067424RFI00005: USAID Gauteng Provincial Care and Treatment Activity” no

72067424RFI00005

USAID Gauteng Provincial Care and Treatment Activity later than the date and time stated above.

Only electronic submissions will be accepted. Responses to this RFI must be written in English.

Respondents will only receive an electronic confirmation acknowledging receipt of your response but will not receive individualized feedback on any suggestions. Questions regarding this announcement will not be accepted or answered. Not responding to this request does not preclude participation in any future solicitation, if any is issued. No basis for claims against the U.S.

Government shall arise as a result of a response to this request for information or from the U.S.

Government’s use of such information.

Standard Provision: FAR 52.215-3 Request for Information or Solicitation for Planning Purposes

(OCT 1997)

(a) The Government does not intend to award a contract on the basis of this request or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18 Bid and Proposal Costs, of the Federal Acquisition Regulation.

(b) Although “proposal” and “offeror” are used in this Request for Information, your response will be treated as information only. It shall not be used as a proposal.

(c) This request is issued for the purpose of obtaining information related to a potential Gauteng

Provincial Care and Treatment Activity.

This RFI will not be construed as a commitment by the U.S. Government to issue any solicitation, award any grant, or pay for any information submitted as a result of this request. Responders are solely responsible for bearing all expenses associated with preparation and submission of the response to this RFI.

It should be noted that responding to this RFI will not give any advantage to any organization in any subsequent procurement. Any information submitted in response to this notice is voluntary.

Thank you for your interest in USAID programs and we look forward to your responses.

Sincerely, Kerry West

Contracting/Agreement Officer

USAID/Southern Africa

Request for Information

USAID/Southern Africa

Bilateral Health Office (BHO)

USAID Gauteng Provincial Care and Treatment Activity – Request for Information

PURPOSE:

The purpose of this RFI is to solicit feedback on the technical design of a new Activity and notify the community that USAID/SA is interested in identifying local organizations in Gauteng that may have the institutional capacity to implement the conceptual program or components of the program described in this RFI. It is not to be construed as a commitment that any future solicitations in this area will be limited to local organizations.

Submissions in response to this RFI will be used to:

1) Refine the design of the Activity to validate our current assumptions and gain a better understanding of what is needed to close the gap to HIV/TB epidemic control while building a resilient health system and leveraging community, civil society, and private sector partnerships;

and

2) Identify qualified South African organizations with institutional capabilities and/or potential to implement either a broad range of technical interventions or a specific “niche” area of technical interventions in support of achieving HIV epidemic control in Gauteng. This RFI aims to further advance work at the provincial and district levels to achieve HIV and TB epidemic control. A provincial approach to epidemic control, in addition to work being done at the national level, is supported by the South African National Department of Health (NDoH) and reinforced through agreements between governments of the United States and South Africa as part of the President’s Emergency Plan For AIDS Relief (PEPFAR) Country Operational Planning process.

Respondents are not obligated to provide answers to all questions. They are encouraged to only provide answers to questions where they have experience or where they are confident that their response will add value to USAID/Southern Africa to achieve its purpose regarding this RFI.

The subject RFI has two (2) parts which are as follows:

I) Narrative Statement – This refers to responses to any or all of the eight questions below regarding the attached Activity’s Conceptual Results Framework and its three conceptual objectives; and

II) Capabilities Statement – Which describes the experiences of South African organizations in the Gauteng Province, indicating their institutional capacity to potentially be able to implement a program or components of a program as conceptually described in this RFI.

BACKGROUND:

The conceptual goal of this USAID/Southern Africa Provincial HIV/TB Care and Treatment Activity in Gauteng is to support healthy lives for the population of South Africa by achieving and sustaining HIV epidemic control through locally-led solutions that enable access to equitable health care. The Activity is in support of and aligned with the four goals of the South Africa National Strategic Plan (NSP) 2023-2028 and achievement of the UNAIDS “95-95-95” targets. In December 2020, UNAIDS released a new set of ambitious targets calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy, and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025.

The Activity reflects the urgency to accelerate and broaden the reach of a comprehensive HIV and TB response within the wider primary and public health systems, and to progressively transition toward long-term ownership and sustainability of this response. The Activity will be tailored to address health systems challenges at the provincial and district levels. In Gauteng, the Activity will also align to the most recent Provincial Implementation Plan on HIV, AIDS, and Tuberculosis. The plan prioritizes a provincial data-driven response to these epidemics through general direct service delivery, technical assistance, and targeted programs that enhance, amongst other things, quality improvement, differentiated models of care (DMOC), and other interventions designed to address health needs in a constrained budget setting.

This Activity aims to: 1) close the gaps to HIV epidemic control; 2) sustain health gains by strengthening and improving resilient health systems that align to broad provincial priorities; and

3) leverage community, civil society, and private sector partnerships to improve service delivery and client outcomes. Each component is interlinked to achieve the overall goal.

The Activity’s Conceptual Results Framework is found in Attachment 1. The following describes the three conceptual objectives under the Activity.

Objective 1: Close the gaps to HIV epidemic control.

The main goal of this objective is to achieve population-based viral suppression among PLHIV and to prevent further transmission of the virus, so that the total number of new HIV infections falls below the total number of deaths from all causes among people living with HIV (PLHIV). South Africa has the largest HIV epidemic in the world, with an estimated 7.8 million PLHIV and 5.2 million on anti-retroviral therapy (ART). This reflects an overall HIV prevalence of 12.7% of its population of 61 million people according to the latest census data. While incidence is declining each year, the HIV burden in South Africa continues to grow and has not reached epidemic control.

National progress toward the 95-95-95 goals for the total PLHIV population is 90-91-94 as of the 2022 Sixth South African National HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI).

Nationally, challenges across the cascade remain. In the 27 high-HIV burden districts currently supported by PEPFAR, the Second 95 remains a critical gap: All but three districts nationally—including four of the five metro areas—have achieved the first 95, while none have achieved HIV treatment coverage of 95%.

In Gauteng, HIV prevalence among adults aged 15 years and older is estimated to be 15% as of the SABSSM VI. This figure remains largely unchanged since 2017. The SABSSM VI survey estimates Gauteng’s viral load suppression (<1,000 copies/ml) among PLHIV aged 15+ to be at 79%. Complex barriers to quality health care, client psychosocial barriers, treatment hesitancy, and other challenges lead to failed treatment initiations and treatment interruptions.

This objective aims to close the gap to HIV epidemic control through simplified, client-centered HIV and TB prevention and treatment models, including high-quality, client-tailored differentiated services implemented in a comprehensive manner for all age and sex bands in both communities and health facilities.

Objective 2: Sustain health gains through strengthened and more resilient health systems.

As South Africa progresses toward HIV epidemic control and elimination of TB, the management of HIV as a chronic condition, and TB as a curable infectious disease, will require a health system that is impactful, responsive and adaptive to changing health needs, and well-financed and efficiently managed. Access to care must be equitable and affordable, and the necessary systems for planning for such access must be functioning. This objective supports building health systems that will maintain and sustain HIV and TB epidemic control over time, and will be resilient in the face of system-wide shocks, such as emergent infectious disease outbreaks. The objective will also address and support Gauteng’s near-term policy priorities and the national priority to shift to a national health insurance system. This objective will focus specifically on human resources for health, essential medicines and commodities, health information systems, data use for decision making, policy and guideline implementation, and effective governance and management systems at the provincial and district levels.

Objective 3: Leverage community, civil society, and private sector partnerships to improve service delivery and client outcomes.

USAID is committed to improving the underlying drivers and socio-economic determinants that currently limit service delivery and negatively affect health outcomes of our clients in Gauteng. To do so, this objective requires the strengthening of indigenously-led innovation, leadership, and implementation to improve the accessibility, quality and impact of sustained HIV and TB care.

Enhancing partnerships with community groups, PLHIV-led organizations, civil society, and the private sector is key to ensure the sustained engagement and leadership of these key stakeholders in the province’s HIV and TB programming. Ending the HIV and TB epidemics, and sustaining those achievements, will require a whole-of-government and multi-sectoral approach with stakeholders particularly at provincial and district levels to ensure locally-relevant and co-owned innovations.

SPECIFIC QUESTIONS INTO WHICH USAID SEEKS INPUT:

The following are questions to solicit information to refine the design of the Activity, to obtain feedback on USAID current assumptions and gain a better understanding of what is needed to close the gap to epidemic control while building a resilient health system and leveraging community, civil society and private sector partnerships:

Achieving Epidemic Control

1. Describe the top three major impediments and/or development challenges of the HIV/TB epidemic within the holistic health system at the provincial, district, and sub-district levels that are preventing the achievement of epidemic control for the population in Gauteng, and specifically for sub-populations that are lagging according to the latest HIV cascade data? Please define the problem statement for each impediment.

2. What are context-specific interventions that would be transformative in reaching epidemic control in Gauteng overall, and/or for sub-populations that are lagging according to the latest HIV cascade data?

3. What are opportunities to expand treatment options and support networks beyond health clinics, particularly through existing community systems (e.g., faith-based organizations, migrant support groups), indigenous groups (e.g., traditional healers, community, and home-based care networks), and PLHIV-led organizations, and how would these opportunities be activated for the sustainable achievement of epidemic control in Gauteng?

Partnership with the Government of South Africa

4. What different ways of working would be needed to ensure an effective partnership with Provincial and District Departments of Health in order to align with the Gauteng Provincial Implementation Plans on HIV, AIDS, and Tuberculosis? What would be the measure(s) of success?

5. What would be the most effective approach to leverage GoSA structures outside of the Department of Health to promote a comprehensive HIV response?

Community, Civil Society and Private Sector Involvement

6. What innovations and opportunities exist to engage and empower community, civil society, and private sector partners to improve service delivery and client outcomes, including those that address the social determinants of health that impact client retention in care?

What would be the measure(s) of success?

7. What are the hurdles across Gauteng to including more community-based, indigenous partners in the program for achieving epidemic control and a sustainable health system?

What are ways to overcome those hurdles?

Other:

8. What changes would you make on the proposed scope and technical approach to assure improved health outcomes for all sub-populations and sustained HIV and TB epidemic control?

INSTRUCTIONS FOR RESPONDING TO THE RFI:

1) Part I - Narrative Statements:

Respondents are not requested to respond to all eight questions listed under the Section entitled

“SPECIFIC QUESTIONS INTO WHICH USAID SEEKS INPUT”.

Respondents are requested to select and tailor which of the eight questions they respond to based on areas where they have the most useful insights and expertise to provide USAID/SA with information to achieve the purpose of the RFI. Response to Part I “Narrative Statements” shall be submitted electronically in the English language in writing specified by the due date and time indicated on the cover page not to exceed eight (8) pages using a 11-point font size, single spaced, 1-inch margin. Please indicate each question in your response using the correct number from the list.

2) Part II - Capabilities Statement:

Respondents are requested to send an additional two(2) page (11-point font size, single spaced, 1-inch margin) capabilities statement which describes their experience, specifically in the Gauteng Province, indicating their institutional capacity to implement a program or components of a program as conceptually described in this RFI.

Please note, this one-page statement should include all the following information:

● Technical capacity to successfully provide assistance in one or more component(s) of the RFI (respondents may respond to one or multiple components based on their expertise);

● Understanding the PEPFAR program and the unique context of the operational environment in South Africa in dealing with HIV/AIDS;

● Experience in implementing PEPFAR-supported programs;

● Corporate experience managing multi-million-dollar annual budgets;

● Organizational capacity to oversee human resources, finances, subcontracts, logistics and donor relations; and

● Existing or potential membership or participation in associations, consortiums, and partnerships (local, regional, or global) in the HIV/ AIDS/ TB health sector.

For more information about USAID/SA, please refer to: https://www.usaid.gov/south-africa https://www.usaid.gov/south-africa

Attachment 1: Illustrative Conceptual Results Framework of the USAID Provincial Care and Treatment Activity