cdc-rfa-ck-26-0230_v3 mod_for posting.pdf

Notice of Funding Opportunity

Application due Wednesday, September 30, 2026

Division of Foodborne, Waterborne and Environmental Diseases (DFWED) Mycotic Diseases Branch (MDB)

Advancing Global Capacity to Detect and Respond to Fungal Diseases Opportunity number: CDC-RFA-CK-26-0230

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Agency priorities 10

Program description 13

Step 2: Get Ready to Apply 39

Get registered 40

Find the application package 41

Help applying 41

Join the informational call 42

Step 3: Build Your Application 43

Application checklist 44

Application contents and format 46

Step 4: Understand Review, Selection, and Award 55

Application review 56

Award notices 58

Step 5: Submit Your Application 59

Submission requirements and deadlines 60

Step 6: Learn What Happens After Award 61

Post-award requirements and administration 62

Contacts and Support 67

Before you begin 3

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up to date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on Wednesday, September 30, 2026.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 8

Agency priorities 10

Program description 13

Basic information Centers for Disease Control and Prevention (CDC)

Division of Foodborne, Waterborne and Environmental Diseases (DFWED)

Mycotic Diseases Branch (MDB)

Detecting and responding to fungal disease threats around the globe more quickly and effectively.

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name:

Advancing Global Capacity to Detect and Respond to Fungal Diseases

Opportunity number:

CDC-FRA-CK-26-0230

Assistance listing:

93.318

NOFO version: Original

Key dates

Application submission deadline:

September 30, 2026

Informational call:

August 4, 2026

Expected award date:

December 2026

Expected start date:

January 2027

See Submit Your Application for other time frames that may apply to this NOFO.

Summary This funding opportunity will help strengthen sustainable systems that countries use to identify and control fungal disease threats. Activities supported may include:

• Strengthening laboratory and diagnostic capacity.

• Enhancing surveillance systems.

• Supporting workforce development.

• Improving data collection, analysis, and use to guide public health action.

Projects are expected to:

• Build on existing national and regional public health structures.

• Promote practical approaches that countries can sustain and integrate into broader communicable disease and public health programs.

Ideally, this work will strengthen national and regional capacity to detect, characterize, and respond to fungal diseases and improve coordination across sectors and borders.

Strengthened systems will help countries better understand fungal disease patterns, identify emerging threats earlier, and carry out public health interventions quickly and effectively.

Over time, these efforts are intended to:

• Improve how quickly countries detect and respond to fungal threats.

• Reduce the global burden of fungal diseases.

• Strengthen global health security.

• Reduce the risk of spreading diseases internationally, including to the United States.

Step 1: Review the Opportunity 5

Funding details Funding type: Cooperative agreement

Expected awards: 10

Period of performance: Five years in 12-month budget periods.

Expected total program funding over the performance period:

$15,000,000

Estimated average award per applicant over the period of performance:

$1,250,000

Expected funding per applicant per 12-month budget period:

$100,000 to $1,000,000

The number of awards is subject to available funds and program priorities.

Funding strategy This NOFO is a cooperative agreement with two components. This funding strategy is designed to allow you to carry out your program and rapidly respond to new public health needs, if and when they emerge.

Funding will be provided for an initial 12-month budget period. Continued funding in future budget periods will depend on the availability of funds, your performance, and program priorities.

This NOFO includes two components:

Component 1 – Core Capacity Strengthening (required) You must apply for Component 1.

Component 1 will support activities that strengthen sustainable systems for fungal disease detection, diagnosis, surveillance, and response. These activities are expected to improve surveillance, laboratory capacity, workforce development, and data use. Over time, the goal is to build national and regional capacity to identify fungal disease threats sooner and respond effectively.

We anticipate making multiple awards under this component.

Step 1: Review the Opportunity 6

Component 2 – Emerging Public Health Needs and Rapid Response (optional) Component 2 is optional. It supports urgent public health actions, such as investigating outbreaks, conducting targeted surveillance for emerging fungal pathogens, and responding to antifungal-resistant threats.

You may include Component 2 in your application if you anticipate conducting activities related to emerging or evolving fungal disease threats.

If your application meets technical and programmatic requirements for this component, it may be approved but unfunded (ABU). (CDC expects to only fund Component 1 activities at the time of the initial award.) CDC may fund Component 2 activities if additional funding becomes available or if emerging fungal disease threats require a rapid public health response, during the period of performance.

Alternatively, you may submit proposals for Component 2 during the project period if new public health needs arise and additional funds become available.

Step 1: Review the Opportunity 7

Eligibility Eligible applicants Only these types of organizations may apply.

• State governments.

• County governments.

• City or township governments.

• Special district governments.

• Independent school districts.

• Public and state-controlled institutions of higher education.

• Native American tribal governments (federally recognized).

• Public housing authorities and Indian housing authorities.

• Native American tribal organizations, other than federally recognized tribal governments.

• Nonprofits having a 501(c)(3) status, other than institutions of higher education.

• Nonprofits without 501(c)(3) status, other than institutions of higher education.

• Private institutions of higher education.

• For-profit organizations other than small businesses.

• Small businesses.

• Ministries of health.

• Bona fide agents applying on behalf of state, territorial, local, and tribal government organizations.

Bona fide agents must submit documentation that demonstrates their arrangement with the eligible applicant. See attachments.

Responsiveness criteria We will review your application to make sure it meets these requirements.

These are the basic requirements you must meet to move forward in the competition. We won’t consider an application that:

• Is from an organization that doesn’t meet all eligibility criteria. See requirements in eligibility.

• Is submitted after the deadline.

Step 1: Review the Opportunity 8

• Proposes research activities. See the definition of research.

• Does not include Component 1 (Core Capacity Strengthening). If you only request funding for Component 2, your application will be considered non-responsive.

• Combines activities or budgets for both components within a single work plan or budget. You must include a separate work plan and budget for each component.

• Is submitted without all the requirements in the application checklist.

• Exceeds page limits or formatting requirements specified in the NOFO.

See the application checklists to understand which elements of your application are part of the responsiveness criteria.

Application limits You must follow these limits on the number of applications your organization can submit.

Under this NOFO, you may submit only one application under your organization’s UEI.

Cost sharing and matching funds This program has no cost-sharing requirement, meaning you do not need to contribute to the costs of this project.

If you choose to include cost-sharing funds, we won’t consider it during review. If you receive an award, we will include your voluntary commitment in the award, and you must report on the funds.

Post-award requirements

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 9 https://www.cdc.gov/grants/additional-requirements/ar-31.html

Agency priorities Required alignment with CDC priorities The recipient of this award must implement any funds awarded under this NOFO to effectuate program goals or agency priorities in accordance with the Centers for Disease Control and Prevention (CDC) Priorities when authorized (for a full description of the CDC Priorities, please follow the provided hyperlink).

Funded activities must:

• Align with CDC’s core priorities by demonstrating a commitment to gold-standard science, transparency, and evidence-based practices.

• Support CDC’s mission to protect Americans from infectious and chronic diseases, strengthen public health systems, and advance innovation in health data and infrastructure.

• Contribute to rapid, science-driven responses to health threats, promote global health leadership, and adhere to principles of integrity, accountability, and compliance with applicable laws and federal priorities.

Consistent with CDC’s values, in carrying out any project funded under this NOFO, the recipient must adhere to the following principles where consistent with the authority and scope of the award and its activities:

• A commitment to gold-standard science and ensuring trust, transparency, and credibility: To build trust and improve CDC’s ability to lead during health crises, CDC will increase transparency, be more accountable, and follow strict, gold-standard scientific practices that are open, unbiased, and based on clear evidence.

• A commitment to global leadership: With staff in 63 countries and supporting 20 more, CDC’s Global Health Center:

◦ Works to prevent disease and advance emergency response.

◦ Detect health threats early, sends response teams, trains health workers, and provides personal protective equipment, vaccines, and medicines.

◦ Test disease samples from around the world to prepare for flu and other serious outbreaks.

◦ Has strengthened systems to better protect people at home and abroad after the COVID-19 outbreak.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 10 https://www.cdc.gov/about/cdc/index.html

• A commitment to ensuring rapid, evidence-based responses to crises:

During public health emergencies, ensuring rapid, science-driven responses is critical to minimizing harm, maintaining public trust, and restoring stability. To achieve this goal, CDC must continue to strengthen its emergency response systems by:

◦ Streamlining internal processes.

◦ Improving risk communication strategies.

◦ Ensuring that laboratory capacity is fully equipped and tested—capable of rapidly developing and deploying scalable diagnostics during crises.

◦ Embedding structures for real-time learning, independent after-action reviews, and the application of lessons learned will ensure that each crisis response is smarter, faster, and more effective than the last.

• A commitment to vaccine safety and efficacy research: CDC will apply “gold-standard” science to all of its vaccine safety and effectiveness research. It will make vaccine data, research methods, and related datasets publicly available through simple data use agreements to improve transparency, accountability, and trust.

• A commitment to advancing our understanding of the causes of autism spectrum disorder (ASD), neurodevelopmental disorders (NDDs), and chronic disease: CDC conducts research and works with partners to better understand the causes of autism spectrum disorder, neurodevelopmental disorders, and chronic diseases. It will use new and existing data to study the rise in these conditions, including the increase in autism diagnoses from 1 in 150 to nearly 1 in 31 over the past 25 years.

• A commitment to modernizing public health infrastructure and enhancing our approach to health data: CDC will modernize public health infrastructure to create a faster, more efficient health system that can detect and respond to outbreaks in real time. This effort includes:

◦ Replacing data silos with integrated systems.

◦ Using advanced technology.

◦ Strengthening partnerships with states to ensure shared responsibility and strong local health data systems.

◦ Emphasizing collaboration across federal and state partners, resilient and adaptable systems, and accountability for funded programs to ensure they align with these priorities and federal requirements.

Step 1: Review the Opportunity 11

• Conflicts of interest: CDC will not support funding programs with conflicts of interest and ensure its work is based on transparent, unbiased science.

• Immigration: CDC funds will not be used to support or encourage illegal immigration, consistent with federal law.

• Protecting life and the family: CDC funds will not be used to support elective abortions, consistent with the Hyde Amendment, and will promote maternal health, the dignity of life, and strong families.

• Ending disorder on America’s streets: CDC will not support evidence-based programs that reduce homelessness, drug use, and public disorder. It will support comprehensive services for people with serious mental illness and substance use disorder. CDC will not support housing-first strategies, harm-reduction or safe consumption sites, or related activities. To the extent allowable by federal law, CDC intends to give priority to grantees in States and municipalities that have laws and policies that support and enforce CDC’s priorities.

• Gender ideology and protecting children [PDF]: CDC will not fund medical interventions for minors seeking gender transition and will define sex based on biological criteria.

• DEI: CDC will not support DEI initiatives based on group identity and focus on merit-based, evidence-driven approaches to improve health outcomes.

• Parental rights: CDC will support policies that protect parental authority, promote transparency, and give parents greater control over their children’s education.

The recipient must demonstrate ongoing compliance with the full description and listing of CDC values and priorities, in all programs that are authorized to advance them, through program design, implementation, reporting, and evaluation.

Failure to meaningfully align funded activities with the applicable requirements may result in corrective action, additional reporting requirements, or other enforcement actions consistent with federal grant regulations found at 2 CFR part 200 and the terms and conditions of this award. The full CDC Priorities Statement can be found here: Centers for Disease Control and Prevention (CDC) Priorities.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 12 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf

Program description Background Fungal diseases are an important and often underrecognized global public health threat. Many infections go undetected or are misdiagnosed. This contributes to preventable illness, death, disease transmission, and the emergence of antifungal resistance. Limited data and surveillance systems also limit understanding of the true burden of fungal diseases.

In recent years, transmissible and antifungal-resistant pathogens, such as Candida (Candidozyma) auris and Trichophyton indotineae, have emerged and spread across multiple regions of the world, including the United States.

Outbreaks of invasive mold infections and zoonotic infections, such as sporotrichosis, have affected both immunocompromised and immunocompetent populations globally.

Gaps in laboratory capacity, surveillance systems, public health workforce, and data use prevent countries from being able to quickly detect and respond to diseases. These gaps allow fungal pathogens to spread, increase the risk of antifungal resistance, and contribute to cross-border transmission.

Related work

National center for emerging and zoonotic infectious diseases The National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) works domestically and internationally to prevent illness, disability, and death caused by infectious diseases. By partnering globally, NCEZID supports countries with work that strengthens surveillance systems, laboratory capacity, and public health workforce capability to detect and respond to emerging infectious disease threats. These efforts contribute to global health security and improve early detection of pathogens that could affect the United States.

Division of foodborne, waterborne, and environmental diseases Within NCEZID, the Division of Foodborne, Waterborne, and Environmental Diseases (DFWED) and its Mycotic Diseases Branch (MDB) lead CDC’s work to prevent and control fungal diseases. MDB collaborates with ministries of

Step 1: Review the Opportunity 13 health, public health institutes, academic institutions, and international partners across regions including the Americas, Africa, and Asia. Together, we work to strengthen fungal disease surveillance, improve diagnostic capacity, and support public health response to emerging fungal threats. MDB also provides specialized laboratory reference services, technical assistance, and outbreak response support to public health laboratories and health authorities in the United States and globally.

CDC’s global fungal work focuses on improving the detection and management of serious fungal infections that are frequently underdiagnosed or misdiagnosed. Fungal diseases contribute to substantial illness and death worldwide, particularly among people with weakened immune systems.

Improving surveillance, diagnostic testing, and clinical awareness is critical to reducing the burden of fungal diseases and improving patient outcomes.

Global fungal disease surveillance and capacity Through the Global Fungal Disease Surveillance and Capacity cooperative agreement, CDC and partners have worked to strengthen the foundational public health systems that detect and respond to fungal diseases globally.

Activities supported through this cooperative agreement have included:

• Expanding fungal disease surveillance.

• Strengthening laboratory diagnostic capacity.

• Providing training and technical assistance to healthcare providers, laboratorians, and public health professionals.

These efforts have improved countries’ abilities to detect fungal infections, characterize disease burden, and respond to emerging fungal threats.

The cooperative agreement has also supported efforts to improve the detection and management of fungal diseases such as cryptococcal meningitis and histoplasmosis. In particular, among people living with HIV and other immunocompromising conditions who are at increased risk of severe disease and death. In addition, partners have helped strengthen laboratory detection and public health response to emerging fungal pathogens, including Candida [Candidozyma] auris. This fungus is resistant to many drugs, has rapidly spread worldwide, and poses an increasing public health threat.

Together, these efforts have helped strengthen global capacity to detect and respond to fungal diseases and improve understanding of fungal disease epidemiology. Ultimately, they make sure we’re ready to address emerging fungal threats that may pose risks to global and U.S. public health.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 14 https://simpler.grants.gov/opportunity/ea34baeb-d066-4a89-9ee8-da320bfa09e8 https://simpler.grants.gov/opportunity/ea34baeb-d066-4a89-9ee8-da320bfa09e8

Purpose This NOFO supports activities to strengthen sustainable systems to detect and respond to fungal diseases globally. You’ll work to improve surveillance, laboratory capacity, workforce development, and data use to:

• Enhance early detection of fungal threats.

• Improve public health responses.

• Reduce preventable illness and death from fungal diseases that can impact public health nationally and globally.

Approach Overview This NOFO seeks to strengthen countries’ abilities to detect, characterize, and respond to fungal disease threats more quickly and effectively. In many regions, gaps in laboratory capacity, surveillance systems, public health workforce, and effective data use delay disease detection and response. This allows fungal pathogens to spread and increases the risk of antifungal resistance and cross-border transmission.

Approach To address these gaps, this NOFO will support activities that strengthen sustainable systems for fungal disease detection, diagnosis, surveillance, and response. The approach focuses on:

• Strengthening laboratory and surveillance capacity.

• Supporting workforce development.

• Improving the use of data to inform public health action.

Components This NOFO includes two components.

Component 1 — Core Capacity Strengthening (required)

This component will support activities that strengthen surveillance systems, laboratory and diagnostic capacity, workforce development, and data use for fungal disease detection and response.

Step 1: Review the Opportunity 15

Component 2 — Emerging Public Health Needs and Rapid Response (optional)

This component will address emerging fungal disease threats, such as outbreaks, unexpected increases in cases, or the emergence of antifungal-resistant pathogens.

Program logic model The following logic model includes the strategies and activities allowed under this NOFO.

The logic model also includes the program’s expected outcomes. Outcomes are the results that you intend to achieve. They usually show the intended direction of change, such as increase or decrease.

Not all outcomes apply to all strategies. The table shows how they apply. You will use these outcomes as a guide for developing performance measures.

Table: Strategies and outcomes

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 1:

Strengthen fungal disease surveillance systems

• Establish or expand surveillance systems.

• Assess surveillance systems and available data to identify gaps and inform future assessments of fungal disease burden.

• Strengthen surveillance reporting and data systems.

• Increased recognition of fungal diseases as a public health priority.

• Improved epidemiologic capacity to monitor fungal diseases.

• Improved understanding of surveillance system gaps and data availability.

• Functional surveillance systems for fungal diseases.

• Improved detection of emerging fungal threats and antifungal resistance.

• Improved ability to characterize fungal disease patterns and trends.

• Sustainable national and regional surveillance systems capable of detecting fungal disease trends and emerging threats.

Step 1: Review the Opportunity 16

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 2:

Strengthen laboratory and diagnostic capacity

• Expand access to fungal diagnostics.

• Improve laboratory identification and characterization of fungal pathogens.

• Strengthen laboratory networks and antifungal resistance detection.

• Improved laboratory capacity to detect and identify fungal pathogens.

• Increased laboratory workforce skills and training.

• Improved diagnostic practices and laboratory systems.

• Enhanced detection of antifungal resistance and emerging fungal pathogens.

• Sustainable laboratory systems supporting fungal disease detection, surveillance, and resistance monitoring.

Strategy 3:

Strengthen workforce capacity and partnerships

• Provide training and technical assistance to laboratorians and clinicians.

• Develop tools, guidance, and training resources.

• Strengthen national and regional partnerships.

• Increased awareness of fungal diseases among clinicians and public health professionals.

• Improved workforce knowledge and technical skills.

• Improved clinical and public health practices for fungal disease detection and management.

• Strengthened regional partnerships supporting fungal disease activities.

• Sustainable workforce and regional capacity to prevent, detect, and respond to fungal diseases.

Strategy 4:

Strengthen data use and outbreak

• Improved capacity to analyze and

• Increased use of surveillance and laboratory data to

• Reduced illness and death associated with fungal diseases

Step 1: Review the Opportunity 17

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes detection and response

• Strengthen data analysis and interpretation capacity.

• Promote coordination across surveillance, laboratory and clinical partners.

• Support detection and response to fungal disease outbreaks.

interpret fungal disease data.

• Increased collaboration across surveillance laboratory, and clinical sectors.

guide public health action.

• Improved timeliness of outbreak detection and response.

and improved clinical outcomes.

Strategy 5:

Strengthen monitoring, learning, and program improvement.

• Track implementation of strategies and activities to inform program adjustments.

• Use data and findings to guide decision-making and improve program activities.

• Strengthen systems to support ongoing learning and program improvement.

• Improved ability to monitor program activities and use data for decision-making.

• Increased availability of program performance data.

• Improved program effectiveness through data-informed adjustments.

• Sustainable use of data to guide program improvement and strengthened fungal disease prevention, detection, and response efforts.

Step 1: Review the Opportunity 18

Component 2 is designed to address emerging fungal disease threats that may not be known before this NOFO is released. Because activities may vary based on need, timing, and scope, this component allows a more flexible logic model approach. Applicants must still ensure that activities align with and support the overall outcomes in this NOFO logic model.

Strategies and activities This section elaborates on the strategies and activities described in the logic model and provides details about how we expect you to implement your program.

The activities listed with each strategy are examples that contribute to the outcomes in the logic model. You may include activities that are different from or beyond these. But the activities you propose must align with:

• At least one strategy described in the logic model.

• Your organizational capacity, country context, existing public health infrastructure, public health priorities or needs, and opportunities for collaboration with national and regional partners.

You’re not expected to implement all strategies and activities at the same time. As your capacity develops over the five-year period of performance, you’re expected to strengthen and expand activities across strategies to support progress toward the outcomes.

Step 1: Review the Opportunity 19

Strategy 1: Strengthen fungal disease surveillance systems If you propose activities under this strategy, describe how they’ll strengthen surveillance systems and improve the availability and use of fungal disease data for public health action.

Activities may include those in the logic model:

• Establish or expand surveillance systems for fungal diseases.

• Assess existing surveillance systems, laboratory capacity, and available data to identify gaps and inform future assessments of fungal disease burden.

• Strengthen surveillance data collection, reporting systems, and data quality.

You may also opt to:

• Support integration of fungal disease surveillance into existing surveillance platforms or public health information systems.

• Facilitate collaboration among ministries of health, public health institutes, healthcare facilities, laboratories, and other partners involved in fungal disease surveillance.

Strategy 2: Strengthen laboratory and diagnostic capacity If you propose activities under this strategy, describe how they’ll strengthen laboratory systems and improve the detection and characterization of fungal pathogens.

Activities may include those in the logic model:

• Expand access to fungal diagnostics.

• Improve laboratory identification and characterization of fungal pathogens.

• Support laboratory networks and antifungal resistance detection.

You may also opt to:

• Collaborate with national reference laboratories, clinical laboratories, and public health laboratories to strengthen diagnostic and laboratory capacity.

• Provide technical assistance related to laboratory diagnostics or fungal pathogen identification.

Step 1: Review the Opportunity 20

Strategy 3: Strengthen workforce capacity and partnerships If you propose activities under this strategy, describe how they’ll strengthen workforce capacity and support collaboration among organizations involved in fungal disease prevention, detection, and response.

Activities may include those in the logic model:

• Provide training and technical assistance to laboratorians and clinicians.

• Develop tools, guidance, and training resources.

• Strengthen national and regional partnerships.

You may also opt to:

• Provide training or educational opportunities for healthcare providers, laboratory professionals, and public health personnel.

• Support the development of regional expertise or centers of excellence related to fungal diseases.

Strategy 4: Strengthen data use and outbreak detection and response If you propose activities under this strategy, describe how they’ll strengthen the use of data for public health decision-making and support timely detection and response to fungal disease threats.

Activities may include those in the logic model:

• Strengthen data analysis and interpretation capacity.

• Promote coordination across surveillance, laboratory, and clinical partners to detect and respond to fungal disease outbreaks.

You may also opt to:

• Support systems that enable timely data-sharing among public health partners.

• Support outbreak detection, investigation, or response activities related to fungal diseases.

• Support public health interventions that reduce transmission or mitigate fungal disease threats.

Step 1: Review the Opportunity 21

Strategy 5: Monitoring, learning, and program improvement If you propose activities under this strategy, describe how they’ll track implementation, identify what is working, and adjust activities to improve program.

Activities may include those in the logic model:

• Track implementation of strategies and activities to inform program adjustments.

• Use data and findings to guide decision-making and improve activities.

• Strengthen systems that support ongoing learning and program improvement.

You may also opt to:

• Use findings to adapt activities during the project period.

• Identify effective approaches and apply them to strengthen implementation.

• Document lessons learned to support sustainability and future planning.

Outcomes This section includes information about the outcomes we expect you to report progress on and achieve within the performance period.

The extent to which you contribute to these outcomes will depend on the strategies and activities you propose and carry out, as well as country context and existing public health infrastructure.

Short-term outcomes Strategy 1: Strengthen fungal disease surveillance systems

• Increased recognition of fungal diseases as a public health priority.

You’re expected to reach public health authorities, clinicians, laboratory professionals, and other relevant stakeholders. This may include increased awareness of fungal diseases, and greater prioritization of detection, diagnosis, surveillance, and prevention activities within national or regional public health programs.

• Improved epidemiologic capacity to monitor fungal diseases.

This may include improved ability of public health institutions and partners to assess surveillance systems, identify gaps, and collect, manage, analyze, and interpret surveillance data related to fungal infections and outbreaks.

Step 1: Review the Opportunity 22

• Improved understanding of surveillance systems gaps and data availability.

This includes assessing existing surveillance systems, identifying gaps, and understanding available data to inform improvements in fungal disease detection and reporting.

Strategy 2: Strengthen laboratory and diagnostic capacity

• Improved laboratory capacity to detect and identify fungal pathogens.

This may include strengthening diagnostic capabilities, increasing access to laboratory testing, and improving laboratory systems that support fungal disease detection and characterization.

• Increased laboratory workforce skills and training.

The workforce includes laboratory personnel involved in fungal disease detection and identification. The outcome may include improved competencies related to laboratory diagnostics, fungal pathogen identification, and antifungal resistance detection.

Strategy 3: Strengthen workforce capacity and partnerships

• Increased awareness of fungal diseases among clinicians and public health professionals.

This may include improved understanding of fungal disease risk factors, diagnosis, treatment, and prevention.

• Improved workforce knowledge and technical skills.

This includes strengthened ability of healthcare, laboratory, and public health professionals to apply training, technical guidance, and knowledge in practice.

Strategy 4: Strengthen data use and outbreak detection and response

• Improved capacity to analyze and interpret fungal disease data.

This includes the capacity of public health partners to analyze and interpret fungal disease data from surveillance, laboratory, and other information systems to inform public health decision-making.

• Increased collaboration across surveillance, laboratory, and clinical sectors.

This includes improved coordination and collaboration among surveillance programs, laboratories, healthcare providers, and other partners involved in fungal disease detection and response.

Step 1: Review the Opportunity 23

Strategy 5: Monitoring, learning, and program improvement

• Improved ability to monitor program implementation and use data for decision-making.

This includes strengthening how programs track activities and use information to understand what is working and where improvements are needed.

• Increased availability and use of program data to guide improvement.

This includes improving how information is collected, organized, and used to adjust activities, strengthen implementation, and support program improvement over time.

Intermediate outcomes Strategy 1: Strengthen fungal disease surveillance systems

• Functional surveillance systems for fungal diseases.

This includes helping to establish or strengthen functional surveillance systems that can monitor fungal disease trends, identify surveillance gaps, and detect potential public health threats.

• Improved detection of emerging fungal threats and antifungal resistance.

This includes contributing to improvements in diagnostic practices and laboratory systems to detect fungal pathogens more accurately and quickly.

• Improved ability to characterize fungal disease patterns and trends.

Strategy 2: Strengthen laboratory and diagnostic capacity

• Improved diagnostic practices and laboratory systems.

• Enhanced detection of antifungal resistance and emerging fungal pathogens.

Strategy 3: Strengthen workforce capacity and partnerships

• Improved clinical and public health practices for fungal disease detection and management.

This includes contributing to improvements in clinical and public health practices to detect, diagnose, treat, and prevent fungal diseases.

• Strengthened regional partnerships supporting fungal disease activities.

Step 1: Review the Opportunity 24

Strategy 4: Strengthen data use and outbreak detection and response

• Increased use of surveillance and laboratory data to guide public health action.

This includes contributing to increased use of surveillance and laboratory data to inform public health decision-making, including prevention strategies, outbreak detection, and response activities.

• Improved timeliness of outbreak detection and response.

Strategy 5: Monitoring, learning and program improvement

• Improved program effectiveness through data-informed adjustments.

This includes using monitoring and learning findings to improve activities, strengthen implementation, and guide program decisions over time.

Long-term outcomes Strategy 1: Strengthen fungal disease surveillance systems

• Sustainable national and regional surveillance systems capable of detecting fungal disease trends and emerging threats.

This includes helping to strengthen, over time sustainable surveillance systems that support ongoing monitoring of fungal diseases and enable early detection of emerging threats.

Strategy 2: Strengthen laboratory and diagnostic capacity

• Sustainable laboratory systems supporting fungal disease detection, surveillance, and resistance monitoring.

This includes helping to strengthen laboratory systems that can reliably detect fungal pathogens, support surveillance activities, and identify antifungal resistance.

Strategy 3: Strengthen workforce capacity and partnerships

• Sustainable workforce and regional capacity to detect, prevent, and respond to fungal diseases.

This includes helping to strengthen the capacity of the public health workforce and partner organizations to coordinate and sustain their work to detect, prevent, and respond to fungal diseases.

Strategy 4: Strengthen data use and outbreak detection and response

• Reduced illness and death associated with fungal diseases and improved clinical outcomes.

This includes earlier detection of outbreaks, faster public health response, and improved use of data to guide actions that reduce illness and death.

Step 1: Review the Opportunity 25

Strategy 5: Monitoring, learning and program improvement

• Sustainable use of data to improve program implementation and outcomes.

This includes ongoing use of data to adjust activities, improve how programs are carried out, and strengthen fungal disease prevention, detection, and response over time.

Work plan You must provide a work plan for your project. The work plan connects your performance outcomes, strategies and activities, and measures. It provides more detail on how you will measure outcomes and processes.

Include a separate work plan for each component you’re applying for.

Table: Sample format

Activities you will implement

Progress or process measures

From the data, monitoring, and evaluation section.

Relevant period of performance outcomes

From the outcomes section.

Responsible position or party

Completion date

Strategy 1:

1.

2.

3.

Strategy 2:

1.

2.

3.

Step 1: Review the Opportunity 26

Data, monitoring, and evaluation CDC strategy CDC collects and reports on indicators to measure progress toward achieving the activities and outcomes. CDC will also use results for program planning, improvement, accountability, and reporting. CDC will share the results with key parties.

CDC will work with you throughout the life of an award to ensure that all activities and expected outcomes align with your strategies and goals, and those of the U.S. government.

You should dedicate some of award funds to evaluate and monitor the performance of your project. You and CDC will agree on the final funding amount, but we expect that you will dedicate approximately 5% to 10% of your project’s funding to monitoring, reporting, and evaluation activities.

CDC will collaborate with recipients to:

• Monitor how activities supported through this cooperative agreement are carried out.

• Assess progress toward achieving the expected outcomes described in the program logic model.

Within six months of award, CDC and recipients will finalize performance measures, reporting expectations, and monitoring approaches aligned with the strategies and outcomes described in this NOFO.

CDC may use multiple approaches to monitor program implementation and evaluate outcomes, including:

• Review of recipient progress reports and program documentation.

• Technical consultations with recipients.

• Analysis of programmatic, surveillance, or laboratory data related to fungal disease activities.

• Monitoring implementation and evaluating outcomes through routine program oversight, including site visits (virtual or in-person), as appropriate.

• Periodic program reviews and evaluation activities conducted in collaboration with recipients.

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CDC and recipients will use monitoring and evaluation findings to support continuous program improvement throughout the period of performance.

This may include identifying implementation challenges, adapting strategies and activities as needed, and sharing lessons learned with recipients and partners.

CDC may also conduct or support additional evaluation activities in collaboration with recipients to assess the effectiveness of strategies used to strengthen fungal disease detection, surveillance, and response capacity.

These evaluation activities may examine factors that facilitate or hinder implementation of fungal disease detection and response activities and identify approaches that support sustainable public health capacity.

Potential data sources for evaluation activities may include program reports, surveillance data, laboratory data, training records, or consultations with public health stakeholders.

Required performance measures This section describes the draft performance measures you will need to report on after award. We will likely refine the required measures for this program. If so, we will work with you and finalize them before we require you to submit any data.

If you’re funded under this NOFO, you’ll be required to collect and report information that allows CDC to monitor implementation of activities and assess progress toward program outcomes.

Performance measures will include both process measures (to monitor implementation of strategies and activities) and outcome measures (to assess progress toward achieving the outcomes identified in the logic model).

Examples of process measures may include:

• Implementation of surveillance-strengthening activities.

• Expansion or improvement of laboratory diagnostic capacity for fungal pathogens.

• Workforce training or technical assistance activities conducted.

• Development or dissemination of public health guidance, tools, or resources.

• Partnerships or collaborations established or strengthened to support fungal disease detection and response.

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Examples of outcome measures may include:

• Improvements in fungal disease surveillance systems.

• Strengthened laboratory capacity for detection and characterization of fungal pathogens.

• Increased knowledge and technical capacity among healthcare, laboratory, and public health professionals.

• Increased use of surveillance or laboratory data to inform public health action.

• Strengthened national or regional capacity to detect and respond to fungal disease threats.

If funded, you’ll be expected to submit periodic performance and progress reports describing implementation of activities and progress toward program outcomes.

Evaluation and performance measurement plan You must provide an evaluation and performance measurement plan. Use the measures required under the CDC strategy.

Include the following elements.

Methods Describe how you will:

• Collect the performance measures.

• Respond to the evaluation questions.

• Incorporate evaluation and performance measurement into planning, implementing, and reporting project activities.

• Use evaluation findings for continuous program quality improvement.

Additionally, explain:

• How key program partners will participate in the evaluation and performance measurement process.

• How feasible it will be to collect appropriate evaluation and performance data.

• How you will share evaluation findings with communities.

• Other relevant information, such as performance measures you propose.

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Data management plan For all public health data you plan to collect, you must have a data management plan (DMP). For a definition of “public health data” and more information about CDC’s policy on the DMP, see Data Management and Access.

Submit your DMP as part of your application using a narrative or checklist format. You may also use your organization’s format or adapt a publicly available template, such as the CDC Data Management Plan template.

Your DMO should include the following elements:

• The data you will collect or generate, and what its sources will be.

• Who can access data and how you will protect it.

• Data standards that explain what documentation the released data will have. That documentation should describe collection methods, what the data represent, and data limitations.

• Archival and long-term data preservation plans.

• Any reasons you cannot share data collected or generated under this award with CDC. These could include legal, regulatory, policy, or technical concerns.

• How you will update the DMP as new information becomes available over the life of the project. You will provide updates to the DMP in annual reports.

Evaluation activities You must take on specific evaluation activities. Describe:

• The type of evaluations you will complete, such as process, outcome, or both.

• Key evaluation questions these evaluations will address.

• Measures and data sources.

• Any other relevant information.

Submit an initial draft of your evaluation and performance measurement plan, including the DMP, with your application. You must submit a more detailed plan within the first six months of the award. See reporting.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

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Paperwork Reduction Act Any activities involving information collection from 10 or more individuals or organizations may require the Paperwork Reduction Act (PRA) approval. The PRA requires review and approval of the information collection by the White House Office of Management and Budget. To determine if a proposed activity requires PRA approval, contact your program contact.

Collections include items like surveys and questionnaires. If you have collections requiring PRA approval, CDC is responsible for working with OMB to gain the approval.

For more information about CDC’s requirements under PRA see CDC Paperwork Reduction Act Compliance.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 31 https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm#cdc_data_surveillance_section_1-cdc-paperwork-reduction-act-compliance https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm#cdc_data_surveillance_section_1-cdc-paperwork-reduction-act-compliance

Organizational capacity You must demonstrate the organizational capacity, technical expertise, partnerships, and administrative systems necessary to carry out the strategies and activities described in this NOFO and achieve the expected outcomes.

Describe your organizational capacity in the Project narrative.

Address the following:

Experience, skills, and abilities Describe your experience and capacity to:

• Carry out public health activities related to fungal disease detection, surveillance, laboratory strengthening, workforce development, or outbreak response.

• Collaborate with ministries of health, public health institutes, laboratories, healthcare systems, academic institutions, or regional networks.

• Carry out monitoring and evaluation activities that align with the expected outcomes.

• Conduct program planning, implementation, and performance monitoring.

• Analyze and use data to inform public health decision-making.

• Conduct health communication, dissemination, or workforce development activities.

• Manage procurement, contracts, or subawards as needed to carry out proposed activities.

If your organization doesn’t yet have fully established systems for fungal disease activities, demonstrate that you have a clear and feasible plan to strengthen capacity during the period of performance.

Program management and staffing Describe:

• A staffing plan. Identify the key personnel responsible for leadership, technical implementation, monitoring and evaluation, and administrative management.

• The project management structure and organizational placement of the project.

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• Roles and responsibilities for key personnel.

• Plans to fill vacant positions, if any.

You must be responsible for managing, overseeing, and carrying out the activities supported by this NOFO.