CDC-RFA-GH21-2180.pdf

Centers for Disease Control and Prevention

Center for Global Health

Global Noncommunicable Disease Prevention and Health Promotion

CDC-RFA-GH21-2180

08/13/2021

Table of Contents A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Application and Submission Information

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

Part I. Overview Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA- GH21-2180. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Global Noncommunicable Disease Prevention and Health Promotion C. Announcement Type: New - Type 1:

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52- 2.pdf. Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr- 46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-GH21-2180

E. Assistance Listings Number:

93.318 F. Dates:

1. Due Date for Letter of Intent (LOI):

N/A

2. Due Date for Applications:

https://www.grants.gov/ https://www.grants.gov/ https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html

08/13/2021 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

G. Executive Summary:

1. Summary Paragraph Worldwide, non-communicable diseases (NCDs) kill over 40 million people each year, representing 71% of the world’s deaths. More than 80 percent of NCD-related deaths are in low-and middle-income countries, where health systems are often not equipped to respond, and about 46% of those deaths occur before age 70. The enormous social and economic toll of NCDs worldwide calls for an integrated strategic approach to reduce illnesses and deaths due to NCDs globally.

The purpose of this NOFO is to promote health and prevent NCDs across the globe by supporting surveillance, capacity building, and implementation activities that focus on key NCD conditions and risk factors such as cardiovascular disease, diabetes, nutrition, maternal and infant health, and tobacco control.

This NOFO has a required component funding structure. Please refer to Funding Strategy section.

a. Eligible Applicants:

Single

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$ 185,710,000

e. Average One Year Award Amount:

$ 2,142,000

f. Total Period of Performance Length:

g. Estimated Award Date:

August 30, 2021

h. Cost Sharing and / or Matching Requirements:

No Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview Worldwide, noncommunicable diseases (NCDs) kill over kill over 40 million people each year, representing 71% of the world’s deaths. More than 80 percent of NCD-related deaths are in low-and middle-income countries, where health systems are often not equipped to respond, and about https://www.grants.gov/

46% of those deaths occur before age 70. The enormous social and economic toll of NCDs worldwide calls for an integrated strategic approach to reduce illnesses and deaths due to NCDs globally.

NCDs such as cardiovascular disease, cancer, diabetes, and chronic lung disease kill more people globally than infectious diseases. Several NCDs share the common risk factors of tobacco use, unhealthy diets, physical inactivity, and harmful use of alcohol, as well as high blood pressure and high cholesterol.

Surveys, surveillance, and monitoring for NCDs are crucial to provide countries with needed information to develop evidence-based prevention strategies, programs, and policies; to assess the progress and impact of these efforts; and to identify effective interventions for global dissemination and learning. The capacity to implement NCD surveillance varies greatly around the world and often is inadequate in low and middle-income countries (LMICs).

The purpose of this NOFO is to promote health, provide expertise and training to regions and countries across the globe to prevent and control NCDs, their risk factors, and related causes through effective programs in collaboration with the recipient.

Activities that address NCD prevention and control are outlined in program-specific funding opportunity descriptions. These programs include the following:

Component 1: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCT)

Component 2: Global Tobacco Control (Global Youth Tobacco Survey) Component 3: NCD Surveillance and the NCD Global Monitoring Framework and

Global Action Plan Component 4: Global Hearts Component 5: Global Maternal and Infant Emergency Response and Birth Defects

Prevention and Monitoring

Recipient will build on NCD prevention, surveillance and health promotion activities previously carried out under DP09-909, GH14-1420, and GH19-1954 cooperative agreements.

In addition to Core Global Health Security Priorities (Components 1-5), this NOFO will support additional activities when a disease outbreak or other public health emergency reaches a scale that requires a moderate (Component 6, Rapid Response to Small-Scale Infectious Disease Outbreaks or Other Public Health Emergencies) or substantial response (Component 7, Rapid Response to Large-Scale Infectious Disease Outbreaks or other Public Health Emergencies).

This NOFO also supports activities to combat COVID-19 and other emerging infectious disease threats (Component 8, Emerging Infectious Disease Threats [EIDT]). Applicants must apply to all components.

b. Statutory Authorities Section 307 of the Public Health Service Act [42 USC 242I] and Section 301(a) [42 USC 241(a)] of the Public Health Service Act.

c. Healthy People 2030 This project supports the following Healthy People 2030 topic areas:

Global Health Public Health Infrastructure Health Care Access and Quality Infectious Disease Emergency Preparedness

d. Other National Public Health Priorities and Strategies Activities funded through this cooperative agreement must align with the following United States Government (USG) and HHS/CDC strategies and policies:

CDC’s strategy for improving global health security (GHS), based on three concepts embedded in the agency’s mission to protect public health worldwide: 1) Prevent 2) Detect 3) Respond https://www.cdc.gov/globalhealth/security/index.htm The Department of Health and Human Services’ (HHS) Global Health Strategy https://www.hhs.gov/about/agencies/oga/about-oga/why-hhs-works-globally/hhs-global-strategy/index.html International Health Regulations (IHR) 2005 and supporting policies and frameworks https://www.who.int/topics/international_health_regulations/en/

e. Relevant Work Recipient will build on NCD prevention, surveillance and health promotion activities previously carried out under DP09-909, GH14-1420, and GH19-1954 cooperative agreements.

2. CDC Project Description

a. Approach Bold indicates period of performance outcome.

CDC-RFA-GH21-2180 Logic Model

Component 1: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCT) Strategies Short-Term

Outcomes Intermediate Outcomes

Long-Term Outcomes https://health.gov/healthypeople/objectives-and-data/browse-objectives/global-health https://health.gov/healthypeople/objectives-and-data/browse-objectives/public-health-infrastructure https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality https://health.gov/healthypeople/objectives-and-data/browse-objectives/infectious-disease https://health.gov/healthypeople/objectives-and-data/browse-objectives/emergency-preparedness https://www.cdc.gov/globalhealth/security/index.htm https://www.hhs.gov/about/agencies/oga/about-oga/why-hhs-works-globally/hhs-global-strategy/index.html https://www.hhs.gov/about/agencies/oga/about-oga/why-hhs-works-globally/hhs-global-strategy/index.html https://www.who.int/topics/international_health_regulations/en/

Strategy 1: Improve NCD/nutrition surveillance systems, tools, and protocols, and system implementation; support analysis and interpretation of NCD/nutrition surveillance data, and disseminate findings to stakeholders

Strategy 2: Improve NCD/nutrition training materials and learning platforms for public health workers to increase capacity to address NCDs/nutrition and associated risk factors

Strategy 3: Improve implementation of evidence-based NCDs/nutrition prevention, treatment, management, and control strategies

Increase evidence of vitamin and mineral status prevalence, trends, and country-level needs in LMICs

Strengthened surveillance and information systems

Increased implementation of effective strategies to prevent and control malnutrition

Development and availability of standard training tools and guidelines to address malnutrition

Improved nutrition surveillance and monitoring systems

Stronger data to use in setting nutrition priorities and decision making

Increased use of evidence-based guidelines, interventions, and programs

Strengthened and sustained global surveillance systems

Country leadership to demonstrate increased recognition that reducing NCDs and improved nutrition are critical public health priorities

Decrease in malnutrition, NCDs and NCD risk factors causing morbidity and mortality

Component 2: Global Tobacco Control (Global Youth Tobacco Survey) Strategies Short-Term Outcomes Intermediate

Outcomes Long-Term Outcomes

Strategy 1: Improve NCD/tobacco surveillance systems, tools, and protocols, and system implementation; support analysis and interpretation of NCD/tobacco surveillance data, and disseminate findings to stakeholders

Strategy 2: Improve NCD/tobacco training materials and learning platforms to increase capacity for public health workers to address NCDs/tobacco and associated risk factors

Strategy 3: Improve implementation of evidence-based NCD/tobacco prevention, treatment, management and control strategies

Strengthened NCD/tobacco surveillance and information systems

Development and availability of standard training tools and guidelines

Increased implementation of effective strategies to prevent and control NCDs

Enhanced local capacity for NCD/tobacco surveillance and monitoring, evaluation, and program implementation

Improved NCD/tobacco surveillance and monitoring systems

Stronger tobacco data to use in setting priorities and decision-making

Sustained NCD/tobacco surveillance systems

Component 3: NCD Surveillance and the NCD Global Monitoring Framework and Global Action Plan Strategies Short-Term Outcomes Intermediate

Outcomes

Strategy 1: Improve NCD surveillance systems, tools, and protocols, and system implementation; support analysis and interpretation of NCD surveillance data, and disseminate findings to stakeholders

Increased evidence of NCD prevalence, trends, and country-level needs in LMICs

Strengthened NCD surveillance and information systems

Increased awareness of NCDs in LMICs

Improved NCD surveillance and monitoring systems

Sustained

NCD

surveillance systems

Component 4: Global Hearts Strategies Short-Term

Outcomes Intermediate Outcomes Long-Term

Outcomes

Strategy 1: Improve

NCD/CVD

surveillance systems, tools, and protocols, and system implementation;

support analysis and interpretation of

NCD/CVD

surveillance data, and disseminate findings to stakeholders

Strategy 2: Improve NCD/CVD training materials and learning platforms to increase capacity for public health workers to address NCDs/CVDs and associated risk factors

Strategy 3: Improve implementation of evidence-based

NCD/CVD

prevention, treatment, Increase data utilization on prevention and management of CVD and risk factors in collaboration with stakeholders

Increase implementation of effective strategies to prevent, manage, treat, and control CVD and risk factors

Development and availability of training tools and guidelines to address CVD and risk factor management and prevention

Enhanced local capacity for CVD and risk factor surveillance, Increase awareness of CVD and risk factor burden in LMICs

Improve CVD surveillance and monitoring systems to prioritize addressing premature deaths from heart attacks and strokes

Generate stronger data on the effectiveness of ongoing prevention activities to use in setting priorities and decision making

Increase in LMICs with strategic plans that address CVDs

Increase use of evidence-based guidelines, interventions, and programs

Increase recognition by high-level country leadership that CVDs are a critical public health priority

Sustained

CVD

surveillance systems

Sustained

NCD/CVD

prevention and control programs and initiatives

Improved cardiovascular health and healthy living management and control strategies monitoring, evaluation, and program implementation

Improve alignment of NCD/CVD training programs with national NCD needs and priorities

Component 5: Global Maternal and Infant Emergency Response and Birth Defects Prevention and Monitoring Strategies Short-Term

Outcomes Intermediate Outcomes

Strategy 1: Improve birth defects surveillance systems, tools, and protocols, and system implementation; support analysis and interpretation of surveillance data, and disseminate findings to stakeholders

Strategy 2: Improve training materials and learning platforms to increase capacity for public health workers to address maternal and infant needs and birth defects and associated risk factors

Strategy 3: Improve implementation of evidence-based prevention, treatment, management and control implementation strategies to improve maternal and infant health and reduce birth defects and risk factors

Update evidence-based training tools and guidelines related to maternal and infant needs and birth defects to inform prevention efforts, including during emergency response

Improve quality of data and disseminate surveillance findings to better understand the impact of birth defects

Effective implementation of strategies to prevent birth defects

Generate peer-reviewed publications and dissemination of birth defects surveillance data

Establish a global warning system for international threats to mothers and babies

Increase data dissemination to inform decision-making for maternal and infant health and birth defects prevention

Improve prevention of birth defects and emerging health threats affecting newborns in LMICs

Components 6, 7, and 8: Rapid Response to Small Scale and Large Scale Infectious Disease Outbreaks or Other Public Health Emergencies and Emerging Infectious Disease Threats

Strategy Short-Term Outcomes

Intermediate

Long-Term Outcomes

Strategy 1:

Intensify active surveillance, case finding, contact tracing, monitoring and other outbreak response measures at local levels

Strategy 2:

Strengthen capabilities for epidemiologic and laboratory analysis and program evaluation

Strategy 3:

Intensify social mobilization, community and professional education and engagement.

Strategy 4:

Improve outbreak case management and infection control

Strategy 5:

Strengthen non-outbreak related public health

Improved time to deploy healthcare workers to respond and control the spread of infectious diseases

Strengthened coordination and robust emergency preparedness and response capacities

Improved disease outbreak case management and infection control

Shortened time to detect highly infectious disease outbreaks through active surveillance and case finding

Reduced transmission of highly infectious diseases in clinical and community

Reduced time to reinvigorated public health activities that have been interrupted or slowed due to outbreak response

Improved access to health services by individuals in outbreak affected areas

Increased capacity of countries for early warning, risk reduction and management of national and global health risks

Sustained improvements in timeliness of achieving outbreak/epidemic/pandemic control

Reduced morbidity and mortality attributed to disease outbreaks or other public health threats

Reduced spread of infectious outbreaks into other countries

Improved preparedness for potential future outbreaks and other highly infectious diseases

i. Purpose The purpose of this NOFO is to provide expertise and training to regions and countries across the globe to prevent and control non-communicable diseases, their risk factors, and related causes through effective regional, national and community health programs.

ii. Outcomes As reflected in the logic model, the recipient is expected to show measurable progress made toward short-term, mid-term (intermediate), and long-term outcomes for this five-year period of performance. Below are the period of performance outcomes by discrete program area:

Component 1: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCT) Short-term outcomes:

activities that are impacted by the outbreak

Strategy 6:

Increase security and logistics for local responders Strategy 7:

Strengthen capabilities for preparedness and response to highly infectious diseases settings

Increased awareness, knowledge, and support for local disease outbreak response and prevention efforts at the community level

Rapid identification of and containment of highly infectious disease outbreaks

Increased evidence of vitamin and mineral status prevalence, trends, and country-level needs in LMICs

Strengthened surveillance and information systems for nutrition Increased implementation of effective strategies to prevent and control malnutrition, particularly micronutrient malnutrition Development and availability of standard training tools and guidelines to address malnutrition, particularly micronutrient malnutrition

Intermediate outcomes:

Improved nutrition surveillance and monitoring systems, especially for micronutrients Stronger data to use in setting nutrition priorities and decision making Increased use of evidence-based guidelines, interventions, and programs

Long-term Outcomes:

Strengthened and sustained global surveillance systems, particularly for nutrition.

Country leadership to demonstrate increased recognition that reducing NCDs and improved nutrition are critical public health priorities.

Decrease in malnutrition, NCDs and NCD risk factors causing morbidity and mortality

Component 2: Global Tobacco Control (Global Youth Tobacco Survey) Short-term Outcomes:

Strengthened NCD/tobacco surveillance and information systems across five of the six World Health Organization (WHO) Regions

Development and availability of standard training tools and guidelines to address NCDs/tobacco, including the translation of developed trainings into various languages to increase global reach and comprehension

Increased implementation of effective strategies related to the prevention and control of tobacco use across five of the six World Health Organization (WHO) Regions

Enhanced local capacity for NCD/tobacco surveillance and monitoring, evaluation, and program implementation

Intermediate Outcomes:

Improved NCD/tobacco surveillance and monitoring systems Stronger tobacco data to use in setting priorities and decision-making

Long-term Outcomes:

Sustained NCD/tobacco surveillance systems

Component 3: NCD Surveillance and the NCD Global Monitoring Framework and Global Action Plan

Increased evidence of NCD prevalence, trends, and country-level needs in LMICs

Strengthened NCD surveillance and information systems

Intermediate outcomes:

Increased awareness of NCDs in LMICs Improved NCD surveillance and monitoring systems

Long-term outcomes:

Sustained NCD surveillance systems

Component 4: Global Hearts

Increase identification, sharing, improvement, and utilization of existing data on prevention and management of CVD and risk factors in collaboration with stakeholders

Increase implementation of effective strategies to prevent, manage, treat, and control cardiovascular disease risk factors

Development and availability of standard training tools and guidelines to address cardiovascular disease and risk factor management and prevention

Enhanced local capacity for cardiovascular disease and risk factor surveillance and monitoring, evaluation, and program implementation, including linkages with local field epidemiology training programs and academic institutes

Intermediate Outcomes:

Increase awareness of cardiovascular disease and risk factor burden in LMICs Improve CVD surveillance and monitoring systems to prioritize addressing premature deaths from heart attacks and strokes Generate stronger data on the effectiveness of ongoing prevention activities to use in setting priorities and decision making Increase in LMICs with public health strategic plans that address CVDs Increase use of evidence-based guidelines, interventions, and programs Improve alignment of NCD/CVD training programs with national NCD needs and priorities

Long-term Outcomes:

Increase recognition by high-level country leadership that CVDs are a critical public health priority

Sustained CVD surveillance systems Sustained NCD/CVD prevention and control programs and initiatives Improved cardiovascular health and healthy living

Component 5: Global Maternal and Infant Emergency Response and Birth Defects Prevention and Monitoring

Update evidence-based training tools and guidelines related to maternal and infant needs and birth defects to inform prevention efforts, including during emergency response

Improve quality of data and disseminate surveillance findings to better understand the impact of birth defects in SEARO (WHO Southeast Asia Regional Office) region

Intermediate outcomes:

Effective implementation of strategies to prevent birth defects, including but not limited to neural tube defects (NTDs)

Generate peer-reviewed publications and dissemination of birth defects surveillance data

Long-term Outcomes:

Establish a global warning system for international threats to mothers and babies Increase data dissemination to inform decision-making for maternal and infant health and birth defects prevention including folic acid fortification programs to prevent neural tube defects

Improve prevention of birth defects, in particular neural tube defects (NTDs), as well as emerging health threats affecting newborns in LMICs

Components 6, 7, and 8: Rapid Response to Small Scale and Large Scale Infectious Disease Outbreaks or other Public Health Emergencies and Emerging Infectious Disease Threats

(EIDT)

Short-Term Outcomes

Improved time to deploy healthcare workers to respond and control the spread of infectious diseases

Strengthened coordination and robust emergency preparedness and response capacities Improved disease outbreak case management and infection control Shortened time to detect highly infectious disease outbreaks through active surveillance and case finding Reduced transmission of highly infectious diseases in clinical and community settings Increased awareness, knowledge, and support for local disease outbreak response and prevention efforts at the community level.

Rapid identification of and containment of highly infectious disease outbreaks

Intermediate Outcomes

Reduced time to reinvigorated public health activities that have been interrupted or slowed due to outbreak response

Improved access health services by individuals in outbreak affected areas Increased capacity of countries for early warning, risk reduction and management of national and global health risks

Long-Term Outcomes

Sustained improvements in timeliness of achieving outbreak/epidemic/pandemic control

Reduced morbidity and mortality attributed to disease outbreaks or other public health threats

Reduced spread of infectious outbreaks into other countries Improved preparedness for potential future outbreaks and other highly infectious diseases

iii. Strategies and Activities While the activities for this NOFO span across many different funding streams and discrete program projects, all the strategies and activities broadly focus on the areas outlined in the logic model.

Component 1: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCT) Short-Term Outcomes:

Increased evidence of vitamin and mineral status prevalence, trends, and country-level needs in LMICs

Strengthened surveillance and information systems for nutrition Increased implementation of effective strategies to prevent and control malnutrition, particularly micronutrient malnutrition Development and availability of standard training tools and guidelines to address malnutrition, particularly micronutrient malnutrition

Intermediate Outcomes:

Improved nutrition surveillance and monitoring systems, especially for micronutrients Stronger data to use in setting nutrition priorities and decision making Increased use of evidence-based guidelines, interventions, and programs

Long-Term Outcomes:

Strengthened and sustained global surveillance systems, particularly for nutrition.

Country leadership to demonstrate increased recognition that reducing NCDs and improved nutrition are critical public health priorities.

Decrease in malnutrition, NCDs and NCD risk factors causing morbidity and mortality

Component 2: Global Tobacco Control (Global Youth Tobacco Survey) Short-Term Outcomes:

Strengthened NCD/tobacco surveillance and information systems across five of the six World Health Organization (WHO) Regions

Development and availability of standard training tools and guidelines to address NCDs/tobacco, including the translation of developed trainings into various languages to increase global reach and comprehension

Increased implementation of effective strategies related to the prevention and control of tobacco use across five of the six World Health Organization (WHO) Regions

Enhanced local capacity for NCD/tobacco surveillance and monitoring, evaluation, and program implementation

Intermediate Outcomes:

Improved NCD/tobacco surveillance and monitoring systems Stronger tobacco data to use in setting priorities and decision-making

Long-Term Outcomes:

Sustained NCD/tobacco surveillance systems

Component 3: NCD Surveillance and the NCD Global Monitoring Framework and Global Action Plan Short-Term Outcomes:

Increased evidence of NCD prevalence, trends, and country-level needs in LMICs Strengthened NCD surveillance and information systems

Intermediate Outcomes:

Increased awareness of NCDs in LMICs Improved NCD surveillance and monitoring systems

Long-Term Outcomes:

Sustained NCD surveillance systems

Component 4: Global Hearts Short-Term Outcomes:

Increase identification, sharing, improvement, and utilization of existing data on prevention and management of CVD and risk factors in collaboration with stakeholders

Increase implementation of effective strategies to prevent, manage, treat, and control cardiovascular disease risk factors

Development and availability of standard training tools and guidelines to address cardiovascular disease and risk factor management and prevention

Enhanced local capacity for cardiovascular disease and risk factor surveillance and monitoring, evaluation, and program implementation, including linkages with local field epidemiology training programs and academic institutes

Intermediate Outcomes:

Increase awareness of cardiovascular disease and risk factor burden in LMICs Improve CVD surveillance and monitoring systems to prioritize addressing premature deaths from heart attacks and strokes Generate stronger data on the effectiveness of ongoing prevention activities to use in setting priorities and decision making Increase in LMICs with public health strategic plans that address CVDs Increase use of evidence-based guidelines, interventions, and programs Improve alignment of NCD/CVD training programs with national NCD needs and priorities

Long-Term Outcomes:

Increase recognition by high-level country leadership that CVDs are a critical public health priority

Sustained CVD surveillance systems Sustained NCD/CVD prevention and control programs and initiatives Improved cardiovascular health and healthy living

Component 5: Global Maternal and Infant Emergency Response and Birth Defects Prevention and Monitoring Short-Term Outcomes:

Update evidence-based training tools and guidelines related to maternal and infant needs and birth defects to inform prevention efforts, including during emergency response

Improve quality of data and disseminate surveillance findings to better understand the impact of birth defects in SEARO (WHO Southeast Asia Regional Office) region

Intermediate Outcomes:

Effective implementation of strategies to prevent birth defects, including but not limited to neural tube defects (NTDs)

Generate peer-reviewed publications and dissemination of birth defects surveillance data

Long-Term Outcomes:

Establish a global warning system for international threats to mothers and babies Increase data dissemination to inform decision-making for maternal and infant health and birth defects prevention including folic acid fortification programs to prevent neural tube defects

Improve prevention of birth defects, in particular neural tube defects (NTDs), as well as emerging health threats affecting newborns in LMICs

Components 6, 7, and 8: Rapid Response to Small Scale and Large Scale Infectious Disease Outbreak or other Public Health Emergencies and Emerging Infectious Disease Threats

(EIDT)

Strategy 1: Intensify active surveillance, case finding, contact tracing, monitoring, and other critical response efforts at local levels

Conduct and improve ongoing active surveillance, with laboratory confirmation to ensure rapid identification of missed, new or newly imported outbreak cases

Strengthen capacity for general surveillance including support for personnel required for surveillance and epidemiology activities.

Strengthen surveillance at entry points (border posts, airports and maritime ports) from countries with ongoing transmission

Strategy 2: Strengthen capabilities for epidemiologic and laboratory analysis and program evaluation

Improve operational and technical analysis, coordination and monitoring of interventions Assess the impact of the epidemic on health care seeking and health care provision

Strategy 3: Intensify social mobilization, community and professional education and engagement, and psychosocial care for infected persons and their families where applicable

Conduct intensified social mobilization and community engagement to enhance awareness and gather community support, acceptance and participation in implementation of containment measures

Provide psychosocial first aid training for community agents and their supervisors so they can provide direct psychosocial support to contact cases and their families.

Develop and conduct communications to contain the outbreaks and enforce the theme of "Staying at Zero Cases."

Develop and disseminate key health risk communication messages

Strategy 4: Improve outbreak case management and infection control

Develop plans for patient management at community and clinical settings.

Improve infection control practices, particularly in facilities that might receive outbreak cases for example, on a border with a country with ongoing transmission

Strategy 5: Strengthen non-outbreak related public health activities that are impacted by the outbreak

Restore priority aspects of the health/public health system such as surveillance and assessment of vaccination coverage for epidemic-prone disease (e.g., measles), that are negatively impacted or stalled due to the outbreak

Strategy 6: Increase security and logistics for local responders

Strengthen field security to ensure operational security, and protect national and international staff involved in the response

Strategy 7: Strengthen capabilities for preparedness and response to highly infectious diseases

Develop/implement partnership mechanisms for a more robust and responsive global health emergency workforce.

Train frontline responders on emerging infectious diseases.

Strengthen critical International Health Regulations (IHR) and health systems capacities in affected region and elsewhere

1. Collaborations

a. With other CDC programs and CDC-funded organizations:

Recipient(s) are required to work with other CDC implementing partners, including non-governmental organizations, universities, Ministry of Health and other host governmental bodies and multi-lateral organizations that receive CDC funds. Recipient(s) should ensure their proposed activities are not duplicating activities already implemented by other CDC-funded organizations

b. With organizations not funded by CDC:

The recipient will work primarily and directly with partner governments specifically with the Ministries of Health and other government entities who are working towards the objectives of this NOFO. In addition, the recipient(s) will be expected to work with other in-country and global stakeholders, including but not limited to government entities, non-governmental organizations, universities, civil society, the private sector, and other USG agencies.

Component 1: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCT)

Recipient may collaborate with country officials and subject matter experts from universities; United Nations (UN), bilateral or multilateral agencies that work in global nutrition and development; and technical advisory groups to achieve outcomes. These collaborations may be necessary to identify data sources for global nutrition surveillance;

to develop global guidance, recommendations, and other technical resources.

Component 2: Global Tobacco Control (Global Youth Tobacco Survey)

Recipient will collaborate with the following WHO Regional Offices: AFRO (Africa Regional Office), EMRO (Eastern Mediterranean Regional Office), WPRO (Western Pacific Regional Office), EURO (Europe Regional Office) and SEARO (Southeast Asia Regional Office), to further the work in these regions.

Component 3: NCD Surveillance and the NCD Global Monitoring Framework and Global Action Plan

Recipient is encouraged to build and expand collaborative relationships with strategic partners at the international and regional levels to achieve greater impact and sustainability, avoid duplication of efforts, leverage funds, and expand working relationships between ministries of health and education and WHO and CDC.

Recipient should collaborate with experts at the regional, national, and local levels, academic centers, clinical institutions, Ministries of Health and other governmental and non-governmental institutes and organizations whose work centers on prevention of NCDs.

Component 4: Global Hearts

Recipient is encouraged to build and expand collaborative relationships with strategic partners at the international and regional levels to achieve greater impact and sustainability, avoid duplication of efforts, leverage funds, and expand working relationships between ministries of health and education and WHO and CDC.

Recipient should collaborate with experts at the regional, national, and local levels, academic centers, clinical institutions, Ministries of Health and other governmental and non-governmental institutes and organizations whose work centers on prevention of NCDs.

Component 5: Global Maternal and Infant Emergency Response and Birth Defects Prevention and Monitoring

Recipient shall collaborate with the World Health Organization’s regional office in South-East Asia (SEARO) in order to continue to advance ongoing work in surveillance and prevention of birth defects and emerging health threats affecting newborns in LMICs.

Recipient shall collaborate with the International Clearinghouse on Birth Defects Surveillance and Research and other regional (e.g., All India Institute of Medical Sciences) and global experts in birth defects identification, diagnosis, and/or surveillance as appropriate.

Recipient shall foster and maintain collaborations with WHO Country offices and Ministries of Health in countries funded to conduct birth defects surveillance

Recipient may collaborate with global or regional organizations and initiatives, such as the Flour Fortification Initiative, Nutrition International, the Global Alliance for Improved Nutrition, and the United States Agency for International Development, whose work supports prevention of birth defects or monitoring of blood folate concentrations.

2. Target Populations The target populations for this NOFO include at-risk populations for non-communicable diseases and/or other public health emergencies. The target populations for this NOFO may also include, but are not limited to, those individuals infected and affected by infectious diseases, or at risk for becoming infected by an infectious disease. The work under this NOFO may also target increased capacity at the national and sub-national level to implement activities in alignment with the objectives of this NOFO.

Component 1: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCT) The recipient will not be limited to working only with specific target populations, but may concentrate efforts among those most vulnerable to malnutrition, including young children less than five years of age, women of reproductive age, and adolescence.

Component 2: Global Tobacco Control (Global Youth Tobacco Survey) The target population for the proposed strategies and activities are countries and regions worldwide (excluding countries in the region of the Americas, AMRO) that are seeking to build and/or expand their tobacco control efforts.

Component 3: NCD Surveillance and the NCD Global Monitoring Framework and Global Action Plan Recipient will carry out activities in LMICs in the areas of surveillance, monitoring and evaluation, capacity building, and training to reduce deaths related to NCDs.

Component 4: Global Hearts Recipient will carry out activities in LMICs in the areas of surveillance, monitoring and evaluation, capacity building, and training to reduce deaths related to NCDs.

Component 5: Global Maternal and Infant Emergency Response and Birth Defects Prevention and Monitoring The target population for the proposed strategies and activities are countries and regions worldwide seeking to improve birth defects surveillance and prevention initiatives as well as emerging health threats affecting newborns in LMICs.

a. Health Disparities Recipients are expected to use epidemiologic, social determinants, and linked laboratory, epidemiological, and surveillance data to identify communities disproportionately affected by infectious diseases or non-communicable diseases in the target areas to ensure that program activities appropriately cover these populations. Recipients should ensure that supported services are accessible and available to all patients regardless of age, sex, race/ethnicity, sexual orientation, gender identity, or socio-economic status in order to achieve the outcomes of this

NOFO.

iv. Funding Strategy This NOFO is divided into eight components. Applicants are required to apply for all components and include a separate budget and work plan for each component. The applicant’s application package should be inclusive of all component work plans and budgets; multiple applications will not be reviewed. Applicants are encouraged to submit component budgets toward the year one award ceiling for each component. However, budget proposals for year one may not exceed the year one award ceiling. Please note these amounts are subject to approval and the availability of funds.

Component 1: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCT) These activities support strengthened surveillance for global nutrition with funding up to approximately $250,000 at the time of the award. These activities are intended to be funded on an annual basis. Future years funding level will be dependent on funding availability.

Component 2: Global Tobacco Control (Global Youth Tobacco Survey) These activities support global tobacco surveillance with funding up to approximately $392,000 at the time of the award. These activities are intended to be funded on an annual basis. Future years funding level will be dependent on funding availability.

Component 3: NCD Surveillance and the NCD Global Monitoring Framework and Global Action Plan These activities support NCD surveillance with funding up to approximately $500,000 at the time of the award. These activities are intended to be funded on an annual basis. Future years funding level will be dependent on funding availability.

Component 4: Global Hearts These activities support global hearts with funding up to approximately $500,000 at the time of the award. These activities are intended to be funded on an annual basis. Future years funding level will be dependent on funding availability.

Component 5: Global Maternal and Infant Emergency Response and Birth Defects Prevention and Monitoring These activities support maternal and infant health emergency response activities and birth defects surveillance and prevention with funding up to approximately $500,000 at the time of the award. These activities are intended to be funded on an annual basis. Future years funding level will be dependent on funding availability.

Component 6: Rapid Response to Small Scale infectious disease outbreaks or other Public Health Emergencies This is intended to be approved but unfunded (ABU) as a baseline practice. It would be funded to support additional activities needed within a budget period when a disease outbreak or other public health emergency reaches a scale that requires a moderate response. Estimated year one ceiling is $10,000,000.

Component 7: Rapid Response to Large Scale Infectious Disease Outbreaks or other Public Health Emergencies This is intended to be approved but unfunded (ABU) as a baseline practice. It would be funded to support additional activities needed within a budget period when a disease outbreak or other public health emergency reaches a scale that requires a substantial response. Estimated year one ceiling is $15,000,000.

Component 8: Emerging Infectious Disease Threats (EIDT) This is intended to be an approved but unfunded (ABU) component that will support activities to combat COVID-19 and other emerging infectious disease threats globally, including efforts related to global health security, global disease detection and response, global health protection, global immunization, and global coordination on public health. It would be funded to support additional activities needed within a budget period for COVID-19 and other emerging disease threats. Estimated year one funding amount is $15,000,000.

Emergency Management and Response The ability to respond rapidly and effectively to public health emergencies is a key component of global health security. International public health emergencies including humanitarian crises are by nature unpredictable, requiring fulfilment of changing and often unpredictable needs that vary widely according to context. Consequently, funding for public health emergencies is also unpredictable and based on external factors. In recent years, there has been a sharp rise in the number of people living in regions of the world affected by public health emergencies, including humanitarian emergencies, which has often led to additional funding resources from the USG to respond to these threats. Given this unpredictability and the resulting need for rapid, flexible, and efficient process to award funding under an emergency situation, recipients that are selected for funding under this NOFO will be eligible to receive additional expedited supplemental funding when a public health emergency occurs to scale up activities included within the scope of work of this NOFO.

Definition of public health emergency:

In order to qualify for supplemental emergency funding, one of the following situations must apply:

1. When the UN or the WHO classifies the emergency as a Level 3 (L3)

2. When the US Congress appropriates funding for an international response related to humanitarian or public health crisis with the words containing “emergency” in the program title. The appropriated funding could be for CDC directly or is transferred to CDC through an Interagency Agreement (IAA) by HHS or another USG entity

3. When the US government (Congress, White House, National Security Council, etc.)

declares a public health emergency as national security priority

4. When the CDC Director activates the Emergency Operation Center (EOC) in response to an international public health threat

5. When the US Department of State or the US Agency for International Development (USAID) transfer funds to CDC to respond to an international disaster or humanitarian assistance under 2 FAM 060 (International Disaster and Humanitarian Assistance)

If a public health emergency situation meets any one criteria listed above, then selected recipients under this NOFO will be eligible to receive supplemental emergency funding to scale up public health activities included in the scope of work of this NOFO on a single-source basis (i.e. without additional competition, within a 12-month budget period and throughout the 60-month period of performance). There is no limit on the number of emergency supplemental funding that a recipient may receive within a 12-month budget period or the 60-month period of performance under a public health emergency situation. Recipients receiving funds under a public health emergency will be eligible to receive emergency funding without constraint to the period of performance funding ceiling, annual budget period ceiling, or lack of component funding. In addition, applications for funding under a public health emergency will not need a merit review and will only require approval from the CDC Project Officer and Grants Management Officer (GMO) in order to be funded.

All reporting requirements listed under this NOFO still apply to any emergency supplemental funding.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy The applicant should describe how they plan to measure and collect data on the funded activities and bolded outcomes identified in the logic model. The purpose of collecting and reporting these data is to determine the progress toward achieving the NOFO activities and outcomes. The results will also be used for program planning, development and improvement, accountability and reporting, and for sharing with partners and other stakeholders. CDC will work with the recipient throughout the life of this award to ensure that all activities and expected outcomes are in alignment with current USG and the recipient’s strategies and goals. The recipient should dedicate funds made available under this NOFO for evaluation and performance monitoring within each project. The final funding amount will be agreed upon by both CDC and the recipient; however, it should be expected that approximately 3% (of a given project’s funding) will be dedicated to monitoring, reporting, and evaluation activities. CDC and the recipient will agree upon the specific funding amounts within review of each project’s work plan and budget.

Monitoring CDC expects that the work conducted under this NOFO will be structured as a series of discrete projects oriented at achieving elements of the NOFO’s strategic objectives. CDC and the recipient will jointly develop formal performance measures shortly after award based on activities within each project. For each project, these performance measures must include CDC’s Division of Global Health Protection’s Division-wide Indicators (DWIs), as well as other CDC or recipient’s standard indicators relevant to the intended outcomes of the project. The DWIs include indicators that are required reporting for CDC, such as for OMB, HHS, USG Global Health Security Agenda (GHSA) interagency, and Healthy People. At a minimum, applicants should describe proposed process measures for the strategies and activities in the logic model, and proposed outcome measures for the period of performance outcomes in the logic model.

While recipients will be responsible for reporting on DWIs relevant to proposed strategies and activities, they are not limited to only DWIs listed below. Applicants can, and are encouraged to, propose additional relevant indicators that, combined with relevant DWIs, will be monitored over the life of the NOFO. Recipients will also be encouraged to identify relevant USG GHSA Interagency Metrics, WHO Joint External Evaluation (JEE), and/or Healthy People 2030 standardized metrics and WHO benchmarks.

Technical Area Division of Global Health Protection (DGHP) Division-wide Indicators (DWIs) as of April 2019* WD#1: Number of individuals trained by CDC to prevent, detect and respond to public health threats

WD#2: Number of Field Epidemiology Training Program (FETP) residents trained by CDC that have participated in outbreak investigations and responses WD#3: Number and proportion of subnational jurisdictions per country that have had at least one staff member trained by FETP-Frontline

Workforce Development

(WD)

WD#4: Number of CDC staff ready to provide emergency management and response assistance EMR#1: Number of public health events of international importance monitored and reported

EMR#2: Number of public health events and other global health emergency responses supported by CDC EMR#3: Number of outbreaks investigated and responded to by the country

Emergency Management and Response (EMR)

EMR#4: Number and proportion of countries with an established Public Health Emergency Operations Center (PHEOC) that have used…