cdc-rfa-jg-26-0042_v4_forPublication.pdf

Division of Global Health Protection

Notice of Funding Opportunity

Application due Friday, October 2, 2026

Improving global health security in Côte d’Ivoire to stop the spread of infectious disease Opportunity number: CDC-RFA-JG-26-0042

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Agency priorities 11

Program description 14

Step 2: Get ready to apply 34

Get registered 35

Find the application package 36

Help applying 36

Step 3: Build Your Application 37

Application checklist 38

Application contents and format 40

Step 4: Understand Review, Selection, and Award 53

Application review 54

Award notices 56

Step 5: Submit Your Application 57

Submission and deadlines 58

Step 6: Learn What Happens After Award 60

Post-award requirements and administration 61

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 Friday, October 2, 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 11

Program description 14

Basic information Centers for Disease Control and Prevention (CDC)

Global Health Center

Division of Global Health Protection

Making America safer, stronger, and more prosperous by strengthening global health security through surveillance, prevention, and response in Côte d’Ivoire.

Have questions?

See Contacts and Support.

Key facts

Opportunity name:

Improving global health security in Côte d’Ivoire to stop the spread of infectious disease

Opportunity number:

CDC-RFA-JG-26-0042

Assistance listing:

93.318: Protecting and Improving Health Globally: Building and Strengthening Public Health Impact, Systems, Capacity, and Security

NOFO version:

Original

Key dates

Application submission deadline:

October 2, 2026

Expected award and start date:

October 30, 2026

We will inform you of your application status by the end of October 2026.

Summary Côte d’Ivoire received support from U.S. government agencies and other partners to build up the country’s health system capabilities to better detect, notify, and respond to outbreaks of infectious diseases through the Global Health Security (GHS) program. This funding opportunity continues this work, helping keep Americans safer by stopping infectious disease threats at their source. It will build upon previous gains in health security, increasing the capacity of and strengthening:

• Surveillance systems.

• Laboratory systems.

• Workforce development.

• Emergency preparedness and response.

Funding details Funding Type: Cooperative agreement

Expected total NOFO funding for Year 1: $4,000,000 This is the expected total Year 1 funding for all awards made under this NOFO.

Expected awards: 2 The number of awards is subject to available funds and program priorities.

Exact amounts for each award under this NOFO will be determined upon award.

We plan to award projects for five 12-month budget periods for a five-year period of performance.

Step 1: Review the Opportunity 5

Funding strategy

Funding amounts We encourage you to submit an application that includes a budget and work plan for each required component, consistent with the applicable component ceilings. For Year 1, applicants must submit separate budgets and work plans for all three components, not exceeding each component ceiling, although only Component 1 core activities are expected to be funded initially and Components 2 and 3 may be approved but unfunded pending future availability of funds.

Funding amounts for Years 2 through 5 will be set at continuation. We will continue funding based on:

• Availability of funds.

• Evidence of satisfactory progress, as documented in your required reports.

• The determination that continued funding is in the best interest of the federal government.

Component funding

Overview

We fund all Global Health Security (GHS) cooperative agreements using component funding. You must apply for all components and include a budget and work plan for each. Note: For the purposes of this NOFO, component 1 is considered the core component, meaning it supports baseline GHS activities that are not dependent on emergency funding. This does not change the requirement that applicants apply for all components.

Component funding allows us to provide funding as it becomes available. To do so, we fund sets of activities by project (such as emergencies or routine), when necessary.

CDC may fund one or more of your components to start the budget period, and then consider other components based on available funding later. If we can’t yet fund your other components, we will designate the remaining components as “approved but unfunded.” This allows us to award more funding later. We include approved but unfunded components for public health emergencies in all awards. These components are funded when a disease outbreak or other public health emergency requires additional funding.

Step 1: Review the Opportunity 6

Component 1 is for activities related to core global health security priorities.

When funding is available, this NOFO will support activities for a moderate (component 2) or a substantial (component 3) response to a disease outbreak or other public health emergency.

The emergency components follow the same logic model, with identical overarching strategies and activities.

Setting up components

You must set up your components in your application. While preparing your application:

• Review the expectations for Year 1 activities in the strategies and activities section.

• Group your activities under the anticipated components. Only include the activities planned for Year 1:

◦ Component 1: Core Global Health Security Priorities

▪ Component 1 Ceiling: $2,000,000

◦ Component 2: Rapid Small-Scale Response to Infectious Disease Outbreaks or other Public Health Emergencies

▪ Component 2 Ceiling: $5,000,000

◦ Component 3: Rapid Large-Scale Response to Infectious Disease Outbreaks or other Public Health Emergencies

▪ Component 3 Ceiling: $10,000,000

For information on how to incorporate component funding into your application, see the following sections:

• Budget narrative

• Component funding instructions for SF-424A

Local partner funding preference This NOFO includes a funding preference for local partners. Your organization will receive 15 extra points during the selection process if you both:

• Meet the local partner definition.

• Document your status as a local partner.

Step 1: Review the Opportunity 7

Eligibility Statutory authority This program is authorized under:

• Section 307 of the Public Health Service Act [42 USC 242l].

• Section 301(a) [42 USC 241(a)] of the Public Health Service Act.

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.

• Foreign or non-U.S. based entities.

Other required qualifying factors

Delivery location You must conduct the project in Côte d’Ivoire.

Step 1: Review the Opportunity 8

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.

• Proposes research activities. See the definition of research.

• Requests funding that exceeds the applicable Year 1 component ceilings described in the Funding Strategy section.

• Exceeds the 30-page limit for the project narrative (see the Project narrative section for what counts toward the page limit).

• Does not include all components.

• Is not in English.

• Includes a budget or budget narrative that uses a currency other than U.S. dollars.

• Does not respond to or is outside the scope of this NOFO.

See the Application checklist 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.

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

Cost sharing and matching funds This program has no cost-sharing or matching funds requirement. We will not consider cost-sharing fund contributions during your application review.

However, if you submit voluntary cost-sharing funds and we fund your project, we will require you to report on these 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.

Step 1: Review the Opportunity 10

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 11 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 meet 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 12

• 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 prioritize 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 13 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf

Program description Background, overview, and related work Epidemic threats and health challenges In 2024 and 2025, Côte d’Ivoire regularly reported suspected and confirmed cases of various epidemic diseases: yellow fever, dengue, malaria, cholera, measles, influenza (A & B), COVID-19, meningitis, and monkeypox. In 2022, the maternal mortality rate was 385 per 100,000 live births and life expectancy was estimated at 58 years old according to data compiled by the National Office of Statistics of Côte d’Ivoire.

This NOFO will help reduce morbidity and mortality in Côte d’Ivoire and improve the country’s capacity to detect, notify, and respond to infectious disease threats. Improving Côte d’Ivoire ’s capacity to prevent infectious disease threats from spreading to America makes America safer, stronger, and more prosperous by preventing illness and averting healthcare and economic costs.

Supporting Global Health Security core pillars in Côte d'Ivoire This NOFO supports the development of Global Health Security core pillars in Côte d’Ivoire. This includes:

• Strengthening real-time surveillance and reporting.

• Advancing linkages between surveillance and laboratory with electronic reporting systems.

• Further developing laboratory point-of-care diagnostics.

• Promoting effective antimicrobial stewardship.

• Building a more robust laboratory workforce.

It will also build a public health workforce that supports sustainable and functional public health surveillance and response. It will focus on training and mentoring a group of public health workers through the Field Epidemiology Training Program (FETP). FETP supports improved emergency preparedness and response planning, communication, and coordination.

Step 1: Review the Opportunity 14

Time-driven frameworks In the event of infectious disease outbreaks or other public health emergencies that require a fast, large-scale response, this NOFO encourages additional intervention techniques. This is an opportunity to adapt frameworks that are based on timeliness metrics and are benchmark driven, such as the 7-1-7 framework. These frameworks build upon the evaluation and continuous capacity building of Cote d’Ivore’s early detection and response systems. (i.e., evaluation and continuous capacity building of Cote d’Ivore’s early detection and response system). Recent epidemics and pandemics highlighted the limitations of existing measures of health security capacity and the importance of assessing both the presence and the real-time performance of early detection and response systems.

For example, the 7-1-7 framework uses a simple set of three timeliness metrics. The goal is to assess and improve the actual performance of early detection, notification, and response capacities of the system as:

• 7 days to detect a suspected public health threat.

• 1 day to notify a responsible public health authority.

• 7 days to complete early response measures.

Building on past successes for global health security The activities of this NOFO will build upon the activities implemented under the expiring NOFO GH20-2093 and their successful outcomes over the past five years. They will:

• Build more robust surveillance and reporting systems.

• Advance laboratory system capacities.

• Improve national biosafety and biosecurity systems.

• Support workforce development.

• Improve emergency operations, management, and response capabilities.

The expiring NOFO GH20-2093 directly strengthened the country’s health surveillance system. It expanded community-based surveillance to include Integrated Disease Surveillance and Response (IDSR). It also trained health workers at national and regional levels to use the IDSR third edition manual.

This training covered monitoring at entry points, including mapping all land borders, seaports, and airports. NOFO GH20-2093 developed event-based surveillance and integrated it into the DHIS2 surveillance platform, reinforced the influenza sentinel site surveillance network, and provided health staff

Step 1: Review the Opportunity 15 with training, operational support, and funding to respond effectively to outbreaks of COVID-19, dengue, cholera, avian influenza, measles, monkeypox, and other disease threats.

NOFO GH20-2093 also helped Côte d’Ivoire establish and run six regional emergency operation centers (EOCs) and keep the national EOC fully operational. Activities under it, included developing key technical documents, like standard operating procedures and plans, and supported government plans, decrees, and other regulatory texts. NOFO GH20-2093 provided training for health staff to manage and operate both the national and regional EOCs and prepared Rapid Response Teams (RRTs) to handle infectious disease outbreaks. Additionally, it funded several simulation exercises for the EOCs to practice emergency responses. Through the country’s FETP, it helped reinforce the country’s public health workforce by implementing ten frontline cohorts, two intermediate cohorts, and introducing Côte d’Ivoire’s first in-country advance cohort.

Public health priorities and strategies Your funded activities must also align with CDC’s global health priorities.

These priorities guide how we build, carry out, and evaluate our global health work. We use it to measure progress and impact and make informed decisions about global health activities across CDC. The goals include:

• Stop health threats at their source before they spread to the United States and other countries.

• Contain disruptive outbreaks of disease across the globe.

• Use global data to prevent and mitigate disease in the United States and other countries.

• Save lives and improve health globally.

To make progress on these goals, we encourage you to:

• Strengthen national public health bulletins, health alert notices, CDC’s Morbidity and Mortality Weekly Report and Health Alert Network, and other emergency risk communication strategies.

• Share timely, credible, useful public health information with healthcare and public health professionals locally and nationally within our partner countries.

• Develop civil registration, vital statistics systems, and mortality surveillance systems so our partner countries know what is causing deaths in their population and whether interventions to reduce them are working.

Step 1: Review the Opportunity 16

• Additionally, the effectiveness of your work should be demonstrated in results from timeliness analyses (like the 7-1-7 framework) for early detection and response. For example, the 7-1-7 target provides a standardized benchmark for evaluating the effectiveness of outbreak detection and response systems globally. The framework outlines a timeline to aim for in response to a suspected outbreak:

◦ Within 7 days of emergency: Detect the outbreak.

◦ Within 1 day of detection: Notify public health authorities and start the investigation.

◦ Within 7 days of notification: Begin responding effectively to the emergency.

• We also recommend using these supporting strategies and frameworks:

• CDC’s strategy for improving GHS, based on three core parts of the agency’s mission to protect public health worldwide:

◦ Prevent.

◦ Detect.

◦ Respond.

• Global Health Security Agenda (GHSA) framework.

• The Department of State America First Global Health Strategy.

• United States Global Health Security Strategy

Purpose The purpose of this NOFO is to make America safer, stronger, and more prosperous by:

• Reinforcing and improving Côte d’Ivoire ’s capacity to detect, notify, and respond to infectious disease outbreaks at their source.

• Preventing infectious disease outbreaks from threatening Americans’ health and safety.

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

Step 1: Review the Opportunity 17 https://www.cdc.gov/global-health/topics-programs/global-health-security.html?CDC_AAref_Val=https://www.cdc.gov/globalhealth/security/index.htm https://globalhealthsecurityagenda.org/ https://www.state.gov/america-first-global-health-strategy/ https://www.state.gov/releases/office-of-the-spokesperson/2025/09/america-first-global-health-strategy

Approach Program logic model The following logic model includes the expected strategies under this NOFO.

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

The asterisked (*) outcomes are those we expect you to achieve or substantially contribute to during the five-year period of performance. You must report on these outcomes.

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 surveillance systems and real-time data collection at all health system levels for early outbreak detection.

Improved district and regional capacity for early outbreak detection and notification, following a time based framework (such as the 7-1-7 approach), using the national surveillance system.*

Improved key surveillance staff skills in the districts and regions for early outbreak detection, following a time-based framework (such as the 7-1-7 approach).*

Improved event-based indicators to detect early outbreaks.*

Improved International Health Regulation (IHR) (2005) reporting in accuracy and timeliness.*

Improved access to national comprehensive, harmonized surveillance data.*

Reduced detection time to 7 days following a timeliness analyses (such as the 7-1-7 approach) for 90% of outbreaks in Côte d’Ivoire.*

Step 1: Review the Opportunity 18

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

Strategy 2:

Strengthen emergency management and response capacities at the national and regional levels for better preparedness and rapid response.

Improved emergency response through annual simulation exercises (real or simulated) in each of the regional EOCs following time-based metrics (e.g, the 7-1-7).*

Improved skills and abilities of key region staff on emergency management and operations response staff following time-based metrics (e.g., 7-1-7).*

Decreased time to identify and respond to a public health threat at the district, regional, and national levels.*

Improved functioning of EOC’s.*

Strengthened information and communication channels.*

Decreased notification time to align with the 1-day timeline following time-based metrics (like the 7-1-7 metrics) for 90% of outbreaks in Côte d’Ivoire.*

Strategy 3:

Strengthen workforce development for health workers at the national, regional, and district levels to get better skills in preparation, detection, and response to outbreaks.

Developed knowledge of the 113 health district staff on basic and intermediate epidemiology to respond to time-based metrics (such as the 7-1-7 framework).*

Increased FETP cascade training in health facility level.*

Improved evaluation of response to outbreak following time-based approaches (e.g, the 7-1-7 framework).*

Improved knowledge of trained staff on the use of time-based metrics (e.g., 7-1-7 framework) 7- as a routine tool in outbreaks detection, notification, and response.*

Developed national public health workforce strategy.*

Improved response time to align with the 7-days target following time-based metrics (like 7-1-7 framework) for 50% of outbreaks in Côte d’Ivoire .*

Strategy 4:

Support and strengthen public

Improved quality of public health programs.*

Improved ability to follow-up on cases or

Improved and effective coordination between public health

Step 1: Review the Opportunity 19

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes health programs, health service delivery, and implementation science programs.

Strengthened public health service delivery programs.*

A skilled and responsive public health workforce is available to support public health operations and respond to emergencies.* events of public health importance.*

Increased coverage of service delivery programs to meet community needs.* systems, clinical care, and communities in preparedness, response, and recovery efforts.*

Strategies and activities This section elaborates on the strategies described in the logic model by providing expected activities for Year 1 and details about how we expect you to implement your program.

Following are strategies and the required activities under this NOFO. You may also propose additional related strategies and activities to achieve the expected outcomes.

Strategy 1: Strengthen surveillance systems and real-time data collection at all health system levels for early outbreak detection

• Reinforce the country’s capacity to use existing integrated disease surveillance and response (IDSR), community-based surveillance (CBS), and event-based surveillance (EBS) systems to quickly detect infectious disease outbreaks.

• Develop event indicators and data collection methods for community detection of outbreaks.

• Support the implementation of a national central database (DHIS2), data sharing, data linkage, and training of surveillance focal points and other stakeholders.

Step 1: Review the Opportunity 20

Strategy 2: Strengthen Emergency Management and Response Capacities at the national and regional levels for better preparedness and rapid response

• Provide technical and operational support through training and simulation exercises to new and existing staff, at both new and established EOCs (national and regional levels).

• Support improved emergency management and response capabilities by conducting response simulations that test the emergency management system. This includes rapid response team simulations.

• Provide technical input and guidance to improve response plans.

• Set up additional regional emergency operational centers (EOC).

Strategy 3: Strengthen Workforce Development for health workers at the national, regional, and district levels to get better skills in preparation, detection and response of outbreaks

• Provide training to health workers at the national and sub-national level through the FETP.

• Reinforce trainings on IDSR, CBS, EBS and DHIS2 platform.

Strategy 4: Support and strengthen public health programs, health service delivery, and implementation science programs

• Provide additional health services and programs for communities to support public health initiatives and outcomes during an outbreak, response, or routine operations, as needed or as requested.

• Integrate evidence-based practices, policies, and interventions into routine health care and public health settings.

• Provide expertise to host country governments and partners to strengthen disease and outbreak responses, develop future pandemic preparedness and response capacity, and mitigate the effects of disease outbreaks on public health programs such as:

◦ GHS

◦ Polio eradication

◦ Measles eliminations

◦ Malaria control

Step 1: Review the Opportunity 21

◦ Cholera

◦ Ebola

◦ Marburg

◦ Monkeypox

◦ Meningitis

• Support a quality and comprehensive package of services for prevention, care, and treatment of priority diseases. This includes strengthening linkages between community and facility-based interventions and systematic approaches to setting multisectoral response mechanisms.

• Support public health campaigns, including routine vaccination campaigns or outbreak response campaigns.

• Improve multilevel public health workforce capacities to investigate outbreaks, conduct event-based surveillance, strengthen diagnostic capacities, and improve sample transportation and laboratory diagnostic quality.

• Identify and analyze knowledge and skill gaps to develop a continuous training program that addresses the key identified gaps among the multisectoral public health workforce. This should align with globally agreed upon competency models and increasing quality of public health programs.

• Develop task- or function-specific standard operating procedures (SOPs) to incorporate data use and data-backed decision-making in service delivery and public health programs.

We expect you to provide copies of and/or access to all data, software, tools, training materials, guidelines, and systems you develop under this NOFO to the Ministry of Health, CDC, and other relevant stakeholders for appropriate use consistent with underlying authorities.

Related guidance Your activities under this project should follow CDC’s global health priorities.

You might also be asked to follow other strategies, guidance, or planning documents that are released later.

Geographic focus If the program or GHS priorities change during the period of performance, you may be asked to change the geographic area of your activities.

Step 1: Review the Opportunity 22

Outcomes We expect you to achieve or substantially contribute to the outcomes asterisked ( * ) in the logic model by the end of the five-year period of performance. You will be expected to report on these outcomes.

Organizational capacity You must include a heading in your project narrative titled “Organizational capacity.” In this section, briefly describe your organizational capacity to carry out these strategies and activities.

You must also provide supporting documentation in your attachments. See the attachments section for full instructions.

Collaborations If funded, we will expect you to collaborate with:

CDC programs and funded organizations CDC implementing partners, including:

• Non-governmental organizations.

• Universities.

• Ministry of health.

• Other host governmental bodies and multi-lateral organizations that receive CDC funds.

Organizations not funded by CDC Stakeholders, government or not, such as:

• Governmental organizations at national, regional, and district levels working in human health. When appropriate, this includes other sectors such as animal and environmental sectors.

• Non-governmental organizations and other public health partners and funders.

• Surveillance and laboratory system partners.

• Emergency Operations Center staff and coordinators.

Step 1: Review the Opportunity 23

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 this award to ensure that all activities and expected outcomes align with your strategies and goals, and those of the U.S. government.

Your strategies and goals will be monitored and evaluated. You should dedicate some of the NOFO’s 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.

Required performance measures While completing your work plan, identify indicators within the partner-level indicator list that best align with your proposed activities for each component.

You can find the separate list within the application package on grants.gov.

These indicators are your performance measures. You will also include these indicators in your initial evaluation and performance measurement plan (EPMP). If awarded, we will work with you to finalize the partner-level indicators that will best measure your funded strategies and activities. We will provide a more detailed description of the indicators when you are awarded.

You will report on your performance measures in the annual progress report.

While you will be responsible for reporting on your partner-level indicators, you can use additional indicators to assess your program. You’re encouraged to, propose additional relevant indicators that you will monitor over the course of the project.

Step 1: Review the Opportunity 24

Evaluation and performance measurement plan You must submit an initial draft of your EPMP plan with your application. In your EPMP, you will identify which of the partner-level indicators you plan to report on in your annual performance report). These indicators will be finalized with CDC.

You must submit a more detailed plan within the first six months of the award. See Reporting.

Be sure to align your evaluation and performance measurement plan with host country, agency, and program requirements and priorities.

Include the following elements in your evaluation and performance measurement plan.

Methods Describe how you will:

• Collect the performance measures.

• Respond to the evaluation topics.

• Use evaluation findings for continuous program quality improvement.

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

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 and stakeholders.

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

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.

You must submit an initial draft of your DMP with your application. You will submit a more detailed plan within the first six months of the award. See Reporting.

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Step 1: Review the Opportunity 25 https://www.cdc.gov/grants/additional-requirements/ar-25.html https://www.cdc.gov/grants/additional-requirements/ar-25.html

Submit your DMP with your application and include:

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

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

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

• Archival and long-term data preservation plans.

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

• 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.

In addition to the other requirements listed, also include:

• Cybersecurity plans.

• How you will protect personally identifiable information (PII) when you collect, store, transfer, and use this data.

• How you will remove information from the data that could reveal participants’ identities (de-identify the data) in intermediate and final data sets.

CDC will inform you of data you need to share with us and how and when it should be shared.

Evaluation activities You must carry out at least one evaluation for each cooperative agreement during your funding. The evaluation can be one of these:

• A process evaluation, which measures:

◦ How you delivered the services.

◦ What worked and what did not.

◦ The differences between who you intended to serve and who you actually served.

◦ Who could access your services.

• An outcome evaluation, which measures how the intervention affected changes in knowledge, attitudes, or behavior.

• An economic evaluation, which measures:

◦ How much the intervention cost.

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◦ What caused these costs.

◦ Cost effectiveness.

◦ Efficiency.

◦ The economic impact of the intervention.

Describe:

• The type of evaluations (process, outcome, and/or economic).

• Key evaluation questions these evaluations will address.

• Other information, such as measures and data sources.

Work plan You must provide a work plan for each component for your project. For each component, provide a detailed work plan for the first year and a high-level work plan for later years. The work plan connects your performance outcomes, strategies and activities, and measures. It provides more detail on how you will measure outcomes and processes. A sample work plan is provided below.

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.

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

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.

Dissemination of evaluation results By the end of the period of performance, your evaluation and performance measures will yield findings to demonstrate the value of your projects. You will disseminate these findings through the Annual Performance Report (APR).

You are expected to pursue additional dissemination in public domains and through informal channels. Dissemination channels could include:

• Local and international conferences and forum abstract presentations.

• Conference poster displays.

• Public health and global health journals.

• Manuscripts.

• Bulletins.

• Reports.

• Presentations to technical working groups and stakeholder meetings.

• Other approved products in print and electronic media, including websites and newsletters.

Program interest holders will be the primary intended users of your evaluation results and findings.

CDC and interest holders will use your evaluation findings during the five-year project period to share and implement key recommendations to strengthen program implementation, effectiveness, sustainability, and continued improvement after the award ends.

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

Step 1: Review the Opportunity 28 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

Funding policies and limitations Changes in HHS regulations As of October 1, 2025, HHS has adopted 2 CFR 200, with some exceptions included in 2 CFR 300. These regulations replace those in 45 CFR 75. You can find details in HHS Summary of Regulatory Changes, which is posted in the Grants.gov Related Documents tab for this opportunity.

General guidance All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate;

racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

• Your budget is arranged in eight categories: salaries and wages, fringe benefits, travel, equipment, supplies, contractual, other (includes consultant costs), and indirect costs.

• You may use funds only for reasonable program purposes consistent with the award, its terms and conditions, and federal laws and regulations that apply to the award. If you have questions about this determination, ask the grants management officer.

• Generally, you may not use funds to purchase furniture or equipment.

Clearly identify and justify any such proposed spending in the budget.

• All requests for funds contained in the budget should be stated in U.S.

dollars.

• Cost increases due to changes in exchange rates are allowed if enough funding is available. If an increase in the exchange rate would reduce the scope of the project or cause you to need more federal funding, you must get prior approval for exchange rate fluctuations.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

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Step 1: Review the Opportunity 29 https://www.ecfr.gov/current/title-2/part-200 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-300 https://ecfr.io/Title-45/Part-75 https://www.law.cornell.edu/definitions/index.php?width=840&height=800&iframe=true&def_id=13f24ea1f961f5f0d14b87ec1b39b25f&term_occur=999&term_src=Title:45:Chapter:A:Subchapter:A:Part:75:Subpart:E:Subjgrp:39:75.440

◦ Satisfactory progress in meeting your project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• If we receive more funding for this program, we will consider:

◦ Funding more applicants.

◦ Extending the period of performance.

◦ Awarding supplemental funding.

See also program-specific limitations.

Unallowable costs You may not use funds for:

• Research.

• Clinical care, except as allowed by law.

• Pre-award costs, unless we give you prior written approval.

• Other than for normal and recognized executive-legislative relationships:

◦ Publicity or propaganda purposes, including preparing, distributing, or using any material designed to support or defeat the enactment of legislation before any legislative body.

◦ The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before any legislative body.

◦ See Anti-Lobbying Restrictions for CDC Recipients [PDF].

• For guidance on some types of costs that we restrict or do not allow, see 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost.

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Step 1: Review the Opportunity 30 https://www.cdc.gov/grants/documents/Anti-Lobbying-Restrictions.pdf https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72

Indirect costs Indirect costs are those shared across multiple projects and not easily separated. Learn more at CDC Budget Preparation Guidelines [PDF].

To charge indirect costs you can select one of two methods:

Method 1 — Approved rate. If you currently have an indirect cost rate approved by your cognizant federal agency, you may use that rate.

Enclose a copy of the current approved rate agreement in your attachments.

Method 2 — De minimis rate. If you do not have a current negotiated indirect cost rate, you may elect to charge a de minimis rate (see 2 CFR 200.414(f)). If you choose this method, costs included in the indirect cost pool must not be charged as direct costs. This rate is 15% of modified total direct costs (MTDC). See the definition of MTDC (2 CFR 200.1). You can use this rate indefinitely.

Foreign organizations and foreign public entities Indirect costs on awards to foreign organizations and foreign public entities performed fully outside of the U.S. and its territories may be paid to support the costs of complying with federal requirements.

This rate is fixed at 8% of MTDC exclusive of tuition and related fees, direct expenditures for equipment, and subawards in excess of $25,000.

Negotiated indirect costs may be paid to the American University, Beirut, and the World Health Organization.

See 2 CFR § 300.414.

Other indirect cost policies

• As described in 2 CFR 200.403(d), you must consistently charge items as either indirect or direct costs and may not double charge.

Indirect costs may include the cost of collecting, managing, sharing, and preserving data.

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Step 1: Review the Opportunity 31 https://www.cdc.gov/grants/documents/budget-preparation-guidance.pdf https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC)) https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-300/subpart-E/section-300.414…