Division of Global Health Protection

Notice of Funding Opportunity

Application due Friday, October 2, 2026

Protecting and Improving Global Health Security by Engaging Local Partners: Strengthening and Sustaining Public Health Systems in Ghana Opportunity number: CDC-RFA-JG-26-0047

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 9

Agency priorities 12

Program description 15

Step 2: Get Ready to Apply 36

Get registered 37

Find the application package 38

Help applying 38

Step 3: Build Your Application 39

Application checklist 40

Application contents and format 42

Step 4: Understand Review, Selection, and Award 54

Application Review 55

Award notices 57

Step 5: Submit Your Application 58

Submission and deadlines 59

Step 6: Learn What Happens After Award 61

Post-award requirements and administration 62

Contacts and Support 67

Before you begin 3

Contents 2

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

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

See Step 2: Get Ready to Apply

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

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on 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 9

Agency priorities 12

Program description 15

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 Ghana.

Have questions?

See Contacts and Support.

Key facts

Opportunity name:

Protecting and Improving Global Health Security by Engaging Local Partners:

Strengthening and Sustaining Public Health Systems in Ghana

Opportunity number:

CDC-RFA-JG-26-0047

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 This Notice of Funding Opportunity (NOFO) seeks to build and sustain a more resilient public health system in Ghana that can detect, notify, and respond to public health threats to protect the health and safety of Ghanaians and Americans.

Through this NOFO, CDC will use and complement the strengths and resources of multisectoral and multilateral partners in Ghana to build and improve country capacity and leadership at all levels. This NOFO builds upon laboratory, surveillance, emergency response, and workforce development activities that CDC funded to enhance public health and global health security through the previous NOFO, CDC-RFA-GH20-2110. To sustain and build upon tangible improvements in Ghana, this NOFO will include support for surveillance and laboratory capacity-strengthening in border districts, as well as sequencing and bioinformatics.

This NOFO aims to support a broad base of disease surveillance and response capabilities at the subnational level. This will speed the detection of and response to outbreaks of diseases that threaten global health security and will further epidemic prevention.

Step 1: Review the Opportunity 5

Funding details Funding type: Cooperative agreement

Expected total NOFO funding for Year 1: $8,000,000 This is the expected total Year 1 funding for all awards made under this NOFO.

Expected awards: 2 to 4 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.

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, 3, and 4 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(s), meaning it supports baseline GHS

Step 1: Review the Opportunity 6 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 emergency 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 cannot 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.

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.

This NOFO also supports activities to combat other emerging infectious disease threats (Component 4). 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: $5,000,000

Step 1: Review the Opportunity 7

◦ Component 4: Emerging Infectious Disease Threats

▪ Component 4 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 8

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 Ghana.

Step 1: Review the Opportunity 9

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 will not consider an application that:

• Is from an organization that does not 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.

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.

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

Step 1: Review the Opportunity 10 https://www.cdc.gov/grants/additional-requirements/ar-31.html

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 11

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 12 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 13

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

Program description Background, overview, and related work In partnership with the government of Ghana and other public and private stakeholders, CDC seeks to implement public health programs and accelerate progress to ensure that Ghana can detect, notify, and respond to infectious disease threats. This will help protect the health and safety of Americans and promote global health security.

CDC’s primary partner is Ghana Health Service, the implementation arm of the Ministry of Health (MOH). It includes units focused on disease surveillance, disease control, emergency preparedness and response, laboratory services, monitoring and evaluation, risk communication, and community engagement.

CDC works closely with Ghana Health Service to carry out and advance public health and global health security activities. Under the leadership of MOH and Ghana Health Service, various public health sectors in Ghana improved notably during the previous project period. For example, a fourth subnational public health emergency operation center (PHEOC) was established and rapidly activated in response to flooding. It served as a coordination center for response and enhanced disease monitoring activities. CDC also helped Ghana Health Services develop system-level documents to improve public health laboratory networks and tiered diagnostic testing.

Public health laboratory diagnostic capacity has also been decentralized and expanded to include more laboratories. This speeds up detection and diagnosis. These labs have maintained international quality standards and accreditation through the expansion of the National External Quality Assurance (EQA) program.

Likewise, early detection, rapid scale-up of testing capacity, and use of case investigation and contact tracing helped successfully contain outbreaks of mpox and Lassa fever. Ghana’s Field Epidemiology and Laboratory Training Program (FELTP) continues to be a model program and trains participants in frontline, intermediate, and advanced cohorts from Ghana and other countries in West Africa.

Ghana has robust and decentralized systems for indicator-based disease surveillance systems, laboratory diagnostics, and public health event and emergency management. But vulnerabilities remain. The government of

Step 1: Review the Opportunity 15

Ghana completed its second Joint External Evaluation (JEE) in February 2025.

The JEE assesses a country’s ability to prevent, detect, and respond to public health threats. Since Ghana’s last JEE in 2017, five technical areas improved their scores to “developed” or “demonstrated capacity”:

• Biosafety and biosecurity training and practices.

• Effective national diagnostic network.

• Quality laboratory systems.

• Specimen referral transport network.

• Multisectoral workforce strategy.

Notably, Ghana also scored “developed capacity” for a new indicator, mass vaccination for epidemics of vaccine-preventable diseases — an activity recommended, funded, and supported technically by CDC technical assistance and personnel. All surveillance indicators maintained a score of “developed capacity,” while workforce training maintained a score of “demonstrated capacity.”

The results of the 2025 Ghana JEE informed the technical areas that CDC is prioritizing with this NOFO. These include:

• Supporting national public health emergency response and laboratory biosafety and biosecurity operational plans and guidance. This will help detect, report on, and respond to infectious diseases more quickly.

• Improving a broad base of disease detection and response capabilities at the subnational level, including points of entry and border districts.

The primary objective of this NOFO is to sustain gains, contribute to tangible improvements, and support a broad base of disease surveillance, laboratory, and response capabilities at the subnational level to advance public health and increase the speed of outbreak detection and response for diseases that threaten global health security.

Secondary objectives are to:

• Stop health threats at their source and contain disruptive global disease outbreaks.

• Use global data for disease prevention and mitigation programs in Ghana.

This funding opportunity will build and sustain a more resilient public health system in Ghana capable of detecting, notifying, and responding to public

Step 1: Review the Opportunity 16 health threats in the country, and by extension, effectively containing diseases that could threaten the health and safety of America. The NOFO sustains and improves upon laboratory, surveillance, emergency response, and workforce development activities previously supported by CDC. It will expand support for surveillance and laboratory capacity strengthening in border districts and genomic sequencing and bioinformatics. Activities supported with this NOFO will complement the strengths and resources of multisectoral and multilateral partners in Ghana to build and improve country capacity and leadership in outbreak detection and response.

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.

• 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:

Step 1: Review the Opportunity 17

◦ 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 advance GHS objectives to build and sustain a more resilient public health system in Ghana through partnerships.

This includes:

• Supporting a broad base of disease surveillance and response capabilities at the subnational level to detect, notify, and respond to diseases that threaten global health security.

• Stopping health threats at their source and containing disruptive global disease outbreaks.

• Using global data for disease prevention and mitigation programs in Ghana and supporting transparency in sharing disease data from Ghana.

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.

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

Step 1: Review the Opportunity 18 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

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:

Provide laboratory, disease surveillance, and emergency preparedness and response support in Ghana to build, strengthen, and guide health systems, national institutes, and public health programs in preparation for public health emergencies.

Improved integration and enhanced interoperability of national and subnational indicator-and event-based surveillance systems to improve data availability and quality.*

Increased laboratory capacity, safety, and quality, including detecting and characterizing priority diseases at the national and subnational levels.*

Improved coordination and functionality of emergency response structures at the national and subnational levels.*

A skilled and culturally responsive public health workforce is available to support public health operations and

National and subnational public health institutions have increased access to timely and high-quality laboratory and surveillance data to inform efforts to detect, notify, and respond to public health emergencies.*

Improved capacity to rapidly deploy a response-ready multisectoral public health workforce to lead public health emergency efforts.*

Improved coordination of local resources across systems and sectors to manage public health emergency responses at the national and subnational levels.*

Improved coordination and collaborative partnerships among multilateral

National and subnational public health institutions have advanced, sustainable capacity to lead public health emergency preparedness and response efforts, informed by integrated, real-time, high-quality surveillance and laboratory data.

Strengthened coordination between public health systems, clinical care, and communities for effective preparedness, response, and recovery.

Increased reach and effectiveness of response to public health threats through new and existing partnerships.

Accelerated outbreak detection and response.

Strategy 2:

Conduct assessments and/or use implementation science to monitor and improve health systems, national institutes, and public health programs in Ghana.

Strategy 3:

Train the public health workforce in Ghana to strengthen health systems and respond to public health emergencies.

Step 1: Review the Opportunity 19

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

Strategy 4:

Mobilize public health workforce personnel during public health emergency responses in Ghana.

respond to emergencies.*

Increased access to support, tools, and partnerships for timely responses to public health emergencies.*

Improved information sharing and coordinated action across health systems for faster and more effective emergency management.*

Improved quality of public health programs.*

Strengthened public health service delivery programs.* organizations, U.S.

government agencies, and other countries to detect, notify, and respond to public health emergencies.

Improved ability to follow up on cases or events of public health importance.*

Increased coverage of service delivery programs to meet community needs.*

Containment of diseases that threaten global health security and Americans’ health and safety.

Improved and effective coordination between public health systems, clinical care, and communities in preparedness, response, and recovery efforts.*

Strategy 5:

Collaborate across local public health, academic research, and multilateral organizations to establish networks and resources to coordinate public health emergency response in Ghana.

Strategy 6:

Connect country governments and multilateral organizations to provide support at all levels of the health system when needed during a public health emergency.

Strategy 7:

Support and strengthen public health programs, health service delivery, and implementation of science programs.

Step 1: Review the Opportunity 20

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.

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

Strategy 1: Provide laboratory, disease surveillance, and emergency preparedness and response support in Ghana to build, strengthen, and guide health systems, national institutes, and public health programs to detect, notify, and respond to public health emergencies.

Required activities:

• Enhance diagnostic and genomic sequencing capacity at the National Public Health and Reference Laboratory through improved workflow design, procurements, and training on international and national biosafety and biosecurity standards.

• Provide intermediate- and advanced-level training on genomic sequencing and bioinformatics, following international and national guidance and strategy.

• Help implement, monitor, and evaluate the national specimen referral and transport system.

• Support regional risk assessments and mapping of priority diseases to prevent and prepare for disease outbreaks and other public health events.

• Increase partner nations’ capacity to collect, integrate, and use disease surveillance, laboratory, and response data for evidence-based decision-making.

Optional activities:

• Monitor and help expand quality management systems and processes in public health laboratories.

• Expand the current laboratory information system and data reporting platform to cover all zonal public health laboratories and other laboratories in the public health network.

Step 1: Review the Opportunity 21

Strategy 2: Conduct assessments and/or use implementation science to monitor and improve health systems, national institutes, and public health programs in Ghana.

Required activities:

• Monitor and evaluate the use of accepted and innovative surveillance, laboratory, and public health emergency management practices.

• Put into practice accepted and innovative metrics for measuring and monitoring performance of national and subnational disease detection, notification, and response during outbreaks (for example, 7-1-7 bottleneck analyses).

Optional activities:

• Conduct national bio-behavioral surveys to provide data on the epidemiology of vaccine-preventable and epidemic-prone infectious diseases to help develop tailored prevention and preparedness plans.

• Increase the capacity of the National Public Health and Reference Laboratory and academic and research laboratories that support public health to use historical national and international data for predictive modeling of disease threats.

Strategy 3: Train the public health workforce in Ghana to strengthen health systems and respond to public health emergencies.

Required activities:

• Help introduce and monitor the use of early warning and alert systems, nationally and subnationally. These include:

• Revised Integrated Disease Surveillance and Response.

• Event-Based Surveillance.

• Community-Based Surveillance.

• Electronic data capture and management.

• Support preparedness and public health emergency management trainings and exercises.

• Support public health laboratory coordination, biosafety, biosecurity, and bio-risk management by training public health and veterinary laboratory staff on national and international biosafety and biosecurity guidelines and standards.

Optional activities:

• Increase capacity of local entities to certify, monitor, and repair laboratory equipment.

Step 1: Review the Opportunity 22

• Provide competency-based training programs to increase capacity for disease surveillance, laboratory management, and outbreak response at the district, regional, and national levels.

• Provide training on disease detection and containment for non-health border and port staff.

Strategy 4: Mobilize public health workforce personnel during public health emergency responses in Ghana.

Required activities:

• Help put into practice and manage the national and subnational public health emergency operations centers and supportive structures, such as rapid response teams.

• Introduce sustainable and low-tech solutions for public health emergency management staffing, rostering, deployment, and accountability.

• Integrate public health emergency management principles into district-level disease surveillance training and routine activities.

Optional activities:

• Help the partner government develop and implement national and subnational multisectoral workforce surge plans.

Strategy 5: Collaborate across local public health, academic research, and multilateral organizations to establish networks and resources to coordinate public health emergency response in Ghana.

Required activities:

• Collaborate with government-led national and subnational coordinating committees, technical working groups, and steering committees to understand national priorities and plans.

• Collaborate with the U.S. government and bilateral and multilateral stakeholders that support global health security capacity strengthening in Ghana.

Optional activities:

• Help develop a national framework for health security that maps, coordinates, and sustains surveillance and disease intelligence, public health emergency preparedness and response, laboratory systems and networks, information systems, and public health research capacities across the government of Ghana.

Step 1: Review the Opportunity 23

Strategy 6: Connect country governments and multilateral organizations to provide support at all levels of the health system when needed during a public health emergency.

Required activities:

• Support timely, accurate, and routine reporting on priority diseases through weekly epidemiology bulletins, publications in peer-reviewed journals, conference presentations, policy briefs, and national reports.

• Help the government of Ghana convene meetings of internal and external stakeholders during public health events and emergencies.

Optional activities:

• Help Ghana and neighboring countries collaborate to collect data, exchange information, and contain disease.

Strategy 7: Support and strengthen public health programs, health service delivery, and implementation of science programs.

Required activities:

• 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 technical assistance to the government of Ghana and partners to strengthen disease and outbreak responses, develop future pandemic preparedness and response capacity, and mitigate the effects of disease outbreaks on primary health care and public health systems such as:

◦ Global health security.

◦ HIV.

◦ TB.

◦ Malaria.

◦ Cholera.

◦ Ebola.

◦ Marburg.

◦ Mpox.

◦ Immunization.

◦ Vaccine-preventable disease.

Step 1: Review the Opportunity 24

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

• Support public health campaigns, including routine vaccination campaigns and 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 increase the quality of public health programs.

• Develop task- or function-specific standard operating procedures (SOPs) to incorporate data use and data-backed decision-making into 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.

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.

Step 1: Review the Opportunity 25

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:

• Other CDC programs and CDC-funded organizations:

◦ CDC Headquarters offices and programs.

◦ Implementing partners, including governmental and nongovernmental organizations, universities, and multilateral organizations that receive CDC funds.

• Organizations not funded by CDC:

◦ Other stakeholders in-country and at the global level, including other government entities, nongovernmental organizations, universities, civil society, private sector, Department of State and other U.S.

government agencies, and development partners aligned with the priorities of the NOFO.

◦ Other related government agencies or entities in Ghana supporting health system strengthening.

Due to the complexity of the service delivery and the geographic landscape in Ghana, program proposals that allow duplication or inconsistent implementation would be costly and provide limited impact. These proposals will not be funded.

You should make sure your proposed activities do not duplicate activities already being implemented by other CDC-funded organizations. CDC works closely with the government of Ghana, other donors and governments, and health working groups to efficiently use resources from a variety of sources.

You will be required to consider diverse stakeholder inputs, multisectoral approaches, new or existing health sector mapping analyses, and coordination matrices across the full spectrum of health system strengthening. These collaborations allow you and other organizations to use resources in-country to better integrate public health programs and prevent duplication of effort across all organizations and funding sources.

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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.

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.

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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.

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.

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

Step 1: Review the Opportunity 28 https://www.cdc.gov/grants/additional-requirements/ar-25.html

• 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.

◦ What caused these costs.

◦ Cost effectiveness.

◦ Efficiency.

◦ The economic impact of the intervention.

Describe:

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• 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.

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.

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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 31 https://www.cdc.gov/scientific-integrity/php/public-information-collection/ https://www.cdc.gov/scientific-integrity/php/public-information-collection/

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