Division of Global Health Protection

Notice of Funding Opportunity

Application due August 14, 2026

Strengthening Global Health Security by improving public health capacity to detect, notify, and respond to disease outbreaks globally Opportunity number: CDC-RFA-JG-26-0056

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 11

Agency priorities 14

Program description 17

Step 2: Get Ready to Apply 42

Get registered 43

Find the application package 44

Help applying 44

Step 3: Build Your Application 45

Application checklist 46

Application contents and format 48

Step 4: Understand Review, Selection, and Award 62

Application review 63

Award notices 65

Step 5: Submit Your Application 66

Submission and deadlines 67

Step 6: Learn What Happens After Award 69

Post-award requirements and administration 70

Contacts and Support 76

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 August 14, 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 11

Agency priorities 14

Program description 17

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.

Have questions?

See Contacts and Support.

Key facts

Opportunity name:

Strengthening Global Health Security by improving public health capacity to detect, notify, and respond to disease outbreaks globally

Opportunity number:

CDC-RFA-JG-26-0056

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: August 14, 2026

Expected award and start date:

September 30, 2026

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

Summary This notice of funding opportunity (NOFO) will enhance capacity to contain outbreaks through partnerships with Ministries of Health (MOHs), external stakeholders, and other governmental institutions. This NOFO prioritizes durable Global Health Security (GHS) programs to keep Americans safer, stronger, and more prosperous by improving public health globally. It applies lessons learned from recent significant public health events, including outbreaks of viral hemorrhagic fevers (VHF), highly pathogenic strains of influenza, and the COVID-19 pandemic.

As global leaders in strengthening GHS systems, the U.S. government (USG) will use updated frameworks to advance disease detection, notification, and response strategies. This NOFO’s main outcomes are:

• Use time-bound evidence based frameworks, such as the 7-1-7 framework, to detect and respond to outbreaks more quickly for diseases that threaten global health security and the health of Americans at home and abroad.

• Support regional and country public health institutions to independently lead preparedness efforts and create resilient, durable, and locally owned health systems.

• Enhance data systems, lab capacity, and local field epidemiology workforce to effectively combat disease threats of international significance.

Step 1: Review the Opportunity 5

Funding details Funding type: Cooperative agreement

Expected total NOFO funding for Year 1: $24,000,000 This is the expected total Year 1 funding for all awards made under this NOFO.

Expected awards: 4 - 8 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 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: We consider component 1 as core component, meaning it supports baseline GHS activities that are not

Step 1: Review the Opportunity 6 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 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.

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 (components 4 and 5). 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.

This NOFO is divided into five components. The applicant must apply for all five components, and the application must include a clearly marked budget and work plan for each component.

For Component 1, Core Global Health Security Priorities, the applicant should propose work in multiple countries or regions. In addition to Component 1, this NOFO supports additional activities when funding is made available for a moderate (Component 2) or substantial (Components 3-5) response to a disease outbreak or other public health emergency.

Budgets and work plans for Components 2-5 must propose appropriately scaled responses in relevant countries. The same logic model applies for all

Step 1: Review the Opportunity 7 five components. If you are not initially selected for core Component 1, an internal approved but unfunded (ABU) roster will be eligible for awards in the event of a public health emergency, dependent on availability of funds. If this is applicable, CDC will reach out to you.

Applications are not complete without a budget, budget narrative, technical/ project narrative, and workplan for each component included as part of the application (not appendices). Within the application, applicants should clearly indicate which countries they are applying to.

Component 1: Core Global Health Security Priorities Component 1 Ceiling: $3,000,000

These GHS activities are intended to be funded on an annual basis. The estimated Year 1 funding available is $3,000,000/recipient. Future years funding level will be dependent on funding availability.

Applicants are not required to apply for all countries in a region nor is there minimum number of countries for which an applicant can apply; however, priority will be given to applicants who can demonstrate the capacity to work in multiple countries and/or regions. To the extent possible, you should also be registered to work in the country/ies you applied for. Learn more in the Delivery location section.

CDC seeks to maximize coverage of GHS activity support geographically and may fund out of order to ensure coverage in prioritized countries/regions.

Final decision on which countries and activities are funded will be made at the time of award. Applications will be ranked by each country and/or region. CDC can fund out of rank order to:

• Respond to an unforeseen public health emergency in any country of international concern.

• Align with USG and/or agency prioritized technical areas and activities.

• Align with funding availability for countries or geographic area at the time of the award.

• Ensure operational capacity to work in countries applied for, including organizations with in-country registration or certificate of incorporation.

• Ensure maximum coverage of GHS activities geographically.

• Avoid duplication of activities in other CDC funding mechanisms.

Step 1: Review the Opportunity 8

Component 2: Rapid Small-Scale Response to Infectious Disease Outbreaks or other Public Health Emergencies Component 2 Ceiling: $5,000,000

This is intended to be approved but unfunded (ABU) as a baseline practice.

This component would support additional activities needed within a budget period when a disease outbreak or other public health emergency reaches a scale that requires a moderate response. Estimated planning level is $5,000,000.

Component 3: Rapid Large-Scale Response to Infectious Disease Outbreaks or other Public Health Emergencies Component 3 Ceiling: $10,000,000

This is intended to be approved but unfunded (ABU) as a baseline practice.

This component would support additional activities needed within a budget period when a disease outbreak or other public health emergency reaches a scale that requires a substantial response. Estimated planning level is $10,000,000.

Component 4: Small-scale Emerging Infectious Disease Threats Component 4 Ceiling: $15,000,000

This is intended to be approved but unfunded (ABU) as a baseline practice.

This component would support additional activities needed within a budget period when an emerging infectious disease threat reaches a scale that requires a substantial response. Estimated planning level is $15,000,000.

Component 5: Large-scale Emerging Infectious Disease Threats Component 5 Ceiling: $20,000,000

This is intended to be approved but unfunded (ABU) as a baseline practice.

This component would support additional activities needed within a budget period when an emerging infectious disease threat reaches a scale that requires a substantial response. Estimated planning level is $20,000,000.

Step 1: Review the Opportunity 9

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

• Budget narrative

• Component funding instructions for SF-424A

In-country local partner funding preference This NOFO includes a funding preference for local partners. Your organization will receive 10 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 10

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 the region/countries as described below:

While applicants may apply to support GHS activities in any country, applicants are encouraged to submit proposals meeting the objectives of this NOFO in countries or regions aligned with CDC’s Division of Global Health

Step 1: Review the Opportunity 11

Protection (DGHP) bilateral country and regional offices, including but not limited to:

• Countries: Bangladesh, Burkina Faso, Cambodia, Cameroon, China, Cote d’Ivoire, Democratic Republic of Congo, Ethiopia, Georgia, Ghana, Guinea, Haiti, India, Indonesia, Kenya, Liberia, Mali, Nigeria, Pakistan, Philippines, Saudi Arabia, Senegal, Sierra Leone, South Africa, Tanzania, Thailand, Uganda, Ukraine, Vietnam, Zambia.

• Regions: Caribbean Region, Central America Region, Central Asia Region, Southeast Asia Region.

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 60-page limit for the project narrative (see the Project narrative section for what counts toward the page limit) and 90-page limit for attachments.

• 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.

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

Step 1: Review the Opportunity 12 https://www.cdc.gov/grants/additional-requirements/ar-31.html

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.

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 13

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.

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

◦ Tests 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 14 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 15

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

Program description Background, overview, and related work The Centers for Disease Control and Prevention (CDC) works on the frontlines of global health security prioritize the detection, notification, and response to infectious disease threats. CDC is a trusted leader in health security with over 70 years of global experience. By working with partners to strengthen local capacity and stop outbreaks before they reach domestic borders, CDC protects the health, safety and prosperity of Americans.

Public health problem Disease outbreaks are increasing in frequency and severity worldwide.

Outbreaks can spread rapidly, reaching major cities on every continent in as little as 36 hours. Two-thirds of countries are unprepared or underprepared to detect or rapidly respond to international health threats. In addition to costing millions of lives and causing widespread illness, outbreaks can cause major disruptions to the U.S. and global economy. To prevent dangerous and costly health threats, we need to invest in preparedness and GHS.

Due to substantial U.S. leadership and investments, many countries have strengthened local capacity to address emerging infectious disease threats.

However, recent epidemics and global public health threats highlight ongoing GHS vulnerabilities. These vulnerabilities illustrate the critical need to improve detection, notification, response, and coordination efforts for infectious disease outbreaks and other health threats. GHS weaknesses include:

• Geographic areas with limited disease surveillance and containment systems.

• Institutional and logistical barriers to adequate delivery of services and interventions.

• Reluctance to share outbreak information or biological samples.

• Reliance on international resources over building local capacity.

• Emergence of new pathogens or increased drug-resistance.

• Inadequate border health measures.

CDC collaborates closely with Ministries of Health and other partners to address GHS vulnerabilities in over 40 countries. Together, CDC and partners strengthen public health systems and build local capacity to independently and rapidly detect and respond to outbreaks. They support effective outbreak

Step 1: Review the Opportunity 17 response to limit the spread of infectious pathogens, mitigate the loss of human life, and reduce the economic impact. CDC’s global health work is driven by USG GHS strategies and priorities.

Key frameworks for this NOFO The America First Global Health Strategy 2025 [PDF] prioritizes the interest of Americans and builds resilient and durable health systems globally. The America First Global Health Strategy is driven by three key objectives:

• Safer: Enhance global surveillance and response systems to detect and contain outbreaks swiftly, ensuring the safety of Americans at home and abroad.

• Stronger: Strengthen global health systems through strategic bilateral agreements that enhance resilience, leverage international resources for local ownership of durable programs, and integrate data systems for effective monitoring and response.

• More prosperous: Promote American prosperity by containing outbreaks at their source, protecting lives and the economy, while supporting American companies and innovations globally.

Another framework example is the 7-1-7 framework. The 7-1-7 framework details the ideal response timeline for a suspected outbreak, leading to quicker detection and control. It advises:

• Effective response measures in place within 7 days of notification.

• Outbreak detection within 7 days of emergence.

• Public health authorities notified within 1 day of detection.

These frameworks drive CDC’s global health goals and mission to prevent dangerous and costly health threats by stopping diseases at their source.

Building upon CDC’s GHS goals, the main outcomes of this NOFO are:

• Use time-bound and evidence based frameworks to accelerate outbreak detection and response for diseases that threaten global health security and the health of Americans at home and abroad.

• Support regional and country public health institutions to independently lead preparedness efforts. Eventually create resilient and durable health systems that are owned by local governments.

• Enhance data systems, lab capacity, and local field epidemiology workforce to effectively combat disease threats of international significance.

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

Step 1: Review the Opportunity 18 https://www.state.gov/wp-content/uploads/2025/09/America-First-Global-Health-Strategy-Report.pdf

Work done to date This NOFO builds upon activities carried out and outcomes achieved under the previous NOFO, CDC-RFA-GH20-2110. The previous NOFO successfully increased GHS capacities and was leveraged to respond rapidly to the COVID-19 pandemic. It offered funding and technical assistance globally.

Projects under CDC-RFA-GH20-2110 were used to:

• Improve diagnostic capacity.

• Strengthen country emergency response capacity.

• Enhance disease surveillance, reporting, and data management.

Public health priorities and strategies Your funded activities must also align with CDC’s global approach to strengthening global health security. This approach guides 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. The 7-1-7 target provides a standardized benchmark for evaluating the effectiveness of outbreak detection and

Step 1: Review the Opportunity 19 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 approach to 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.

Purpose The purpose of this NOFO is to strengthen countries’ capacity to independently detect, notify, and respond to disease threats of international significance. By stopping outbreaks at their source, this NOFO makes Americans safer, stronger, and more prosperous, both at home and abroad.

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

Step 1: Review the Opportunity 20 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/

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:

Work with governments and other partners to strengthen and guide surveillance, laboratories, data systems, and emergency preparedness and response capabilities in countries’ health institutes and programs to effectively detect, notify, and respond to public health emergencies or threats.

Improved quality, completeness, and timeliness of data and integration of public health data systems.*

Improved functioning of integrated health systems, programs, and National Public Health Institutes (NPHIs) to better prevent, detect, and respond to public health emergencies (PHEs).*

Improved country-specific routine, event-based, and indicator-based surveillance systems.*

Increased ability of laboratory systems to

Increased use of functional systems with timely collection and integration of data at all levels of the health systems to prevent, detect, 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.*

Improved capacity to deploy a response-ready multisectoral public health workforce to lead

Enhanced health system resiliency and durability of health system operations.*

Supported regional and country public health institutions can implement and lead public health preparedness and response efforts.

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

Increased government ownership and

Strategy 2:

Support integration of surveillance, laboratory, clinical, Step 1: Review the Opportunity 21

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes emergency, operational, and health data. Establish interoperable public health systems for improved, more timely outbreak detection, reporting, and response.

detect and contain priority diseases.*

Increased timely and actionable reporting and dissemination of data and reports after detection.*

Strengthened emergency operational data systems to monitor health system readiness.*

Improved quality of public health and public health service delivery programs.*

A skilled public health workforce is available to support public health operations and respond to emergencies.*

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

Improved information sharing across health systems for effective emergency management.*

Accelerated provision of supplies, equipment, personnel, and public health emergency efforts.*

Established processes, resources, information, and networks in place, increasing effective coordination and management of public health emergency responses across national and subnational levels.*

Improved coordination and collaboration among multilateral organizations, and countries to respond to public health emergencies.*

Enhanced capability of host governments to lead effective responses to small and large-scale PHEs.* leadership in public health preparedness and response efforts.*

Increased reach and effectiveness of public health operations and response to threats.*

Increased speed of outbreak detection and response for diseases that threaten global health security.*

Strategy 3:

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

Strategy 4:

Conduct assessments, identify areas for improvement, and collaborate on corrective action planning to monitor and improve health systems, national institutes, and public health programs.

Strategy 5:

Train and institutionalize the public health workforce to strengthen global health systems and mobilize this workforce in response to health emergencies.

Step 1: Review the Opportunity 22

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

Strategy 6:

Collaborate and connect country stakeholders and partners to expand networks and resources which leverage scientific expertise to support public health emergency response coordination. Provide additional response or surge support when needed.

logistical support for public health emergency (PHE) response.*

Strategy 7:

Support effective response to small and large-scale disease outbreaks.

Step 1: Review the Opportunity 23

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

Strategy 1:

Work with governments and other partners to strengthen and guide surveillance, laboratory, data systems, and emergency preparedness and response capabilities in countries’ health institutes and programs to effectively detect, notify, and respond to public health emergencies or threats.

Required activities:

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

• Strengthen and expand laboratory detection and confirmatory capacity to decrease dependence on international partners.

• Conduct disease prioritization workshops to define or redefine priority diseases for surveillance.

• Develop operational plans, standards for data analysis, and data sharing to strengthen the delivery of public health programs.

• Develop and disseminate guidelines to assess risk of unusual case reports and respond to surveillance signals at all levels.

• Produce ad hoc reports of analyzed surveillance data for outbreaks or other public health events and disseminate from the national level.

• Strengthen early warning surveillance systems and laboratory diagnostics in emergency-affected and fragile contexts.

• Develop and support implementation of a training package for data management. This should include data collection, data analysis, trend analysis, as well as developing reports, summaries, or policy briefs.

• Develop a roadmap to ensure GHS sector coordination and interoperability.

Step 1: Review the Opportunity 24

• Provide technical assistance to strengthen foundational indicators, electronic integrated disease surveillance and response, event-based surveillance systems, and workforce capacities.

• Develop or strengthen a functional civil registration and vital statistics (CVRS) system and data management to support mortality surveillance and data for public health use.

• Reinforce subnational capacities in emergency management by implementing or strengthening subnational EOCs and training regional and district-level human resources.

Optional activities:

• Establish sentinel surveillance sites and conduct surveillance for all priority diseases.

• Develop hands-on-training curriculum, complementary to materials developed by CDC, for all surveillance and laboratory staff. It should include task-based training and mentoring in their appropriate technical and administrative areas.

• Increase participation in proficiency testing and comprehensive national or international quality management and assurance systems at multiple laboratory levels (including peripheral).

• Support environmental and wastewater surveillance efforts as a potential early warning surveillance system.

Strategy 2:

Support integration of surveillance, laboratory, clinical, emergency operational and health data and establish interoperable public health systems for improved and more timely outbreak detection, reporting, and response.

Required activities:

• Support use of time-bound framework approaches (including bottleneck analyses, operational planning, implementation of interventions, and monitoring and evaluation of progress) for improving performance of all aspects of an emergency response system.

• Provide technical guidance and improve interoperability of data systems (including operational, laboratory, surveillance and health information systems), networks, and technical analysis across functions and sectors.

This should include environmental, human, and animal health sectors.

Map and assess existing resources and identify any gaps.

Step 1: Review the Opportunity 25

• Strengthen public health system capacities for data management. Ensure reliable, accurate site-level reporting.

• Strengthen public health system capacities for analysis and visualization of data. Ensure reliable, accurate site-level data use and reporting.

• Develop and disseminate or strengthen national public health bulletins containing current, evidence-backed, and actionable public health information.

Strategy 3:

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

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

• Provide technical assistance 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.

• 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 outbreak response campaigns.

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

Step 1: Review the Opportunity 26

Strategy 4:

Conduct assessments, identify areas for improvement, and collaborate on corrective action planning to monitor and improve health systems, national institutes, and public health programs.

Required activities:

• Conduct assessments to identify areas for improvement. Provide technical assistance for planning, implementing, and evaluating evidence-based strategies to help countries improve quality of programs.

• Develop tools and standards for data quality assessment.

• Assess current capacities in all GHS sectors and identify critical gaps for improvement.

• Support and provide continued technical assistance to governments and other stakeholders to conduct and monitor National Action Plans for Health Security (NAPHS), simulation exercises and/or After-Action Reviews. Implement recommendations through evidence-based activities.

• Develop monitoring and evaluation frameworks and/or programs to effectively assess and address gaps during preparedness, response, and recovery phases.

Optional activities:

• Conduct integrated health and WASH assessments in outbreak areas as part of response plans for priority diseases, where applicable.

• Establish operational research paradigms to be able to effectively assess the impact of public health interventions across the health system.

• Support leadership and management capacity development in areas such as financial management, organizational development, leadership training, strategic and operational planning.

Strategy 5:

Train and institutionalize the public health workforce to strengthen global health systems and mobilize this workforce in response to health emergencies.

Required activities:

• Provide technical support in assessing and developing national public health workforce strategies and plans.

Step 1: Review the Opportunity 27

• Build planning capacity to develop or improve human resources for strategies that quantify health workforce needs, demands, and supply under future scenarios.

• Develop a mechanism for multisectoral action on health workforce issues to generate required support from all relevant health sectors, ministries of finance, education and labor (or equivalent), collaborating partners, and stakeholders.

• Conduct engagement meetings with the human, animal, and environmental health sector workforce and other stakeholders to expand the multisectoral public health workforce strategy in response to public health emergencies.

• Establish or strengthen multidisciplinary and multilevel rapid response teams (RRT).

• Develop protocols, SOPs, and technical guidelines to ensure regular review and update of the multisectoral workforce strategy. Also ensure final approval from other relevant sectors and other relevant government agencies.

• Develop and implement training on surveillance, outbreak preparedness, and response for specific cadres (e.g., frontline health workers, laboratory personnel, epidemiologists).

• Develop a strategic plan for an institutionalized field epidemiology training program (FETP) that includes a career progression pathway and an advisory group with a governance structure that includes stakeholders.

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

• Support improved emergency operations and response capacities by conducting exercises to test the emergency system and resiliency of the health system.

• Provide technical input and guidance to improve emergency preparedness and response plans at national and subnational levels.

• Develop and support a surge workforce during outbreaks.

• Train frontline responders to investigate outbreaks and conduct event-based surveillance (EBS) at the national and subnational level.

• Develop a plan and SOPs, including thresholds and levels for activating emergency response operations. Include Public Health Emergency Operations Centers (PHEOC), Rapid Response Teams (RRTs), health communication, and other resource requirements.

Step 1: Review the Opportunity 28

• Develop a training plan for emergency staff, including on the incident management system and functioning of a PHEOC. Implement it at the national and subnational level. This training should include management, communications, finance, and logistics of a PHEOC.

• Establish and maintain a roster of emergency staff with defined roles and functions.

• Support routine integration of timebound framework analyses, such as 7-1-7, into After Action Reviews of disease outbreaks.

• Improve multisectoral workforce capacity in preparedness and response to PHEs by developing and delivering training programs.

Optional activities:

• Design and implement trainings to strengthen the Water, Sanitation, and Hygiene (WASH) workforce to respond to hygiene-related disease threats.

• Identify and document all trainings related to contingency planning, management of emergency situations, risk communications, and joint exercises for multidisciplinary teams.

• Strengthen rapid response capabilities across security, military, public health RRTs, and emergency medical teams.

• Form a steering committee or other management structure to develop objectives, essential functions, and core components. The committee should provide oversight of the EOC’s operations and monitor and evaluate its use.

Strategy 6:

Collaborate and connect country stakeholders and partners to expand networks and resources which leverage scientific expertise to support public health emergency response coordination and provide additional response or surge support when needed.

Required activities:

• Develop technical and management capacities of NPHIs.

• Establish a health sector emergency response coordination mechanism with participation from health and other sectors for managing emergency response at the national and subnational levels.

• Finalize SOPs for coordination of key health sector stakeholders such as surveillance, health facilities, and emergency medical teams.

• Develop and establish plans to share information and act across all levels and sectors of the health system.

Step 1: Review the Opportunity 29

• Support scientific writing training and manuscript development for Ministry of Health (MoH) staff/FETP graduates.

Optional activities:

• Support leadership and management capacity development in areas such as financial management, organizational development, leadership training, strategic and operational planning.

• Map surge operations across and within health programs

• Form a steering committee or other management structure to develop objectives, essential functions, and core components to oversee partner and stakeholder engagement.

Strategy 7:

Support effective response to small and large-scale disease outbreaks.

Required activities:

• Provide rapid, emergency logistical support including supplies, equipment, personnel, or other resources to augment host government-led public health emergency response activities.

• Provide technical support and training in domains that ensure a robust public health emergency response.

• Support strengthening critical health systems capacities nationally or sub-nationally. This includes technical assistance for assessments in coordination with other stakeholders to enhance preparedness and response capabilities.

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 framework Your strategies under this project should follow CDC’s global approach to strengthening global health security.

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

Step 1: Review the Opportunity 30

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. CDC will work with the recipient(s) on any adjustments throughout the period of performance.

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…