cdc-rfa-jg-26-0125_final.pdf

Division of Global HIV and Tuberculosis

Notice of Funding Opportunity

Application due Monday, June 22, 2026

Strengthening tuberculosis (TB) prevention, diagnosis, treatment, and surveillance in Asia Opportunity number: CDC-RFA-JG-26-0125

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Agency priorities 11

Program description 14

Step 2: Get Ready to Apply 33

Get registered 34

Help applying 35

Step 3: Build Your Application 36

Application checklist 37

Application contents and format 39

Step 4: Learn About Review and Award 48

Application review 49

Award notices 54

Step 5: Submit Your Application 55

Submission requirements and deadlines 56

Step 6: Learn What Happens After Award 58

Post-award requirements and administration 59

Contacts and Support 63

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 Monday, June 22, 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. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 8

Agency priorities 11

Program description 14

Basic information Centers for Disease Control and Prevention (CDC)

Global Health Center

Division of Global HIV and Tuberculosis

Making America safer, stronger, and more prosperous by reducing TB and other related health conditions in global settings through data-driven activities, innovative approaches, and strengthened public health systems.

Have questions?

See Contacts and Support.

Key facts Opportunity name:

Strengthening tuberculosis (TB) prevention, diagnosis, treatment, and surveillance in Asia

Opportunity number:

CDC-RFA-JG-26-0125

Announcement type:

New

Assistance listing:

93.494 – Global Tuberculosis

Key dates Application submission deadline: Monday, June 22, 2026

Expected award and start date:

September 30, 2026

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

Summary The purpose of this NOFO is to reduce TB-related morbidity and mortality in India, the Philippines, and Vietnam by strengthening:

• TB case finding, including linked activities such as screening, testing, and diagnostic evaluation.

• TB prevention, including TB preventive treatment (TPT).

• TB treatment, including linkage and improved treatment regimens, as appropriate.

• Surveillance, through adopting, evaluating, and expanding innovative approaches.

Activities implemented will focus on:

• Expanding and improving diagnosis of TB infection and TB disease, including early and asymptomatic TB as well as drug-resistant or multidrug-resistant TB. This will be done by using and evaluating innovative screening and diagnostic methods and scaling up evidence-based approaches.

• Improving TPT outcomes for all individuals at high risk of developing TB disease and improving TB treatment outcomes of individuals with TB disease, including those with drug-resistant or multidrug-resistant TB.

This will be done by using new, shorter, and better-tolerated treatment regimens.

• Strengthening TB surveillance for data-driven decision making, program planning, and public health action.

Step 1: Review the Opportunity 5

Asia carries the highest burden of TB and drug-resistant or multidrug-resistant TB globally. This NOFO will focus on activities in India, the Philippines, and Vietnam because they are three of the top four countries contributing to the TB burden in the U.S. This aligns with the America First Global Health Strategy.

Funding details Funding Type: Cooperative agreement

Expected total NOFO funding for Year 1: $3,000,000 This is the expected total Year 1 funding for all awards made under this

NOFO.

Expected number of awards: 1-3 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, subject to available funds and program priorities.

Funding strategy

Funding amounts Average One Year Award Amount: $1,000,000

The expected total NOFO funding for Year 1 is $3,000,000. For this NOFO, you are strongly encouraged to apply to the Average One Year Award amount of $1,000,000 instead of applying to the full $3,000,000 expected total NOFO funding for Year 1. You should develop a proposal to spend up to $1,000,000 carrying out activities under all NOFO strategies in one of the following countries: India, Philippines, or Vietnam.

Exact funding amounts and the geographic scope for each award under this NOFO will be determined at the time of award. Geographic prioritization may change over the course of the period of performance based on the burden of disease and evolving program priorities.

To align with the responsiveness criteria, if you request more than the Year 1 funding amount, your application will be deemed ‘non-responsive’ and will not be considered for award.

Funding amounts for years two through five will be set at continuation. We will continue funding based on:

Step 1: Review the Opportunity 6

• 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 CDC Global HIV and TB cooperative agreements using component funding.

Component funding allows us to provide funding as it becomes available. To do so, we fund sets of activities by quarter and project.

CDC may fund one or more of your components to start the budget period, and then consider other components based on available funding and recipient performance related to meeting milestones. Component activation and sequence may vary based on buy-ins and interagency allocations. CDC will communicate any adjustments in writing.

Setting up components

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

• Review the expectations for year one activities in the strategies and activities section.

• Group your activities under the following anticipated components. Only include the activities planned for year one.

◦ Component 1: Strategy 1: Enhance and optimize early diagnosis and treatment of TB, drug-resistant/multidrug-resistant TB, and TB infection, while maximizing linkages between screening, diagnostic evaluation, treatment, and prevention activities to strengthen the TB care and prevention cascade.

◦ Component 2: Strategy 2: Strengthen TB surveillance to promote data-driven decision-making and program planning.

◦ Component 3: Additional Global TB Priorities.

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

• Budget narrative

• Component funding instructions for SF-424A

Step 1: Review the Opportunity 7

Eligibility Statutory authority This NOFO supports global TB activities that are consistent, as applicable, with the America First Global Health Strategy and other applicable guidance.

Activities under this NOFO are authorized under applicable statutory authorities. Funding is provided through available appropriations consistent with current law. This program is authorized under Section 307 of the Public Health Service Act [42 USC 242l], as amended and Section 301(a) of the Public Health Service Act [42 USC 241(a)], as amended.

Eligible applicants This is a fully competitive NOFO. Eligibility is unrestricted. All types of organizations are eligible and encouraged to apply, including:

• 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.

Step 1: Review the Opportunity 8

Other required qualifying factors

Delivery location While any type of organization may apply, you must conduct the project in either India, the Philippines, or Vietnam.

The expected total NOFO funding for Year 1 is $3,000,000. CDC will consider any application requesting an award higher than this amount as non-responsive and it will receive no further review. However, for this NOFO, you are strongly encouraged to apply to the Average One Year Award amount of $1,000,000 per country instead of applying to the full $3,000,000 expected total NOFO funding for Year 1.

You should develop a proposal to spend up to $1,000,000 carrying out activities under all NOFO strategies in one of the following countries: India, Philippines, or Vietnam. CDC currently anticipates approximately $1,000,000 per country, although this is subject to change and dependent on geographic priorities and availability of funds. Geographic prioritization may change over the course of the period of performance. CDC will work with the recipient(s) on any adjustments throughout the period of performance.

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 eligibility criteria. See requirements in eligibility.

• Is submitted after the deadline.

• Proposes research activities. See the definition of research.

• Requests more funding than the expected total NOFO funding for Year 1, as referenced in the funding amounts sub-section.

• Exceeds the 20-page limit for the project narrative (see the project narrative section for what counts toward the page limit).

• Is not in English.

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

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

See the application checklist to understand your application requirements.

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

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

For applicants applying to work in India:

Any local recipient (prime applicant or proposed sub-recipient) applying to undertake activities in India under this NOFO must be compliant with Government of India’s Foreign Contribution Regulation Act (FCRA) and must submit documentation of active FCRA registration.

The prime recipient applicant must have the capability to obtain local approval and engage local sub-recipients, as needed, to meet the program objectives.

Failure to provide FCRA registration as part of the application will render an application non-responsive and your application will not move forward.

For applicants applying to work in Vietnam:

Any local or foreign applicant (prime applicant or proposed sub-recipient) applying to undertake activities in Vietnam under this NOFO must be compliant with Government of Vietnam’s required certifications. Foreign applicants must have a Registration Certificate, and local recipients must have a Certificate of Establishment/Juridical Person Status.

The prime recipient applicant must have the capability to obtain local approval and engage local sub-recipients, as needed, to meet the program objectives.

Failure to provide documentation of certification as part of the application will render an application non-responsive and your application will not move forward.

Application limits We do not limit the number of applications an organization may submit.

However, only one applicant/application will be selected to carry out activities in one specified location. CDC reserves the right to choose which location the organization will carry out the activities should one organization rank in the top 3 scoring range for each location and may select out of rank order.

Applicants are encouraged to select their preferred choice of location should such scenario were to occur.

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.

Step 1: Review the Opportunity 10

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

Funded activities must:

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

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

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

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

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

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

◦ Works to prevent disease and advance emergency response.

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

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

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

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

Step 1: Review the Opportunity 11 https://www.cdc.gov/about/cdc/index.html

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

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

◦ Streamlining internal processes.

◦ Improving risk communication strategies.

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

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

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

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

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

◦ Replacing data silos with integrated systems.

◦ Using advanced technology.

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

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

Step 1: Review the Opportunity 12

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

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

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

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

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

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

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

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

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

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

Step 1: Review the Opportunity 13 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf

Program description Background overview and related work The global TB burden TB is the world’s deadliest infectious disease and a significant global health threat, with 10.7 million new cases and 1.23 million deaths each year. Though it is curable and preventable, TB imposes a substantial economic burden on individuals, communities, and healthcare systems: diagnosis, treatment, and lost productivity costs have reached billions of dollars globally. The rise of drug-resistant and multidrug-resistant TB complicates efforts further, as these strains are more difficult and expensive to treat, leading to increased morbidity and mortality. As an airborne disease, TB easily crosses borders through international travel and trade, posing an urgent threat to national safety and security in the United States. Eliminating TB and protecting the U.S.

requires a coordinated global response, particularly in high-burden countries such as India, the Philippines, and Vietnam.

India India has the highest burden of TB globally, with over 2.7 million new cases and 305,000 TB-related deaths in 2024. The TB incidence rate in India is 187 cases per 100,000 population, and around 40% of the population is estimated to be infected with TB. India also faces a significant challenge with drug-resistant or multidrug-resistant TB, accounting for 32% of the global burden.

Despite progress, including an 18% decline in TB incidence over the last decade, the gap between estimated incidence and the number of people diagnosed and treated remains critical. The lack of primary healthcare infrastructure in rural areas and a shortage of trained healthcare workers hinder effective diagnosis and treatment. Progress in India is essential for reducing TB cases in the U.S., as nearly 4 million tourists travel between the U.S. and India each year.

Philippines The Philippines reported approximately 724,000 new cases and 37,000 TB-related deaths in 2024. The country has one of the highest TB incidence rates, of 625 cases per 100,000 population. It accounts for 6.8% of new TB cases globally, despite representing only 1.4% of the global population. Many individuals are not diagnosed or treated due to a fragmented healthcare system and a lack of trained personnel in remote areas. The Philippines also

Step 1: Review the Opportunity 14 has one of the highest burdens of drug-resistant or multidrug-resistant TB, with significant gaps between estimated cases and those enrolled in treatment. The Philippines is a significant contributor to TB cases among non- U.S.-born individuals, so lowering the TB burden in the Philippines is crucial for reducing the TB burden on the U.S. healthcare system.

Vietnam Vietnam also has a high TB burden, with approximately 184,000 new cases and 13,000 TB-related deaths in 2024. Nearly half of TB cases in Vietnam are not diagnosed or treated, and the country struggles with a substantial burden of drug-resistant or multidrug-resistant TB. Challenges include underscreening of high-risk groups, challenges in care linkage, and delays in implementing new drug regimens. Misconceptions about TB further complicate treatment adherence and efforts to eliminate the disease.

Vietnam’s contribution to the global and U.S. TB burden is significant, so it is vital to address TB in Vietnam to reduce incidence rates worldwide.

The current work to end TB The global End TB Strategy envisions a world free of TB — zero deaths, disease, or suffering due to TB by 2035. It serves as a blueprint for countries to end the TB epidemic by driving down TB incidence and deaths and eliminating catastrophic costs, defined as spending more than 20% of annual household income on TB-related costs. The 2025 milestone targets outline a 50% reduction in TB incidence and a 75% reduction in TB deaths compared to 2015 levels. Current trajectories show a 21% and 28% reduction in India, a 14% and 25% increase in the Philippines, and an 8.4% and 28.4% reduction in Vietnam, compared with 2015 levels.

Failure to achieve the global End TB Strategy could reverse decades of progress toward eliminating TB and reducing antimicrobial resistance in the U.S. To prevent a widespread TB resurgence in the U.S., it is critical to fortify TB efforts in countries with the highest burden and those that contribute most to U.S. TB cases. In 2024, 75% of TB cases and 85% of drug-resistant TB cases in the U.S. occurred among non-U.S.-born individuals born in India, the Philippines, or Vietnam, with these three being among the top four contributors. Strengthening TB initiatives in India, the Philippines, and Vietnam aligns closely with national interests and the America First Global Health Strategy, which emphasizes making the U.S. safer, stronger, and more prosperous. By focusing on diagnosing, treating, and preventing TB in these high-burden countries, the U.S. can help mitigate costly and deadly outbreaks at the source and prevent TB and drug-resistant/multidrug-resistant TB

Step 1: Review the Opportunity 15 strains from entering the U.S. This work will ultimately safeguard American lives and livelihoods, and the nation’s economy.

Purpose The purpose of this NOFO is to:

• Enhance early detection, treatment, and prevention of TB using evidence-based, innovative interventions.

• Strengthen TB data systems to optimize TB care and care cascade activities in India, the Philippines, and/or Vietnam.

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. You will use these outcomes as a guide for developing performance measures.

Step 1: Review the Opportunity 16

Table: Strategies and outcomes

Strategies Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 1:

Enhance and optimize early diagnosis and treatment of TB, drug-resistant or multidrug-resistant TB, and TB infection. Maximize linkages between screening, diagnostic evaluation, treatment, and prevention activities to strengthen the TB care and prevention cascade.

Strategy 2:

Strengthen TB surveillance to promote data-driven decision-making and program planning.

Enhanced competencies of healthcare providers, ministries of health, and community workers in TB infection case-finding.*

Increased uptake of quality TB diagnosis and treatment services, including

TPT.*

Increased recognition of drug-resistant and multidrug-resistant

TB.*

Increased recognition and diagnosis of asymptomatic TB disease.*

Increased collection and reporting of timely and accurate data covering the full TB care and prevention cascades.*

Improved capacity at all health-system levels to analyze and interpret TB surveillance data.*

Reduced delays in TB diagnosis, notification, and treatment, especially among high-risk populations.*

Increased case detection in populations at risk for TB, including children and adolescents.*

Increased successful outcomes for all TB patients.*

Reduced time from TB infection to TB treatment.*

Increased real-time use of TB data by government health organizations for decision-making and public health response.*

Increased integration of care systems combining surveillance, screening, and action for timely response.*

Reduced TB mortality and morbidity.

Reduced TB transmission.

Sustained progress toward TB-free regions and countries.

Increased TB programs that are evidence-based and data-driven in countries.*

* Indicates outcomes we expect you to achieve or substantially contribute to during the time period noted in the logic model You must report on these outcomes.

Step 1: Review the Opportunity 17

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

The following are priority activities under each strategy of this NOFO:

Strategy 1: Enhance and optimize early diagnosis and treatment of TB, drug-resistant or multidrug-resistant TB, and TB infection. Maximize linkages between screening, diagnostic evaluation, treatment, and prevention activities to strengthen the TB care and prevention cascade.

Priority activities

Screening and diagnosis

• Implement systematic TB screening using evidence-based, innovative screening tools and approaches in high-risk groups. You should propose groups that are high risk based on the TB epidemiology of the focus country. These groups could include:

◦ Household and non-household contacts.

◦ Undernourished people.

◦ Children and adolescents.

◦ Elderly people.

◦ People with diabetes mellitus.

◦ Tobacco users.

◦ People working or living in healthcare facilities, congregate settings, or crowded settings.

• Integrate TB screening and referral services into existing health services and programs, including:

◦ Nutrition rehabilitation centers.

◦ Health facility departments that treat sick children.

◦ Congregate settings.

• Help ensure that individuals who screen positive for TB promptly receive diagnostic evaluation, including clinical assessments and laboratory tests.

Step 1: Review the Opportunity 18

These evaluations should include advanced and novel diagnostic tests, including near point-of-care diagnostics, where appropriate.

◦ Integrate evaluation into funded activities to ensure that linkages succeed.

TB infection screening and TPT

• Link individuals who screen negative for active TB, but are at high risk for TB, to TB infection screening (as appropriate) and TPT services. Use shorter regimens for eligible people.

• Incorporate TB infection screening, as appropriate, and TPT into routine care in settings where high-risk populations seek services. This helps ensure easy access and supports adherence.

Treatment of active TB cases

• Establish clear pathways for people diagnosed with TB to be tested for drug susceptibility and to receive timely, accurate treatment.

• Integrate case management strategies, including contact investigations, to ensure comprehensive prevention, care, and treatment adherence.

Strategy 2: Strengthen TB surveillance to promote data-driven decision-making and program planning.

Priority activities

• Improve tools and processes to ensure TB data are complete and valid, including linkages between different data systems used for TB prevention and care.

• Build capacity of healthcare workers to:

◦ Document and report relevant clinical and epidemiologic information across the spectrum of TB infection and disease.

◦ Routinely analyze and use data for decision-making.

◦ Promote timely progression from collecting surveillance data to taking programmatic action or making a policy change.

• Strengthen laboratory and diagnostic data systems to track and increase rates of bacteriologic confirmation and drug susceptibility testing.

• Promote use of interoperable laboratory and health information systems, including radiology results, to reduce reporting burden while ensuring data quality.

• Develop and pilot a record linkage activities framework for routine monitoring of underreporting.

Step 1: Review the Opportunity 19

You are expected to provide copies of and/or access to all data, software, tools, training materials, guidelines, and systems developed under this NOFO to Ministry of Health and other relevant interest holders, including HHS/CDC, for appropriate use consistent with underlying authorities.

Related policies

• If awarded, any activities you conduct must align, as applicable, with the

America First Global Health Strategy [PDF].

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

• Projects should support CDC’s mission to:

◦ Protect Americans from infectious and chronic diseases.

◦ Strengthen public health systems.

◦ Advance innovation in health data and infrastructure.

Additionally, applicants should show how their work:

• Contributes to rapid, science-driven responses to public health threats.

• Promotes global health leadership.

• Adheres to principles of integrity, accountability, and compliance with applicable laws and federal priorities.

• For more information about CDC’s priorities, see CDC priorities statement

• Recipients should keep up with the latest guidelines, guidance, and policies found on USG sites including Whitehouse.gov, HHS.gov, CDC.gov, and Department of State/Bureau of Global Health Security. Also, the Notice of Award (NoA) will include important terms and conditions that also apply to this award.

Geographic focus Geographic prioritization may change over the course of the period of performance. 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 as well as milestones achieved in each performance period.

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

Step 1: Review the Opportunity 20 https://www.state.gov/wp-content/uploads/2025/09/America-First-Global-Health-Strategy-Report.pdf https://www.state.gov/bureaus-offices/under-secretary-for-foreign-assistance-humanitarian-affairs-and-religious-freedom/bureau-of-global-health-security-and-diplomacy/

Communities served Under this NOFO communities served include people living with or at increased/higher risk for TB or other related health conditions that can negatively affect the goals of keeping Americans safer, stronger, and more prosperous.

Organizational capacity You must include a heading in your Project Narrative titled Organizational Capacity under which you should include a brief description of 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.

Coordination If funded, we will expect you to work with:

• Other CDC programs.

• CDC-funded and non-CDC-funded ministries of health and local health authorities.

• CDC-funded multilateral organizations such as the Stop TB Partnership.

• Other CDC-funded and non-CDC-funded global TB organizations.

• Regional interested parties, including local and international agencies or organizations, and other entities closely aligned with Stop TB’s Global Plan to End TB (2023–2030), the United Nations sustainable development goals for TB, and the United Nations Political Declaration on the Fight Against TB (2023).

• Other U.S. government organizations, such as the Bureau of Global Health Security and Diplomacy.

Through its global TB program, CDC works with organizations to help prevent TB infection, provide life-saving treatment to people living with TB, and reduce TB-related deaths. We encourage our recipients to coordinate with local organizations, U.S.-based organizations, and international organizations.

The goal of this coordination is to complement efforts to lower costs, make programs more effective, enhance national capacity, sustain the gains, and accelerate progress towards ending TB.

Step 1: Review the Opportunity 21

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. These indicators may include or align with broader USG global health metrics where appropriate, reflecting CDC’s integrated approach to HIV, TB, and global health-security outcomes.

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

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

CDC expectations CDC expects you to review, clean, and use routine performance data for program management and to evaluate program activities to inform program direction and scale-up. There may also be additional non-routine data collection needed as the program and priorities shift. As a result, you should hold regular review meetings to discuss performance and use data to inform program quality improvement activities.

In your application budget, you should allocate at least 5% of funds for monitoring activities and 5% for evaluation activities. We will discuss these percentages and finalize them at or after award. These are estimates for the total funding over the five-year project.

Required performance measures

Overview This program includes:

• Custom indicators that either we or you create. These include process and outcome measures that directly correlate with the logic model.

The indicators shown below may change before the award or in future years.

For example, any gaps or unmet needs not fulfilled in the first year may affect the targets in later years.

Step 1: Review the Opportunity 22

Custom indicators Below we show some anticipated custom indicators, targets, and reporting frequencies for the first year. You may also propose custom indicators.

• Number of healthcare providers and community workers trained in innovative screening tools and diagnostic tests. [Target: 1,000; Reporting Frequency: Quarterly]

• Percent increase in confirmed TB notifications among those at risk for TB from previous year, including children and adolescents. [Target: 25%;

Reporting Frequency: Quarterly]

• Percentage of people diagnosed with active TB disease who initiate TB treatment. [Target: 100%; Reporting Frequency: Quarterly]

• Percentage of people diagnosed with active TB disease without symptoms or who would have otherwise been missed through routine activities. [Target: 25%; Reporting Frequency: Quarterly]

• Percentage of people diagnosed with TB disease who were linked to treatment. [Target: 100%; Reporting Frequency: Quarterly]

• Percentage of TPT coverage among children less than 5 years old who are household contacts of people with TB disease. [Target: 100%; Reporting Frequency: Quarterly]

• Percentage of TPT coverage among household contacts over 5 years old with TB infection. [Target: 85%; Reporting Frequency: Quarterly]

• Percentage of TPT coverage among other eligible persons from high-risk settings, for example healthcare workers, or residents or workers from congregate or crowded settings. [Target: 75%, Reporting Frequency:

Quarterly]

Data sources for custom indicators Data sources may include:

• Routinely used and project-specific registers.

• Tally sheets.

• Electronic and paper patient records.

• Quarterly progress reports.

• Surveillance and survey reports.

• Other program monitoring tools.

Step 1: Review the Opportunity 23

Evaluation Below, we include examples of evaluation topics that we may expect you to answer through process, outcome, or economic evaluation. In your application, include at least one, but no more than three potential evaluation questions. We expect you to conduct a mid-term and end-term evaluation.

• Improvement in TB prevention and care cascade, including number of people screened for TB, number of people who completed TPT, number of people with presumptive TB identified, and diagnosis and treatment outcome.

• Effect of TB case-finding activities, as defined in the NOFO, and care linkage: outcome evaluation.

• Effect of activities, as defined in the NOFO, on changes in TB data system use, accuracy, completeness, and timeliness: outcome evaluation.

Evaluation data sources Data sources may include:

• Routinely used and project-specific registers.

• Tally sheets.

• Electronic and paper patient records.

• Recipient progress reports.

• Focus groups.

• In-depth interviews.

• Surveys.

• Other program evaluation tools.

Dissemination of evaluation results Dissemination channels could include:

• Local and international conferences and forum abstract presentations, if allowable.

• Conference poster displays, if allowable.

• Manuscripts.

• Bulletins.

• Reports.

• Presentations to technical working groups and interest holder meetings.

• Other approved products in print and electronic media.

Step 1: Review the Opportunity 24

The primary intended users of evaluation results and findings will be the wider program interest holders.

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

All evaluation reports will be publicly available.

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

As you develop your evaluation and performance measurement plan, align it with applicable national, global TB, and agency priorities as detailed in the NOFO. If awarded, we will work with you to finalize the plan and help ensure it is in alignment with CDC’s core priorities and with the America First Global Health Strategy.

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 of project activities.

Additionally, explain:

• How findings will contribute to reduce barriers to accessing health and related services, as relevant.

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

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

Step 1: Review the Opportunity 25

• How you will share evaluation findings with communities and populations of interest in a way that meets their needs.

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

Evaluation activities You must carry out specific evaluation activities.

At least one evaluation must be carried out for each cooperative agreement during funding. The evaluation can be:

• Process evaluation: Measures how the intervention was delivered, what worked and did not, the differences between the intended population and the population served, and access to the intervention.

• Outcome evaluation: Determines the effects of the intervention in the focus population, such as change in knowledge, attitudes, behavior, or capacity.

• Economic evaluation: Determines cost, cost drivers, cost effectiveness, efficiency, factors influencing economic behavior and choices, or the economic impact of interventions or activities to justify the investment.

Describe:

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

• Key evaluation questions these evaluations will address.

• Other information, such as measures and data sources.

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

Submit your initial DMP with your application and include:

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

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

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

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

Step 1: Review the Opportunity 26 https://www.cdc.gov/grants/additional-requirements/ar-25.html https://www.cdc.gov/grants/additional-requirements/ar-25.html

• Data standards that explain what documentation released data will have.

That documentation should describe collection methods, what the data represent, and data limitations.

• Archival and long-term data preservation plans.

• How you will update the DMP as new information becomes available during 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 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.

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

You should provide a detailed work plan for the first year and a high-level work plan for later years. Years two through five: submit a high-level plan subject to annual review and update.

Step 1: Review the Opportunity 27

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 logic model.

Responsible position or party

Funding component / 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. To determine if a proposed activity requires PRA approval, contact your program contact.

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

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

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

Step 1: Review the Opportunity 28 http://cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm http://cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm

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

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

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

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

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

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

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

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

dollars.

• Cost increases for fluctuations in exchange rates are allowable costs subject to the availability of funding. Prior approval of exchange rate fluctuations is required only when the change results in the need for additional Federal funding, or the increased costs result in the need to significantly reduce the scope of the project. Before providing approval, the Federal agency must ensure that adequate funds are available to

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

Step 1: Review the Opportunity 29 https://www.ecfr.gov/current/title-2/part-200 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-300 cover currency fluctuations in order to avoid a violation of the Antideficiency Act. Find out more about exchange rates at 2 CFR 200.400.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting your project’s objectives.

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

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

◦ Funding more applicants.

◦ Extending the period of performance.

◦ Awarding supplemental funding.

See also…