cdc-rfa-jg-26-0142_v6_for posting.pdf

Division of Global HIV and Tuberculosis

Notice of Funding Opportunity

Application due Wednesday, September 16, 2026

Ending HIV and TB as public health threats through an accelerated and sustained comprehensive response in India Opportunity number: CDC-RFA-JG-26-0142

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 9

Agency priorities 12

Program description 15

Step 2: Get Ready to Apply 41

Get registered 42

Find the application package 42

Step 3: Build Your Application 44

Application checklist 45

Application contents and format 47

Step 4: Learn About Review and Award 57

Application review 58

Award notices 66

Step 5: Submit Your Application 67

Submission requirements and deadlines 68

Step 6: Learn What Happens After Award 70

Post-award requirements and administration 71

Contacts and Support 77

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 Wednesday, September 16, 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 9

Agency priorities 12

Program description 15

Basic information U.S. 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 HIV, TB, and other priority disease incidence and mortality in global settings through data-driven activities and strengthened public health systems.

Have questions?

See Contacts and Support.

Key facts

Opportunity name:

Ending HIV and TB as public health threats through an accelerated and sustained comprehensive response in India

Opportunity number:

CDC-RFA-JG-26-0142

Announcement type:

New

Assistance listing:

93.067 Global HIV and TB 93.494 Global Tuberculosis

Key dates

Application submission deadline:

Wednesday, September 16, 2026

Expected award and start date:

January 1, 2027

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

Summary CDC invites proposals that align with the America First Global Health Strategy (AFGHS) [PDF], emphasizing efficiency, sustainability, and local ownership of health. This NOFO supports India’s National AIDS Control Organization (NACO), Central Tuberculosis Division (CTD), and other departments in the Ministry of Health and Family Welfare (MoHFW). The goal is to enhance systems that accelerate and sustain epidemic control, in line with the National AIDS Control Program (NACP)-VI and the National TB Elimination Program (NTEP), while working to eradicate HIV and TB as public health threats.

The NOFO aims to transition essential services to local ownership and foster cooperation with interest holders at all levels. To accomplish this goal, you should incorporate innovative and evidence-based strategies to:

• Prevent new infections.

• Facilitate early case detection.

• Ensure seamless linkage to care.

• Promote treatment adherence.

• Achieve viral suppression.

Key activities include:

• Closing gaps in HIV and TB testing and treatment.

• Delivering integrated services for HIV and co-morbidities.

• Strengthening program cooperation and local ownership to enhance national efforts.

• Improving prevention, detection, and response to infectious diseases.

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

Step 1: Review the Opportunity 5 https://www.state.gov/wp-content/uploads/2025/09/America-First-Global-Health-Strategy-Report.pdf https://www.state.gov/wp-content/uploads/2025/09/America-First-Global-Health-Strategy-Report.pdf

Advancing innovative HIV and TB service delivery under local leadership will create a sustainable framework for epidemic control that aligns with U.S.

global health priorities, ultimately saving lives and bolstering global health security.

Funding details Funding Type: Cooperative agreement

Expected total NOFO funding for Year 1: $6,000,000.00 This is the expected total Year 1 funding for all awards made under this

NOFO.

Expected number of awards: 1-2

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

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

We plan to award projects for five 12-month budget periods for a five-year period of performance, subject to available funds and program priorities.

Funding strategy

Funding amounts We encourage you to apply for the expected total NOFO funding for Year 1.

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:

• 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.

Step 1: Review the Opportunity 6

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:

CDC global HIV and TB planning Q1 targets and activities.

◦ Component 2:

CDC global HIV and TB planning Q2 targets and activities.

◦ Component 3:

CDC global HIV and TB planning Q3 targets and activities.

◦ Component 4:

CDC global HIV and TB planning Q4 targets and activities.

◦ Component 5:

CDC global HIV and TB planning additional targets and activities.

◦ Component 6: Global TB priorities.

◦ Component 7: Emerging public health 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

Results Based Funding CDC may fund this Cooperative Agreement using a results-based funding approach, which would rely on articulated milestones and program indicators. Under this approach, CDC may provide federal funds during a budget period based on measurable results as defined in this NOFO (e.g., articulated milestones and program indicators), in the recipient’s approved work plan, and, to the extent allowable by federal law, as may be aligned with country, HHS/CDC, and US government global health priorities. If selected for award, you will receive more detailed information about this funding approach in your NoA or in subsequently issued CDC guidance.

In furtherance of this funding approach, you will have at least 120 days after the start date of this award to collaborate with CDC and submit proposed program indicators and milestones as part of your required Evaluation and Performance Management Plan and component funding structure. Though foundational funding will be provided at the start of the project period, continued funding will be linked to verified progress towards reaching milestones providing clear checkpoints on performance and helping to ensure resources support steady documented progress. These performance results are intended both to help support your progress during the award’s period of performance and to help determine funding amounts in subsequent budget periods.

Global HIV and TB local organization funding preference This NOFO includes a funding preference for local organizations. Your organization will receive 30 extra points during the selection process if you provide sufficient documentation demonstrating you meet the global HIV and TB local organization definition.

Step 1: Review the Opportunity 8

Eligibility Statutory authority This NOFO supports U.S. government (USG) HIV and TB activities that are consistent 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:

• The United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, Public Law 108-25 (22 U.S.C. 7601, et seq.).

• The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, Public Law 110-293.

• The President’s Emergency Plan for AIDS Relief (PEPFAR) Stewardship and Oversight Act of 2013, Public Law 113-56.

• Public Health Service Act (42 U.S.C. 242I).

• 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.

Step 1: Review the Opportunity 9

• 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, which is a public or private organization, whether nonprofit or for-profit, located in a country other than the United States and its territories that is subject to the laws of the country in which it is located, irrespective of the citizenship of project staff or place of performance.

Other required qualifying factors

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

Any local organization applying for this NOFO must comply with the Government of India’s Foreign Contribution Regulation Act (FCRA) and must submit documentation of active FCRA registration. Failure to provide FCRA registration as part of the application will render an application nonresponsive, and your application will not move forward.

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.

Step 1: Review the Opportunity 10

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

• Failure to provide FCRA registration as part of the application will render an application nonresponsive and your application will not move forward.

See the application checklist to understand your application requirements.

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

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 11

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

Funded activities must:

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

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

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

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

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

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

◦ Works to prevent disease and advance emergency response.

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

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

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

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

Step 1: Review the Opportunity 12 https://www.cdc.gov/about/cdc/index.html

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

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

◦ Streamlining internal processes.

◦ Improving risk communication strategies.

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

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

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

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

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

◦ Replacing data silos with integrated systems.

◦ Using advanced technology.

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

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

Step 1: Review the Opportunity 13

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

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

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

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

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

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

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

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

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

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

Step 1: Review the Opportunity 14 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf

Program description Background overview and related work Background India faces a significant public health challenge, hosting the second-largest HIV epidemic globally, with 6.3% of all people living with HIV worldwide. As of 2023, the estimated data reveals that India has approximately 2.54 million people living with HIV and about 68,450 new cases each year. By March 2024, approximately 2 million or 81%, of people living with HIV in India were aware of their status, with 88% receiving antiretroviral therapy (ART). Notably, over 95% of those on ART achieved viral suppression. Substantial progress in prevention, detection, and treatment has been made through the NACP. But significant gaps remain, particularly among at-risk populations that vary by geography and demographics.

In addition to HIV, TB poses a critical threat as the leading cause of death worldwide. With over 26% of global TB cases, India has the highest TB burden.

Foreign-born individuals constitute over 70% of all TB cases in the U.S. India is one of the top five countries contributing to the U.S. TB burden among foreign-born individuals. India’s national strategic plan for TB elimination aims to reduce TB-related mortality and morbidity through the Detect-Treat- Prevent-Build approach.

Approach Building on the previous award under CDC-RFA-GH20-2038, this NOFO is intended to support India’s MoHFW, including NACO, CTD, State AIDS Control Societies (SACS), and other national programs. Its goal is to continue efforts to achieve and sustain the 95-95-95 targets for HIV and eliminate TB across populations and regions. This NOFO also expects to enhance collaboration through participation in Technical Resource Working Groups and develop resilient, self-sustaining health systems that bolster global health security.

Key strategic goals and priorities include:

• Developing and implementing comprehensive HIV and TB care continuum services.

• Introducing innovative case-finding activities to help ensure early diagnosis and linkage to lifesaving HIV and TB services for all at-risk populations.

Step 1: Review the Opportunity 15

• Increasing the use of molecular diagnostics for rapid and accurate TB detection, including drug-resistant strains.

• Enhancing adherence, retention, and re-engagement in integrated HIV and TB care and treatment services, including addressing associated comorbidities such as hepatitis B and C, sexually transmitted infections (STIs), and non-communicable diseases (NCDs).

• Expanding cooperation with community and key interest holders at national and sub-national levels to promote universal health access.

• Strengthening the frontline workforce’s capacity to manage HIV and TB epidemics and respond to emerging public health threats.

• Strengthening global health surveillance and early-warning systems for infectious disease threats, focusing on HIV and TB in high-risk geographies and populations.

Expected outcomes of this NOFO include:

• Increased proportion of individuals living with HIV and TB who are aware of their disease status.

• Enhanced coverage and use of comprehensive, integrated lifesaving HIV and TB and associated comorbidity services.

• Improved national rates of HIV viral load suppression.

• Improved treatment success rates through prevention and early diagnosis of TB among high-risk groups.

• Increased use of health system surveillance data to detect, prevent, and respond to infectious disease threats quickly.

This work represents a critical step in addressing the HIV and TB pandemics in India. Ultimately it will help improve health outcomes, strengthen global health security, and safeguard Americans both domestically and internationally from infectious disease threats

Purpose The purpose of this NOFO is to accelerate the end of HIV and TB epidemics and continue to build sustainable health systems that improve efficiency, country program ownership, and global health security. It focuses U.S. and national support on:

• Frontline workers.

• Private sector engagement.

• Data systems to enhance local capabilities.

Step 1: Review the Opportunity 16

It promotes innovative models of service delivery for early diagnosis, treatment continuity, drug resistance management, and sustainable systems.

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.

Table: Strategies and outcomes

Strategies Short-Term Outcomes

Intermediate Outcomes Long-Term Outcomes

Strategy 1:

Strengthen evidence-based, highly effective, and sustainable HIV and TB programs to assure lifesaving treatment for at-risk populations.

Strategy 2:

Facilitate the implementation of integrated, comprehensive, models of service delivery for HIV, TB, and associated comorbidity services to sustainably manage the epidemic.

Increased availability of integrated, comprehensive HIV and TB services for at-risk populations.*

Expanded coverage of integrated, comprehensive HIV and TB services for at-risk populations.*

Increased capacity of healthcare workers to deliver quality HIV and TB services.*

Increased implementation of innovative treatment continuity interventions for

Increased use of comprehensive integrated HIV and TB services by at-risk populations.*

Increased adherence to appropriate treatment for people living with HIV and

TB.*

Sustained capacity of healthcare workers to deliver high-quality, comprehensive integrated HIV and TB services.*

Increased viral load suppression for people living with

HIV.*

Reduced national HIV and TB incidence rates.

Sustained use of high-quality, integrated HIV and TB and other co-morbidity services for all priority populations.*

Increased progress towards eliminating HIV and TB as public health threats.*

Reduced morbidity and mortality for people living with HIV and TB.

Sustained effective, local ownership of HIV

Step 1: Review the Opportunity 17

Strategies Short-Term Outcomes

Intermediate Outcomes Long-Term Outcomes

Strategy 3:

Strengthen country-led ownership of HIV and TB program through building resilient systems that advance local ownership and align with global health security initiatives.

people living with HIV and TB.*

Increased viral load coverage for people living with HIV.*

Increased TB diagnosis using molecular diagnostics to enhance early detection, treatment, and reduce transmission.*

Improved sustainable data systems for program leadership to monitor HIV and TB care continuum service performance.*

Increased use by program leadership of high-quality, timely data for programmatic improvement.*

Increased capacity of healthcare workers to use HIV and TB data systems for systematic monitoring of emerging public health threats.*

Sustained use of high-quality, timely program data for effective management of HIV and TB programs.* and TB program across all levels.

Sustained country-led monitoring and evaluation for rapid response to global health security initiatives.

Additional information on outcomes in the logic model:

• Integrated, comprehensive HIV and TB services for at-risk populations refers to all services for people living with HIV and TB that are provided at facility or community levels.

• Integrating HIV- and TB-associated comorbidities into standard HIV and TB services, for example:

Step 1: Review the Opportunity 18

◦ Hepatitis B and C.

◦ NCDs.

◦ STI care and treatment.

◦ Preventing new HIV and TB infections, for example:

▪ Biomedical and non-biomedical preventions.

▪ TB-preventative treatment.

◦ Testing services, for example:

▪ Composite testing.

◦ Lifesaving care and treatment services.

• At-risk populations include:

◦ People at elevated risk of HIV infection, including:

▪ Adults.

▪ Pregnant and breastfeeding women, and children.

• Increased capacity of healthcare workers to deliver quality HIV and TB services means that healthcare workers are:

◦ Trained in and able to perform appropriate services, including identification and appropriate clinical response to drug resistance.

◦ Qualified, able, and available to perform HIV and TB services where people need them.

• Healthcare workers include:

◦ Community healthcare workers.

◦ Frontline workers.

◦ Facility-based workers.

◦ Peer educators.

◦ Outreach workers.

◦ Lay providers.

◦ Other service providers.

• Treatment continuity interventions include any intervention that makes it easier for people to receive the correct treatment and either remain on the appropriate treatment or complete treatment if applicable.

• People living with HIV and TB includes adults, pregnant and breastfeeding women, and children.

• Improved data systems to monitor HIV and TB care continuum service performance include:

Step 1: Review the Opportunity 19

◦ Case finding.

◦ Linkage to available treatment.

◦ Adherence.

◦ Retention.

◦ Viral suppression.

• Increased use of comprehensive HIV and TB services by people living with HIV and TB includes:

◦ People using services for viral load testing.

◦ People who are aware of their viral load status.

• Appropriate treatment for people living with HIV and TB includes applicable treatment regimens for:

◦ HIV.

◦ TB.

◦ Other associated comorbidities.

• Effective management of the HIV and TB program means that it is:

◦ Using data to inform and improve the program.

◦ Led by the country.

◦ Sustainable.

• Program data use to enhance the ability to identify, document, and evaluate best practices that can be adapted and scaled for local and national needs.

• Sustained, effective, local ownership of HIV and TB program across all levels includes national and subnational.

• Sustained country-led monitoring and evaluation for rapid response to global health security initiatives includes all programmatic data and results from any mid-term or end-term evaluations.

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

Step 1: Review the Opportunity 20

Strategy 1: Strengthen evidence-based, highly effective, and sustainable HIV and TB programs to assure lifesaving treatment at-risk populations.

Priority activities include:

• Develop and implement innovative and sustainable, models of service delivery that focus on preventing new infections and enhancing testing strategies for at-risk populations, including tailored HIV and TB testing services.

• Continue to identify case-finding and linkage gaps. Design targeted models of service delivery solutions such as index testing, social network testing models, and other innovative and effective case-finding modalities.

• Use the most recent epidemiological and geographical data to guide evidence-based strategies and ensure resources reach priority populations at highest risk for HIV and TB infection or transmission and high-burden regions.

• Work collaboratively with community, sub-national, and national interest holders, including faith-based organizations (FBOs) to expand integrated prevention and testing services.

• Integrate HIV and TB services within national systems and link testing services with other diagnostics to ensure efficient delivery.

• Identify and develop peer-led linkage models to help ensure timely access to treatment to prevent linkage loss.

• Use innovative models of service delivery demand creation approaches to improve uptake of HIV and TB services. For example:

Undetectable=Untransmissible campaigns and virtual outreach.

• Support the expansion of TB prevention and diagnosis using innovative tools and shorter treatment regimens.

Step 1: Review the Opportunity 21

Strategy 2: Facilitate the implementation of integrated, comprehensive, models of service delivery for HIV, TB, and associated comorbidity services to sustainably manage the epidemic.

Priority activities include:

• Develop and implement integrated models of service delivery and care for HIV, TB, and associated comorbidities.

• Use recent data to guide evidence-based care, including early diagnosis and management of comorbidities and advanced HIV disease.

• Expand differentiated service delivery through cooperation with the private sector and FBOs to improve outcomes.

• Strengthen community-focused approaches to promote:

◦ Adherence.

◦ Retention in care.

◦ Viral load monitoring.

• Implement innovative models leveraging existing health systems for early detection and linkage to care for HIV associated conditions such as cervical cancer in women living with HIV.

• Strengthen the existing Centers of Excellence to identify and monitor HIV drug resistance to inform clinical case management.

• Integrate evidence-based HIV, TB, and comorbidity services into national programs for sustained effect and strengthened coordination across levels of governance.

Step 1: Review the Opportunity 22

Strategy 3: Strengthen country-led ownership of HIV and TB program through building resilient systems that advance local ownership and align with global health security initiatives.

Priority activities include:

• Build local workforce capacity to deliver high-quality HIV and TB and comorbidity services.

• Strengthen community and government collaborations at the national and sub-national levels to:

◦ Increase service coverage.

◦ Enhance local ownership.

◦ Build resilience to emerging health threats.

• Implement continuous quality improvement and data-driven program management using national surveillance and evaluation systems.

• Support evidence-based policy development using country-owned data and program monitoring.

• Enhance data literacy and use at all system levels to improve service delivery and decision-making.

• Strengthen surveillance systems for timely response to HIV, comorbidities, and other infectious diseases.

• Provide operational support and program scale-up support for national and state institutions, for example NACP, SACS, and district-level initiatives, to promote sustainability and alignment with U.S. global health priorities.

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.

Epidemic control activities In coordination with the Global Health Security and Diplomacy (GHSD) Bureau at the U.S. Department of State, and as part of the global HIV and TB program, CDC assesses progress toward epidemic control using epidemiologic measures and supports sustainable, country-led systems capable of maintaining gains and advancing broader global health security objectives.

Step 1: Review the Opportunity 23

We consider a national HIV epidemic to be under control when the number of:

• HIV-related deaths are declining.

• New infections are less than the number of deaths.

Controlling the epidemic does not mean that HIV will be eliminated. Instead, it means that the number of people with HIV in the population is decreasing. If new infections or death rates increase, this means the epidemic is no longer under control.

During your award we may ask you to conduct additional activities to reach and maintain epidemic control and/or to ensure resilient and country-led health programs, consistent with the scope of this NOFO and the related policies below. In alignment with the America First Global Health Strategy, which emphasizes efficiency, sustainability, and self-reliance, this may include:

• Improving prevention, testing, and treatment efforts for HIV/AIDS, TB, sexually transmitted infections (STI), related opportunistic infections and other infectious diseases, especially among those most affected as defined in HHS/CDC Global HIV and TB, Department of State, bilateral Memorandums of Understanding (MOUs), subsequent implementation plans and/or other related USG guidance.

• Promoting sustainable, country-led approaches to managing HIV/AIDS and TB and empowering national and local interest holders to take the lead in designing and conducting high-quality and cost-effective programs. This could involve forming new cooperative relationships with private, public, local, faith-based and multi-sector entities that can complement and expand the reach of existing programs.

• Enhancing and expanding laboratory, surveillance, and information systems and using the USG supported platform for broader disease surveillance and public health programs in ways that align with CDC Global HIV, TB, and other infectious disease program goals and initiatives. Where aligned with the award scope, these platforms may also be leveraged for cross-cutting surveillance, laboratory, and information-system strengthening across multiple health programs.

• Enhancing efforts to prevent, detect, respond to, and treat other diseases to keep America safe from infectious threats by supporting surveillance and outbreak response systems.

Step 1: Review the Opportunity 24

Related policies

• If awarded, and as applicable to the work and this NOFO and consistent with law, proposed work should align with:

◦ The America First Global Health Strategy [PDF].

◦ CDC priorities statement.

◦ 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 applicable USG priorities.

• USG global health annual planning guidance and approved implementation plans coordinated through GHSD.

• HHS policies and the approved activities and targets in the global HIV and TB Planning Processes, as appropriate, except as otherwise agreed between GHSD and HHS.

• All proposed work, activities, and budgets should align or be adjusted to align with bilateral USG and host country MOUs, subsequent implementation plans and related guidance.

• To the extent consistent with law and applicable regulations, ensure the Child Safeguarding Principles, or substantively similar standards, are incorporated into programming that includes contact with children, to protect children and youth from abuse, exploitation, and neglect to the greatest extent possible in such global HIV and TB-supported programs

• All statutory and policy requirements for foreign assistance, including related to abortion. HHS must keep full and complete records demonstrating that compliance approaches and systems are proactive, preventive, part of routine program administration, and tailored to local legal and policy contexts. Routine site-level program monitoring is required. For more information, please visit Protecting Life in Foreign Assistance.

• Grantees 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

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

Step 1: Review the Opportunity 25 https://www.state.gov/wp-content/uploads/2025/09/America-First-Global-Health-Strategy-Report.pdf https://www.cdc.gov/about/cdc/index.html https://www.federalregister.gov/documents/2026/01/27/2026-01519/protecting-life-in-foreign-assistance https://www.federalregister.gov/documents/2026/01/27/2026-01519/protecting-life-in-foreign-assistance https://www.state.gov/bureaus-offices/under-secretary-for-foreign-assistance-humanitarian-affairs-and-religious-freedom/bureau-of-global-health-security-and-diplomacy/

Notice of Award (NoA) will include important terms and conditions that apply to this award.

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

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.

Communities served Under this NOFO communities served include people living with or at increased risk for HIV/AIDS, TB, or other priority diseases 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 coordinate with:

Government agencies and programs, including:

• MoHFW and associated institutions.

• NACO.

• Indian Council of Medical Research and its institutes.

• State government entities, including AIDS control societies.

• NTEP including CTD.

• District development coordination and monitoring committees.

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

Step 1: Review the Opportunity 26

• U.S. government implementing agencies and programs.

• Local government agencies.

Non-government organizations and programs, including:

• Community groups.

• FBOs.

• Multilateral organizations.

• Global Fund recipients.

• Private sector organizations.

• Current CDC-funded organizations supporting activities in:

◦ HIV and TB prevention, testing, treatment, and laboratory services strengthening.

◦ Strategic information.

Through the global HIV and TB program, CDC works with organizations to help prevent HIV and TB infection, provide life-saving treatment to people living with HIV and/or TB, and reduce HIV-and 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 epidemic control including where appropriate, programmatic treatment cascade goals related to diagnosis, treatment, and viral suppression that are intended to contribute to HIV epidemic control and towards ending TB.

Step 1: Review the Opportunity 27

Data, monitoring, and evaluation CDC strategy CDC collects and reports on indicators to measure progress toward achieving the activities and outcomes funded under this award. 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. 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 10% 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 two types of indicators. These include:

• U.S. government standard indicators, which are common to all awards.

These standard indicators are based on the scope of the work proposed in the NOFO. You can find additional information regarding indicator reporting in the guidance and resource materials, available at this link.

• Custom indicators that either we or you create. These monitor achievement of outcomes not directly measured by the standard

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

Step 1: Review the Opportunity 28 https://help.datim.org/hc/en-us/articles/360000084446-MER-Indicator-Reference-Guides indicators. These include process and outcome measures that directly correlate with the logic model.

The indicators and targets 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.

Standard indicators Below, we show some anticipated standard indicators, targets, and reporting frequencies for the first year. You can propose any additional relevant standard indicators as part of your initial Evaluation and Performance Measurement Plan.

• Number of individuals who received HIV Testing Services (HTS) and received their test results [Target: 35,000; Reporting Frequency:

Quarterly].

• Number of individuals who received HIV Testing Services (HTS), received their test results, and who tested positive [Target: 4,000; Reporting Frequency: Quarterly].

• Number of adults and children currently receiving antiretroviral therapy (ART) [Target: 223,000; Reporting Frequency: Quarterly].

• Number of adults and children newly enrolled on antiretroviral therapy (ART) [Target: 23,803; Reporting Frequency: Quarterly].

• Number of ART patients (who were on ART at the beginning of the quarterly reporting period or initiated treatment during the reporting period) and then had no clinical contact since their last expected contact [Target: Not Assigned; Reporting Frequency: Quarterly].

• Number of ART patients who experienced an interruption in treatment (IIT) during any previous reporting period, who successfully restarted ARVs within the reporting period and remained on treatment until the end of the reporting period [Target: Not Assigned; Reporting Frequency:

Quarterly].

• Proportion of ART patients who started on a standard course of TB preventive treatment/therapy (TPT) in the previous reporting period who completed therapy [Target: 90%; Reporting Frequency: Semi-Annual].

• Proportion of ART patients screened for TB in the semi-annual reporting period who start TB treatment [Target: Not Assigned; Reporting Frequency: Semi-Annual].

• Percentage of cervical cancer screen-positive women who are living with HIV and on ART eligible for cryotherapy, thermocoagulation or LEEP who

Step 1: Review the Opportunity 29 received cryotherapy, thermocoagulation or LEEP [Target: Not Assigned;

Reporting Frequency: Semi-Annual].

• Percentage of ART patients with a suppressed viral load (VL) result (<1000 copies/ml) documented in the medical or laboratory records/laboratory information systems (LIS) within the past 12 months [Target: >95%;

Reporting Frequency: Quarterly].

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

• Percentage of people tested who were diagnosed with HIV and were initiated on HIV treatment as per national guidelines [Target: >95%;

Reporting Frequency: Quarterly].

• Percentage of people tested for HIV who received a negative test result and were linked to the appropriate comprehensive HIV and TB prevention services [Target: >95%; Reporting Frequency: Quarterly].

• Percentage of healthcare workers trained on comprehensive HIV and TB services during the time frame [Target: 25%; Reporting Frequency: Semi- Annual].

• Proportion of notified TB patients offered Drug Susceptibility Testing [Target: >95%; Reporting Frequency: Quarterly].

• Proportion of notified TB cases initiated on treatment [Target: >95%;

Reporting Frequency: Quarterly].

• Proportion of people that successfully complete treatment among those notified of drug sensitive-TB [Target: >90%; Reporting Frequency: Semi- Annual].

• Proportion of eligible individuals at risk of developing TB initiated on TB preventive treatment. [Target: >90%; Reporting Frequency: Semi-Annual].

Data sources for standard and custom indicators Data sources may include:

• Registers.

• Tally sheets.

• Electronic and paper patient records.

• Quarterly progress reports.

• Surveillance and survey reports.

• Other program monitoring tools.

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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.

• Facilitators and barriers to implementation of innovative approaches for HIV prevention, case-finding, care and treatment: process evaluation.

• Effects of innovative, integrated service delivery models on reaching at-risk populations for HIV testing services: outcome evaluation.

• Facilitators and barriers to implementation of innovative strategies to improve TB prevention, early diagnosis of TB, and drug-resistant TB treatment adherence: process evaluation.

Evaluation data sources Data sources may include:

• Registers.

• Tally sheets.

• Electronic and paper patient records.

• Recipient progress reports.

• Focus groups.

• In-depth interviews.

• Surveys.

• Other…