cdc-rfa-jg-26-0172-rev5_Final to post.pdf

Division of Global HIV and Tuberculosis

Notice of Funding Opportunity

Application due Monday, July 20, 2026

Sustaining life-saving HIV services in Ukraine by strengthening resilient health systems under the Ukraine Ministry of Health, Public Health Center Opportunity number: CDC-RFA-JG-26-0172

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 9

Agency priorities 11

Program description 14

Step 2: Get Ready to Apply 38

Get registered 39

Step 3: Build Your Application 41

Application checklist 42

Application contents and format 44

Step 4: Learn About Review and Award 54

Application review 55

Award notices 65

Step 5: Submit Your Application 66

Submission requirements and deadlines 67

Step 6: Learn What Happens After Award 69

Post-award requirements and administration 70

Contacts and Support 76

Before you begin 3

Contents 2

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

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

See Step 2: Get Ready to Apply

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

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on Monday, July 20, 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 11

Program description 14

Basic information Centers for Disease Control and Prevention

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:

Sustaining life-saving HIV services in Ukraine by strengthening resilient health systems under the Ukraine Ministry of Health, Public Health Center

Opportunity number:

CDC-RFA-JG-26-0172

Announcement type:

New

Assistance listing:

93.067

Key dates

Application submission deadline: July 20, 2026

Expected award and start date: September 30, 2026

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

Summary This NOFO aims to help the Public Health Center (PHC) of the Ministry of Health (MOH) enhance life-saving assistance for HIV and associated prevalent health conditions. This should be accomplished with targeted HIV testing, prevention, and treatment activities amid ongoing instability.

The objectives of this NOFO include:

• Working to ensure that targeted HIV testing, treatment, retention, and prevention services are widely available for people who are at higher risk for HIV. Services should be provided in community settings using social network strategies (SNS). Activities include:

◦ Targeted community-based case finding.

◦ Immediate linkage to available treatment.

◦ Retention support.

◦ Management of advanced HIV disease and HIV/TB co-infection.

• Improving the availability of HIV services by mobile HIV testing, treatment, and prevention. You should use targeted mobile HIV case finding, treatment, retention, and prevention services. Activities include:

◦ Streamlining immediate linkage to treatment.

◦ Strengthening ongoing adherence support.

• Improving the availability and quality of HIV services at medical facilities by implementing differentiated service delivery (DSD) models. Activities include enhancing patients’ retention, adherence, and access to HIV services at the facility level.

Step 1: Review the Opportunity 5

• Enhancing essential, targeted HIV prevention service provision for people at higher risk for HIV, focusing on availability, quality, coverage and timely initiation.

Funding details Funding Type: Cooperative agreement

Expected total NOFO funding for Year 1: $10,000,000.00

This is the expected total Year 1 funding for all awards made under this NOFO.

Expected number of awards: 1

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:

Other global 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

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 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.

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 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).

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.

Step 1: Review the Opportunity 9

• For-profit organizations other than small businesses.

• Small businesses.

• Foreign or non-U.S. based entities.

Other required qualifying factors

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

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.

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.

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

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

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 achieve 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 not support 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 state of the HIV and AIDS epidemic in Ukraine From its onset, the HIV/AIDS epidemic in Ukraine has primarily been concentrated among people who are at higher risk for HIV, which include:

• People who inject drugs and their partners.

• People in prisons and other closed settings.

• People with high-risk sexual behavior and their partners.

• Displaced people.

• Mobile populations.

• Post-military and uniformed services and their families.

People at higher risk for HIV usually have much greater HIV prevalence, incidence, and related morbidity and mortality, lower viral load suppression (VLS) and higher attrition rate, compared to the general population.

Past efforts, achievements, and challenges Past work in Ukraine, through the U.S. government (USG) and the expiring cooperative agreement under CDC-RFA-GH18-1818, has placed targeted, effective interventions to reach people at higher risk for HIV including:

• Community-based HIV testing.

• Mobile testing at remote areas.

• Linking people who test positive to HIV care.

• Ensuring patients adhere to their antiretroviral therapy (ART) treatment.

• Using social network testing strategies to find cases among people at higher risk for HIV.

• Referring people from HIV testing entry points to integrated care settings.

Past achievements include:

• Tracking people who missed appointments at ART sites.

• Deduplicating the national HIV testing results.

• Improving linkage to treatment from 60% to nearly 100% through case management.

Step 1: Review the Opportunity 14

• A 30% increase in people receiving HIV prevention interventions nationwide by immediately linking them with services.

• Improving the quality of HIV services through community engagement and appropriate services for people at higher risk for HIV.

USG continues to support expansion of HIV prevention services coverage. In 2019, HIV prevention was included in Ukraine’s National HIV Guidelines. In 2021, oral pre-exposure prophylaxis was included in the Program of Medical Guarantees Ukraine. In the same year, the National Health Service of Ukraine started funding HIV prevention services at ART sites. In 2024, the program successfully launched long-acting injectable cabotegravir (CAB-LA) for pre-exposure prophylaxis.

Remaining challenges include:

• Complicated access to populations at higher risk for HIV, due to security issues and migration related to war.

• Patients drop out of treatment after 12 months of intensive case management because they were not integrated into the regular medical system.

• Low viral load coverage (VLC) and suppression among people at higher risk of HIV.

• Late HIV diagnoses, with many being diagnosed with or near AIDS.

The effect of the ongoing conflict and resulting instability Since February 2022, the global HIV program in Ukraine has encountered unprecedented challenges. Amid the ongoing war, it’s been especially challenging to meet the expanding needs of people at higher risk for HIV.

The destruction of Ukrainian health and other key infrastructure has created a substantial risk of service interruptions and devastating challenges in availability of life-saving services. This is especially true in areas close to the frontline and in occupied territories.

People at higher risk of HIV have needed even more intensive support since the war began. This is especially so for those who are displaced or living in areas where health services were disrupted. These included new ways to provide services, and increased support to re-engage with HIV care.

Since the war, data from Ukraine’s ART patients’ electronic register, the Information System for Monitoring of Socially Significant Diseases, shows that ART patients move across the country and abroad. These trends likely apply

Step 1: Review the Opportunity 15 across the entire population of people living with HIV, including people at higher risk of HIV.

To sustain achievements related to the 95-95-95 goals, activities for this NOFO should include:

• Aligning program activities with the America First Global Health Strategy

(AFGHS).

• Increasing country ownership and management of national and regional public health programs, with less reliance on USG support.

• Strengthening innovative case-finding and testing strategies, including mobile testing, HIV self-testing, and SNS.

• Using data to sustainably track outcomes like adherence to treatment, re-engagement, and retention in comprehensive HIV services.

• Implementing interventions that provide better counseling on adherence to treatment and managing HIV and related comorbidities.

• Introducing interventions to improve access and coverage with essential life-saving prevention and treatment services for people at higher risk for HIV.

Purpose The purpose of this NOFO is to support the MOH, PHC, and people at higher risk for HIV in Ukraine by enhancing lifesaving HIV services among people at higher risk for HIV amid the ongoing war and resulting service disruptions.

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 :

Facilitate wide availability and use of comprehensive HIV services for populations at higher risk for HIV through innovative, data-driven models and interventions.

Increased availability of comprehensive HIV services for people living with HIV and other populations at higher risk for HIV.*

Increased linkage to comprehensive HIV services for people living with HIV and other populations at higher risk for HIV.*

Increased use of DSD models in communities and medical facilities.*

Increased availability of essential life-saving HIV prevention services and integrated care services for people living with HIV and other populations at higher risk for HIV.*

Increased use of comprehensive HIV services by people living with HIV and other populations at higher risk for HIV.*

Increased adherence to treatment for people living with

HIV.*

Increased retention in comprehensive HIV services for people at higher risk for HIV.*

Sustained use of DSD models in communities and medical facilities.*

Increased use of essential life-saving HIV prevention services and integrated care for people living with HIV and other populations at higher risk for HIV.*

Increased quality of comprehensive HIV services and integrated care for people living with HIV and other populations at higher risk for HIV.*

Sustained VLC and VLS for people living with HIV.*

Decreased morbidity and mortality for people living with HIV.

Decreased new HIV infections.

Decreased advanced HIV disease (AHD) for people living with HIV.

Decreased incidence of HIV among people at higher risk for HIV receiving essential prevention and integrated care services.

Strategy 2 :

Implement innovative, cost-effective DSD models that are sustainable in communities and medical facilities to improve access and engagement with comprehensive HIV services for populations at higher risk for HIV.

Strategy 3 :

Expand availability and improve the quality of essential life-saving HIV prevention services and integrated care services for people living with HIV and other populations at higher risk for HIV.

Step 1: Review the Opportunity 17

Additional information on outcomes in the logic model:

• Comprehensive HIV services include:

◦ Prevention: Oral, long-acting pre-exposure prophylaxis (such as CAB- LA, lenacapavir), post-exposure prophylaxis.

◦ Case-finding and testing: Mobile case finding, SNS for case finding, index testing, HIV self-testing (HIVST).

◦ Linkage to appropriate prevention or treatment services.

◦ Care and treatment: Retention support, adherence counseling.

• People at higher risk for HIV include:

◦ People who inject drugs and their partners.

◦ People in prisons and other closed settings.

◦ People with high-risk sexual behavior and their partners.

◦ Displaced people.

◦ Post-military and uniformed services and their families.

◦ Mobile populations.

◦ People who use non-injecting drugs.

• Increased availability of integrated care services includes:

◦ Care and treatment of HIV and other co-morbidities in one place.

◦ Coverage of services in geographically remote areas and areas where regular services have been disrupted.

◦ Coverage of services in closed settings.

◦ Mobile service delivery.

• Increased quality of comprehensive HIV services includes:

◦ Test and start HIV treatment immediately.

◦ Management of AHD and other HIV comorbidities.

◦ Enhanced counseling and support for adherence to treatment.

◦ Support for VLC and VLS.

◦ DSD for HIV treatment and prevention.

Step 1: Review the Opportunity 18

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.

Strategy 1: Facilitate wide availability and use of comprehensive HIV services for populations at higher risk for HIV through innovative, data-driven models and interventions.

Priority activities:

• Use innovative testing methods for populations at higher risk for HIV, including SNS, index testing, and HIVST.

• Use mobile testing innovations to identify people living with HIV in remote geographic areas or where normal services have been disrupted.

• Implement rapid linkage to care and treatment for people who test positive for HIV.

• Support adherence to treatment for people living with HIV by engaging the community, improving adherence counselling, and developing plans to improve adherence.

• Work with local organizations to maintain program success.

• Address health services gaps in availability and use of comprehensive HIV services for populations at higher risk for HIV.

• Use data and cooperate with the PHC of the MoH of Ukraine to:

◦ Effectively expand comprehensive HIV services to populations that would most benefit from them.

◦ Target emerging public health threats.

Step 1: Review the Opportunity 19

Strategy 2: Implement innovative, cost-effective DSD models that are sustainable in communities and medical facilities to increase access to and engagement with comprehensive HIV services for populations at higher risk for HIV.

Priority activities:

• Increase country ownership and management of national and regional HIV/TB programs with less reliance on USG support.

• Enhance delivery of ART and other treatment options through innovative DSD models, including extended service hours, treatments at community settings, and mobile settings.

• Help people living with HIV adhere to treatment.

• Help people living with HIV stay in care and treatment services through community-based interventions.

• Help people at higher risk for HIV remain in HIV prevention services through community-based interventions.

• Help people living with HIV who have completed case management integrate into the routine state health system.

• In cooperation with PHC of the MoH, use data to effectively monitor and prevent interruptions in treatment by detecting interruptions early and re-engaging with treatment.

• In cooperation with PHC of the MoH, work to add AHD, HIV/TB, and other HIV comorbidities management into standard service delivery at medical facilities.

• Support the sustainable scale-up of blood sample transportation for VL and CD4 as part of the management of AHD and other HIV comorbidities.

• Build capacity among healthcare professionals and community health workers on HIV testing, treatment, adherence support and prevention to support transition and sustainability of lifesaving services.

• Launch mentorship programs and continuous quality improvement visits for better HIV services to ensure life-saving services are sustainable.

Step 1: Review the Opportunity 20

Strategy 3: Expand availability and improve the quality of essential life-saving HIV prevention services and integrated care services for people living with HIV and other populations at higher risk for HIV.

Priority activities:

• Address gaps in availability and use of essential life-saving HIV prevention services for populations at higher risk for HIV.

• Implement rapid linkage to comprehensive, essential life-saving HIV prevention services.

• Define and support integrated care sites where HIV services and other co-morbidities can be managed in one place, using one-window approach.

◦ Coordinate selecting and prioritizing integrated care sites with HIV case finding interventions.

◦ Utilize HIV case finding interventions as an entry point for referrals to integrated care services.

• Provide technical support for developing, adopting, and modernizing the patients’ pathways to link HIV patients with multiple comorbidities to integrated care sites.

• Support adoptions of the improved patients’ pathways in the site-level medical documentation, such as local clinical protocols and standards.

• Provide referrals for HIV positive clients to integrated care sites from HIV testing and prevention entry points.

• Develop service provision models to render comprehensive services of standard quality for HIV-positive patients at the integrated care sites.

• Introduce, practice, and refine integrated care service provision models, allowing quick linkage of eligible candidates for these services.

• Create and sustain the system of programmatic monitoring of integrated care services provision.

◦ Set site-level benchmarks and track cascade of services using non-personally identifiable programmatic information and programmatic monitoring tools.

• Analyze programmatic results, identify weaknesses, and improve service delivery models.

Step 1: Review the Opportunity 21

• Utilize MoH owned electronic information management system(s) (MIS) to register rendered services, track programmatic performance, analyze programmatic results, and modify service delivery models, aiming for optimal results to align with AFGHS.

◦ Tailor MIS(s) to adjust to the programmatic monitoring, evaluation and needs.

• Engage local groups with community-based organizations and work with communities to optimize patient’s pathways, ensure better availability and quality of services for patients.

• Organize and conduct joint site visits to build PHC capacity in alignment of AFGHS goals.

◦ Develop and use standardized monitoring instruments without registering personally identifiable information.

• Revise national guidelines and/or protocols and/or standards on the provision of integrated care services, in cooperation with PHC, and support adoption of the revised medical documentation on the provision of integrated care services at the national level.

• Develop on-line in-service training materials on the provision of integrated care services that align with modernized standards, in coordination with PHC, to support transition and sustainability of services.

• Organize on-line trainings on the provision of integrated care services at PHC web-resources to support transition and sustainability of services.

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 22

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 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 23

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 Memorandums of Understanding (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.

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

Step 1: Review the Opportunity 24 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

• 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.

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 expect you to coordinate with the following:

Government agencies and programs, such as:

• MOH.

• PHC.

• Local government agencies.

• USG supported agencies and programs.

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

Step 1: Review the Opportunity 25 https://www.state.gov/bureaus-offices/under-secretary-for-foreign-assistance-humanitarian-affairs-and-religious-freedom/bureau-of-global-health-security-and-diplomacy/

Non-government organizations and programs, such as:

• Community groups.

• People at higher risk for HIV.

• Multilateral organizations.

• Global Fund recipients.

• Private-sector organizations.

Current organizations implementing USG supported activities in:

• Case finding.

• Prevention and treatment.

• Testing and linkage to care.

• Information management systems.

• Laboratory information management systems.

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.

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.

Step 1: Review the Opportunity 26

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 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 two types of indicators. These include:

• USG 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 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 were identified and tested using Index testing services and received their results. [Benchmark: 5,000; Reporting Frequency: Quarterly]

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

Step 1: Review the Opportunity 27 https://help.datim.org/hc/en-us/articles/360000084446-MER-Indicator-Reference-Guides

• Number of individuals to whom HIV self-test kits have been distributed.

[Benchmark: 20,000; Reporting Frequency: Quarterly]

• Number of individuals who received HIV Testing Services (HTS) and received their test results. [Benchmark: 120,000; Reporting Frequency:

Quarterly]

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 HIV testing mobile teams funded by host government.

• Number of integrated care sites funded by host government.

• Percentage of individuals who tested negative for HIV and were referred to comprehensive HIV prevention services. [Target: 20%; Reporting Frequency: Quarterly]

• Number of individuals successfully referred to comprehensive HIV prevention services and confirmed to be newly initiated on pre-exposure prophylaxis at a facility or community site during the reporting period.

[Target: 20%; Reporting Frequency: Quarterly]

• Number of eligible clients from HIV-testing interventions referred to integrated care services. [Target: 250 –750; Reporting Frequency:

Quarterly]

• Number of clients linked to integrated care services out of those referred from HIV-testing interventions. [Target: 250 –750; Reporting Frequency:

Quarterly]

• Proportion of clients linked to integrated care services out of those referred to integrated care services from HIV-testing interventions.

[Target: ≥90%; Reporting Frequency: Quarterly]

• Number of HIV-positive clients verified as newly enrolled on antiretroviral therapy (ART). [Target: 100%; Reporting Frequency: Quarterly]

• Number of HIV positive, treatment-experienced clients with no clinical contact (or antiretroviral drug pick-up) for greater than 28 days since their last expected contact who are successfully navigated by the case-management to a service delivery point and verified as re-enrolled into treatment. [Target: Not Assigned; Reporting Frequency: Quarterly]

• Percentage of HIV-positive clients that have been reached by the program and are verified as currently enrolled on ART at the end of the reporting period. [Target: 100%; Reporting Frequency: Quarterly]

Step 1: Review the Opportunity 28

• Percentage of HIV positive clients currently receiving care and support services outside of a health care facility. [Target: 100%; Reporting Frequency: Quarterly]

• Percentage of individuals started on ART who are tested for viral load (VL) after 12 months of treatment. [Target: 90%; Reporting Frequency:

Quarterly]

• Percentage of individuals tested for VL that have a VL of less than 50 copies/mL. [Target: 95%; Reporting Frequency: Quarterly]

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.

Evaluation Below, we include an example of an evaluation topic 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 an end-term evaluation.

• Effect of DSD models on achieving HIV epidemic control: outcome 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 program monitoring tools.

Step 1: Review the Opportunity 29

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.

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 on USG resource sites.

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…