DFOP0017890 Advancing Global Health Addendum K NTDs.pdf

Annual Program Statement Addendum Addendum M: Accelerating the Elimination of

Neglected Tropical Disease (NTDs)

U.S. Department of State Bureau of Global Health Security and Diplomacy (GHSD)

A. Basic Information

1. Overview

The Bureau of Global Health Security and Diplomacy (GHSD) of the U.S. Department of State invites organizations to submit Statements of Interest (SOIs) to carry out projects to accelerate progress toward the elimination and interruption of transmission of priority neglected tropical diseases (NTDs) through integrated, country-led, and strategically targeted interventions in high-burden settings. The purpose of this Addendum is to indicate specific areas where the Department of State would like to receive SOIs. Submission instructions are included in the “Advancing Global Health” Annual Program Statement (APS). The submission of an SOI is the first step in a two-step application process. Interested organizations must first submit a concept note presenting a project approach and intended outcomes. Importantly, this is not a full proposal and will not result in a federal assistance award at this stage; the SOI process is to allow applicants to submit project ideas for evaluation prior to requiring the development of a full proposal application.

Funding opportunity title Advancing Global Health Funding opportunity number DFOP0017890 Addendum title Accelerating the Elimination of Neglected

Tropical Diseases Deadline for Questions September 3, 2026 [1700 EDT GMT-4] SOI Due Date October 30, 2026 [1700 EDT GMT-4] Number of awards anticipated Up to 25 awards Total estimated funding Up to $162,000,000, subject to availability Targeted Geography Western Hemisphere: Bolivia, Brazil, Colombia, Dominican Republic, Guatemala, Haiti, Honduras, Mexico, Peru, and Venezuela

Africa: Burkina Faso, Cameroon, Cote d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Madagascar, Malawi, Mali, Niger, Nigeria, Senegal, Sierra Leone, South Sudan, Tanzania, Uganda, Zambia

Asia and Pacific: Bangladesh, Indonesia, Nepal, Papua New Guinea

Proposed projects should be completed in five years or less.

This notice is subject to the availability of funding.

As noted in the “Advancing Global Health” APS, the Department of State may opt to utilize a consultative program design process for certain Addenda. SOIs submitted under this Addendum may be recommended for continued review through consultative program design prior to recommendation for funding and submission of phase two. Additional details about the consultative program design process can be found in the main APS document within Section F:

“Application Review Information.”

2. Executive Summary The Department of State invites eligible organizations noted in the “Advancing Global Health” APS to submit SOIs to support integrated and strategically targeted efforts to eliminate, and interrupt transmission of priority NTDs in high-burden settings. Consistent with the America First Global Health Strategy (AFGHS), the initiative seeks to reduce the burden of infectious diseases that contribute to chronic morbidity, disability, and economic instability while strengthening partner country capacity and advancing sustainable, country-led health systems.

Programming supported under this Addendum is intended to accelerate progress toward elimination through high-impact, cost-effective interventions that strengthen integrated service delivery, surveillance, laboratory systems, and community-based prevention and response capacities. Programs focusing on the last mile should rapidly adjust the elimination strategy in response to newly generated data and transition to long-term preservation of the impact achieved.

Although funding for control strategies is not allowable under this Addendum, activities which demonstrate that the program for a specific NTD could transition from control to elimination would be considered. Funds are expected to prioritize individuals at high risk for NTD infections and strategically important geographies, including settings where NTDs could contribute to economic disruption and regional instability.

The initiative also seeks to strengthen coordination with host governments, local organizations, research institutions, private sector partners, and pharmaceutical companies to improve access to donated medicines, expand operational innovations which support elimination, and reinforce sustainable transition toward country-owned NTD programs. Through integrated and data-driven approaches, the program aims to support measurable reductions in disease burden while advancing shared U.S. and partner-country health security and development priorities.

The Addendum prioritizes NTDs that can be eliminated within the next three years, in the following countries:

Western Hemisphere: Bolivia, Brazil, Colombia, Dominican Republic, Guatemala, Haiti, Honduras, Mexico, Peru, and Venezuela

Africa: Burkina Faso, Cameroon, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Madagascar, Malawi, Mali, Niger, Nigeria, Senegal, Sierra Leone, South Sudan, Tanzania, Uganda, and Zambia

Asia and the Pacific: Bangladesh, Indonesia, Nepal, and Papua New Guinea

B. Program Description NTDs are a diverse group of communicable diseases closely linked to poverty, inadequate water and sanitation, poor housing, vector exposure, and limited access to health services, predominantly affecting tropical and subtropical regions. The 2019 End NTDs Act identifies 17 NTDs, including Buruli ulcer, Chagas disease, dengue, Guinea worm disease, echinococcosis, foodborne trematodes, sleeping sickness, leishmaniasis, leprosy, lymphatic filariasis, river blindness, scabies, schistosomiasis, soil-transmitted helminthiases, taeniasis/cysticercosis, trachoma, and yaws. Globally, more than 1.7 billion people are affected by NTDs, resulting in chronic morbidity, disability, stigma, economic losses, and more than 200,000 deaths annually.

In many settings, NTDs contribute to weakened immune systems, reduced workforce productivity, impaired child development, barriers to education, and increased vulnerability to other infectious diseases.

While many countries have made substantial progress toward reducing and eliminating priority NTDs over the past decade, significant gaps remain in high-burden and underserved areas.

Several countries are now approaching “last mile” elimination targets and require targeted, high-impact support to interrupt transmission, sustain gains, and prevent resurgence. At the same time, weak surveillance systems, insufficient laboratory capacity, fragmented delivery platforms, under-resourced supply chains, and limited domestic financing continue to hinder progress in many endemic settings.

Consistent with the Department of State’s AFGHS, GHSD seeks to support strategically targeted NTD programs that both improve health outcomes and reinforce broader U.S. national security, economic, and foreign policy interests. The initiative also seeks to strengthen strategic bilateral partnerships and advance sustainable, country-led approaches to NTD elimination.

Programming supported under this Addendum is expected to prioritize integrated, evidence-based, and cost-effective interventions that accelerate progress toward elimination targets while strengthening broader health systems and service delivery platforms. Activities may include integrated preventive chemotherapy and mass drug administration campaigns; surveillance, laboratory, and diagnostic strengthening; vector control; community-based prevention and case detection; morbidity management and disability prevention; operational research; digital and data-driven approaches; workforce development; pharmaceutical and private sector partnerships;

and strengthening of systems required to support sustainable transition toward country-owned NTD programming. Programming to address ‘last mile’ to elimination issues and strategic funding to demonstrate transition to elimination will be considered.

Activities are encouraged to leverage existing malaria, HIV, tuberculosis, nutrition, maternal and child health (MCH), water, sanitation, hygiene (WASH), and global health security platforms, where appropriate, to improve efficiency, maximize health impact, and reduce fragmentation across disease programs. GHSD also seeks to encourage innovative partnerships with pharmaceutical companies, research institutions, local organizations, and private sector entities to strengthen access to donated medicines, support operational innovation, improve data-driven targeting, and accelerate elimination efforts in high-burden settings.

Broad-based integrated program SOIs, as well as highly specialized SOIs focused on specific NTDs, geographies, operational barriers, surveillance systems, or elimination challenges, are encouraged. These coordinated resources are intended to strengthen country capacity to prevent, detect, monitor, and respond to NTDs while supporting measurable progress toward elimination, and advancing shared U.S. and partner-country health security priorities.

1. Goals and Objectives The goal of this Addendum is to accelerate progress toward the elimination and interruption of transmission of priority NTDs, through integrated, strategically targeted, and country-led interventions that reduce disease burden, strengthen health systems, and advance health security and economic resilience in high-burden settings. Programming should support sustainable approaches that strengthen partner country capacity, reinforce strategic bilateral partnerships, and improve long-term management of NTD programs consistent with the AFGHS. As noted above, control programs will not be supported with funding under this Addendum.

Single Objective: Accelerate the Elimination of Priority NTDs Through Integrated, High- Impact Interventions

Recipients will implement integrated, evidence-based interventions to accelerate progress toward elimination as a public health problem, or interruption of transmission of priority NTDs in high-burden settings. Activities may include integrated preventive chemotherapy and mass drug administration campaigns; vector control; community-based prevention, screening, and case detection; morbidity management and disability prevention; WASH interventions; and integrated case management approaches. Programming should prioritize high-impact geographies, vulnerable populations, and efficient delivery approaches that strengthen integration with existing health and community platforms where appropriate. Programming to address ‘last mile to elimination’ issues and strategic activities to demonstrate transition to elimination will be considered.

Where appropriate, to support the primary objective, proposed projects should address:

Sub-objective A: Strengthen Surveillance, Laboratory, Supply Chain, and Health System Capacity for NTD Detection, Monitoring, and Response to Accelerate Elimination

Recipients will strengthen systems required to detect, monitor, map, verify, and respond to priority NTDs and support progress toward elimination targets. Activities may include strengthening surveillance systems and data management platforms; laboratory and diagnostic capacity; disease mapping, geospatial tools and digital reporting systems; operational monitoring; workforce development; supply chains and systems for donated medicines and commodities; institutionalization of NTD services within broader health systems and primary health care platforms; and integration of NTD surveillance into broader health security and public health surveillance frameworks. Programming may also support innovative and data-driven approaches to improve targeting, monitoring, and decision-making in high-risk settings.

Sub-objective B: Support the Introduction of Innovative Tools and Operational Research to Accelerate Elimination

Recipients will strengthen collaboration among governments, regional and local organizations, research institutions, pharmaceutical companies, private sector entities, and other stakeholders to accelerate progress toward NTD elimination and improve operational effectiveness. Activities may include identification and evaluation of innovative approaches or tools that improve efficiency and accelerate achievement of milestones or elimination goals.

Approach to country ownership and sustainability

Additional country co-investment in meeting NTD elimination objectives under this APS addendum is not required in the first year. However, it is expected that projects will strengthen country capacity to sustainably plan, cost, finance, coordinate, and manage NTD programs through country-led and integrated approaches. In the first year, projects will work with recipient governments to develop a sustainability plan, if not already in place. The plan must include specific expectations for country co-investment beginning in year two. Co-investment for NTDs may be counted toward overall bilateral health MOU co-investment commitments where applicable.

2. Guiding Principles Projects supported under this Addendum should align with the principles outlined in the AFGHS, emphasizing strategically targeted, country-led, and results-driven programs that reduce NTD burden, strengthen health systems, and advance shared U.S. and partner-country health security priorities. Competitive SOIs are encouraged to demonstrate the following principles:

Strategic Targeting and High-Impact Interventions: Programming should prioritize high-burden populations, vulnerable communities, and strategically important geographies where targeted funding can accelerate measurable progress toward NTD elimination, or interruption of transmission. Applicants are encouraged to demonstrate how proposed interventions are evidence-based, operationally feasible, and designed to maximize impact and cost-efficiency.

Tailor interventions to the last mile: The final stages of interrupting disease transmission often present unique and complex challenges that require tailored strategies to achieve elimination. Applicants should clearly demonstrate how the proposed program is structured to adapt to these "last mile" challenges and should justify the allocation of resources needed to address them. Furthermore, as new tools and strategies for NTDs continue to emerge, certain disease programs currently classified as control programs may have the opportunity to transition toward elimination, provided that strategic investments are made. SOIs seeking to pursue this transition should clearly articulate the specific evidence gap the proposal aims to address and provide a realistic timeline for closing that gap.

Integrated Service Delivery and Health Systems Strengthening: Programming should leverage and strengthen existing health and community platforms, including malaria, HIV, tuberculosis, nutrition, maternal and child health, WASH, and global health security systems where appropriate. Applicants are encouraged to demonstrate how proposed activities will improve coordination, reduce fragmentation, and strengthen integrated service delivery and surveillance systems.

Country Ownership and Sustainable Transition: Consistent with the AFGHS, and the approach to country ownership and sustainability section of this Addendum, competitive SOIs are encouraged to demonstrate how domestic resources and financing commitments would complement U.S. government support over time.

Partnership, Coordination, and Local Engagement: Projects should promote strong coordination with host governments, local organizations, regional organizations, community-based organizations, faith-based organizations, research institutions, and other relevant stakeholders. Applicants should describe implementation partnerships, coordination mechanisms, and opportunities to strengthen local leadership and operational capacity.

Innovation, Data-Driven Decision-Making, and Operational Learning: Programming should promote the use of surveillance, operational data, digital tools, and innovative approaches to improve targeting, efficiency, monitoring, and program performance.

Applicants are encouraged to demonstrate how proposed activities will strengthen evidence generation, operational learning, and adaptive management approaches that support elimination goals.

Accountability and Measurable Results: Projects should prioritize measurable outcomes, efficient use of resources, and responsible stewardship of U.S. government funding.

Applicants should demonstrate clear approaches for monitoring implementation progress, strengthening accountability, and contributing to measurable reductions in NTD burden and transmission risk.