DFOP0017890_Advancing_Global_Health_APS_Round_2b_QA.pdf

“Advancing Global Health” APS, Round 2b Q&A Please be sure to read the Q&A for Round 1 and Round 2a first as those amendments contain many questions relevant to the preparation of your SOI. We do not answer duplicate questions, so it’s critical that you read all three Q&A documents: Round 1, Round 2a, and now this Round 2b

Addendum G: Cameroon Q&A

1. Required Format: Must proposals be submitted in English, or is the local/official language of the country accepted?

Per Section D in the APS, all documents must be written in English.

2. Technical Platform: Is submission made via Grants.gov, direct email, or through a specific embassy portal?

As stated in the APS, SOIs may only be submitted through Grants.gov or MyGrants. SOIs are not accepted by direct email or through an embassy portal. Organizations should follow the submission instructions outlined in Section E of the APS and the applicable Addendum.

3. Scoring Criteria: Is there a scoring grid used by the selection committee to evaluate expressions of interest?

SOIs will be evaluated based on the merit review criteria outlined in Section F of the APS.

4. Financial and Budgetary Arrangements : What is the maximum amount a bidder can claim in

Cameroon?

The total estimated funding available under Addendum G is up to $5,400,000, subject to the availability of funds, with up to three awards anticipated. Organizations should not assume that this amount will be divided equally among anticipated awards. The final size and number of awards will be determined based on the results of the SOI review process and Phase 2.

Organizations should propose a budget that is reasonable and appropriate to the proposed scope and period of performance.

5. During the project implementation period, is it possible for our organization to benefit from another US government project?

Organizations may receive funding under other U.S. government awards during the same period, provided that the activities and costs are distinct, complementary, and not duplicative and that the organization(s) complies with the terms and conditions of each award.

6. Can our organization subcontract with government agencies or religious organizations?

Applicants may propose subrecipient, contractual, consortium, or other partnership arrangements where appropriate to achieve the objectives described in the Addendum. Proposed arrangements must comply with applicable federal assistance requirements, and applicants should clearly describe the roles and responsibilities of participating organizations. Eligible faith-based organizations may participate consistent with the eligibility provisions in Section B of the APS.

Detailed partner and budget arrangements may be further reviewed during Phase 2.

7. Will our organization act as a Technical Assistance Provider to the Government or as an Implementing Institution, transferring resources to the Government?

The Department has not prescribed a single implementation role for a prospective applicant.

Organizations should propose an implementation approach that is responsive to the Addendum and clearly describe their anticipated role, the role of Government of the Republic of Cameroon institutions, and any proposed technical assistance, implementation, or resource-transfer arrangements. Government-to-government (G2G) financing is a distinct mechanism from assistance awarded under the APS.

8. Timeline: Processing Times: What is the estimated date for notification of results after submission of the Expression of Interest?

All SOIs will be reviewed following the applicable submission deadline. The Department aims to complete the review and communicate results in a timely manner; however, the timeline may vary based on the volume of submissions and operational considerations. Applicants should anticipate that the full process from SOI submission to potential award may take several months.

9. Can our organization manage its Expression of Interest independently, without partnering with other organizations?

Applicants may submit an SOI independently or propose a consortium, partnership, or other collaborative implementation arrangement. Organizations should select and clearly justify the structure best suited to achieving the objectives described in the Addendum.

10. Where is the binding constraint in Cameroon’s 7-1-7 pathway? Has the joint Government of the Republic of Cameroon (GRC)-U.S. Government assessment identified whether the principal district-level delay occurs in recognition of an unusual event, notification to the district or Public Health Emergency Operations Center within one day, or verification, specimen referral, and initiation of response within seven days? Are baseline 7-1-7 data, representative districts, or common failure points available that applicants should use to target and measure improvement? This would help applicants distinguish whether the highest-value investment is last-mile signal generation, information routing, or downstream response activation.

The Department has not identified a single binding constraint in Cameroon's 7-1-7 pathway for applicants to target. Applicants are expected to draw on their own analysis, field presence, and understanding of the local context to identify where the most critical operational gaps lie, whether in recognition, notification, verification, specimen referral, or response activation, and to then propose an approach responsive to those gaps. Applicants should identify critical operational gaps and prioritize strategies that strengthen the full 7-1-7 pathway to meet 7-1-7 goals in line with international standards. Consistent with Addendum G's guiding principles, related SOIs should also demonstrate clear technical capacity transfer mechanisms and a roadmap to government-led sustainability by 2030. Organizations should clearly explain in their SOIs how their proposed approach and supporting evidence contribute to achievement of the Addendum's objective.

11. What distinguishes a specialized digital capability from a stand-alone product? The Addendum welcomes highly specialized proposals and anticipates up to three awards. For a proposal centered on smartphone-based AI technology for early detection, what minimum operational components should the applicant deliver directly, and which may be provided through formal interfaces with other recipients or GRC programs, to demonstrate a government-led detection-to-response capability rather than a technology deployment? For example, relevant linkages could include district surveillance and PHEOC governance, frontline and veterinary workforce development, human review, referral and specimen workflows, laboratory feedback, infection prevention and control and risk-communication actions, and Rapid Response Team activation.

A specialized digital capability is not defined by the development of a new application; rather, applicants should demonstrate how the proposed approach advances Cameroon's domestic resilience and self-reliance, consistent with the Addendum's guiding principles. Applicants should build from existing efforts already underway in-country and should demonstrate clear awareness of, and integration with, current GRC systems, rather than duplicating or bypassing them. The pieces the applicant delivers directly versus accesses through formal interfaces with GRC or other recipients is the applicant's own design decision and should be clearly justified in the SOI against the gaps identified on the ground. Organizations should explain in their SOIs how a proposed detection tool would close an identified operational gap and contribute to achievement of the Addendum's objective.

12. What One Health operating model and decision rights should applicants design around? The Addendum identifies the Zoonosis Program as the existing multisectoral platform and notes that the National Public Health Institute is not yet fully established. During the award period, which institution is expected to own cross-sector signal triage, integrated risk assessment, and activation decisions? Does GHSD seek a shared operational workflow, including common event definitions, joint investigations, specimen-referral protocols, simulation exercises, and escalation from border communities and livestock corridors, or primarily technical data interoperability among sector systems?

The One Health institutional landscape in Cameroon is already defined, and applicants should design around it. The Zoonosis Program is the existing multisectoral platform, and the Addendum acknowledges that coordination remains "ad hoc, with limited routine information sharing, lack of joint surveillance, lack of integrated risk assessments, and uncoordinated outbreak investigations", and that the National Public Health Institute is not yet legally established. Applicants should therefore not propose new or competing decision-rights structures but instead design their SOI to reinforce and strengthen the existing platform during this transitional period, while remaining adaptable to the NPHI's eventual assumption of these functions. The Addendum's guiding principles make clear the ambition extends beyond data connectivity to strengthening the Government of Cameroon's resilience in intersectoral outbreak prevention, detection, and response. Applicants should therefore build toward shared operational practice and ground their proposed role in what existing GRC structures are already doing.

13. Can a remote university or teaching-hospital hub anchor a district sentinel network? Would GHSD view a university-affiliated teaching hospital or field-research site in a remote, forested area as an appropriate sentinel, referral, validation, and workforce-development hub if it is formally linked to district and regional authorities? Such a hub could connect community and veterinary workers to specialist review, specimen referral and confirmatory laboratories, PHEOC and Rapid Response Team escalation, simulation exercises, infection prevention and control readiness, and patient transport. What governance or service-agreement arrangements would be needed to ensure that this model strengthens, rather than parallels, government systems?

Organizations may propose a university-affiliated teaching hospital or field-research site as part of a district sentinel or referral network where the approach is responsive to the Addendum and appropriate to the Cameroonian context. The SOI should clearly describe the proposed institution’s role, its formal linkages with relevant district, regional, and national authorities, and how the approach would strengthen existing government surveillance, referral, laboratory, workforce, and response systems rather than establish parallel structures. Specific governance or service-agreement arrangements may be further developed during consultative program design or Phase 2, if applicable.

14. What authoritative systems, data owners, and geospatial data flows should be assumed? At the SOI stage, can GHSD identify the authoritative owners and current or planned platforms for Integrated Disease Surveillance and Response, laboratory information, PHEOC incident management, and One Health reporting in Cameroon, together with any required data-exchange standards? If detailed specifications will only be available later, should applicants propose a vendor-neutral integration layer that can export structured human and animal alerts, referral and specimen status, and anonymized village- or health-area-level geospatial signals? At what stage would selected applicants receive system inventories, data dictionaries, application programming interfaces, and data-sharing requirements?

The Department is not providing additional system inventories, data dictionaries, application programming interfaces, or technical specifications at the SOI stage. Applicants should demonstrate awareness of the relevant Government of the Republic of Cameroon systems, governance structures, and data-protection requirements and clearly explain the assumptions underlying their proposed approach. Organizations may propose vendor-neutral or other interoperable approaches where appropriate, provided they support government ownership, sustainability, and integration with approved national systems. Detailed technical and data-sharing requirements may be further refined with relevant government counterparts during consultative program design or Phase 2, if applicable.

15. What is the required 2030 end state for Cameroonian ownership and financing? For a digital surveillance and workforce component, which functions must be demonstrably under Cameroonian control by December 2030, including data governance, user administration, model and configuration oversight, hosting and compute, help desk, licensing, connectivity, and recurrent workforce costs?

Does the MOU require full GRC budget absorption of these costs, or may a sustainable mixed-financing arrangement involving government, university or hospital, and private-sector mechanisms be acceptable? What evidence of future financing or institutional commitment is expected at the SOI stage?

Applicants should ground their sustainability narrative in the Addendum's own guiding principles, which call for proposals to reinforce host-country leadership and include technical capacity transfer mechanisms with a clear roadmap to government-funded activities by 2030, while also encouraging partnership with the private sector to accelerate innovation and expand the use of advanced technologies.

16. Non-duplication and demarcation of scope. The Addendum requires that funded activities complement, and do not duplicate, existing United States supported programs. Could the Bureau clarify the mechanism and the stage at which the boundary between award activities and ongoing instruments (in particular CDC cooperative agreements, STRIDES, and, where relevant, Global Fund supported activities) will be delineated, and whether the beneficiary Ministry will be consulted in establishing that boundary?

Non-duplication is addressed at multiple stages of this process, with responsibility shared between the applicant and the Department, most especially at full-application stages. Applicants are encouraged to describe, to the best of their knowledge at the SOI stage, how their proposed activities are distinct from and complementary to known ongoing U.S. government, GRC, or other donor-supported programming. Applicants bear primary responsibility for demonstrating a cost-effective approach that avoids duplication, consistent with Addendum G's guiding principles.

17. Articulation with the future National Public Health Institute. Given that the Addendum refers to the establishment of Cameroon's National Public Health Institute (INSP), how does the Bureau expect funded activities to articulate with the Institute's mandate and leadership, notably for the coordination of surveillance and rapid response?

Applicants should design funded activities to be adaptable to the NPHI's evolving mandate and therefore support surveillance and rapid response functions in a manner that strengthens current institutional arrangements during this transitional period, while building the technical foundation that can be transferred to NPHI leadership once it is legally established. Proposals should reflect awareness that NPHI is expected to progressively assume national coordination functions.

18. Eligibility and legal applicant of a national institution. Section B of the Annual Program Statement lists governmental institutions among eligible applicants. For a Cameroonian governmental institution, could the Bureau confirm whether the legal applicant would be the institution itself or the Republic of Cameroon, and specify the legal personality, registration, and public financial management requirements, including any risk review under 2 CFR 200.206, that would apply to such an applicant?

Eligibility requirements are described in Section B.1 of the APS. A governmental institution seeking to apply must have the legal authority and institutional capacity to enter into and administer a U.S. federal assistance award and must satisfy all applicable eligibility and pre-award requirements. Whether a particular institution may apply in its own name will depend on its legal status and authority under applicable Cameroonian law. Additional documentation and required pre-award risk reviews, including those conducted consistent with 2 CFR 200.206, would be addressed during Phase 2 and the pre-award process.

19. Applicant status of a beneficiary-country institution and conflict-of-interest safeguards. Where a governmental institution of the beneficiary country wishes to submit a Statement of Interest, while its parent Ministry acts as the national coordinating authority for the Memorandum of Understanding, could the Bureau confirm that such an institution is eligible to apply, and specify the conflict-of-interest safeguards it expects, including the recusal of the Ministry and of any official connected to a submission from any advisory or review role for Addendum G, so that the integrity of the merit review is preserved?

Governmental institutions are eligible to apply consistent with Section B.1 of the APS, provided they meet all applicable eligibility requirements. The Department of State is responsible for conducting the merit review and selection process in accordance with Section F of the APS and applicable federal assistance requirements. Individuals with an actual or apparent conflict of interest may not participate in the evaluation or selection of a related submission and must disclose and address such conflicts consistent with applicable requirements. Additional safeguards may be established as appropriate during the review and pre-award process.

20. For “Addendum G: Health Foreign Assistance MOU Implementation in Cameroon” under the Global Health APS (#DFOP0017890), the Department of State’s budget ceiling is $5,400,000 USD (subject to availability), for up to 3 awards, with each award having a period of performance of up to 5 years.

As you can appreciate, this is quite a low budget ceiling, amounting to only $360,000 per year per award if three awards are made, and amounting to only about $1 million per year per award if one award is made. (Both estimates assume a 5-year period of performance, to allow sufficient time to transition activities to domestic leadership and ensure their sustainability in the absence of USG funding.) Such a low budget ceiling would severely constrain an offeror’s ability to deliver on even a partial set of the “key interventions” listed on p. 4 of the addendum. With this in mind, would the Department of State consider raising the budget ceiling for this opportunity?

The total estimated funding available under Addendum G remains up to $5,400,000, subject to the availability of funds. Final funding levels and budget periods will be determined during the award process and are subject to availability of funds. The funding amount reflects the total funding available for the initial award(s). The period of performance for the proposed project should be 5 years or less. Additional funding may be added, subject to the availability of funds, contingent on strong performance. Applicants are not expected to address every intervention listed in the Addendum and should propose a focused, feasible approach that is responsive to the Addendum objective and appropriate to the available funding. The final number and size of awards will be determined based on the results of the SOI review process and Phase 2.

21. With STRIDES already supporting GHS in Cameroon, is this funding intended primarily to expand existing activities, transition current activities, or establish new complementary interventions?

The Department has not categorized this funding relative to existing U.S. government-supported instruments, such as STRIDES, and applicants are not required to characterize this relationship in order to submit a competitive SOI. As stated in Addendum G, the Department's expectation is that applicants take appropriate action to avoid duplicating activities funded elsewhere by the U.S. government, GRC, or other funders for the duration that their award is active. The Department will evaluate SOIs based on the extent to which proposed activities are distinct from and complementary to known ongoing programming. Applicants should therefore focus their SOI on clearly describing their proposed activities and demonstrating, to the best of their knowledge, that these activities are distinct from and complementary to known ongoing programming, rather than attempting to characterize their proposal's relationship to any specific named instrument such as STRIDES.

22. Since the addendum award may last five years while other funding streams such as STRIDES, may conclude earlier, could STATE and the Cameroon Post please articulate any preference for a phased approach. Does GHSD have expectations regarding sequencing of activities (e.g., institutional strengthening first, followed by scale-up), or is implementation strategy left entirely to the applicant, FHI 360?

The Department has not prescribed a single sequencing or phasing model. Organizations should propose and justify an implementation strategy that is responsive to the Addendum, feasible within the proposed period of performance and funding level and appropriately coordinated with existing or anticipated investments. Organizations should clearly describe major phases, dependencies, transition milestones, and how the proposed sequencing supports government ownership and sustainability.

23. The Addendum discusses strengthening governance, lack of sustainable financing, and several issues creating a “critical leadership vacuum at the center of the country’s emergency response architecture”. However, policy, governance and financing activities are not included in the discussion of Key Interventions of the single objective. Would State and the Cameroon post please indicate if strengthening governance, health financing, technical leadership, agency mandate clarification and related policy initiatives are considered part of One Health coordination. If not, should bidders be sure to address these governance, finance, and policy level challenges as part of developing sustainable, country-led systems at national and district level?

Governance, financing, technical leadership, and policy-related challenges are described in this Addendum as contextual gaps informing the overall rationale for the program, but they are not enumerated among the key interventions under the single objective. Applicants should focus their SOIs on the technical and operational interventions outlined under the objective and should not assume governance, financing, or policy reform activities are in scope unless directly and clearly tied to enabling one of the listed key interventions. Any proposal seeking to address governance, financing, or policy dimensions should articulate this linkage explicitly and should not treat these as a primary program focus area under this Addendum.

24. Please advise about the requirement of Defense Base Act (DBA) insurance worker's compensation coverage for employees and consultants. Is DBA insurance a requirement that should be included in the budget for U.S. Department of State Opportunities?

Defense Base Act (DBA) insurance is generally a requirement for U.S. government contracts, not for grants or cooperative agreements. DBA insurance is not included in the Department of State's standard award provisions for grants and cooperative agreements. Because awards resulting from this APS and Addendum G are anticipated to be issued as grants, cooperative agreements, or fixed amount awards rather than contracts, applicants generally should not include DBA insurance costs in their budgets. Applicants with questions about their specific personnel arrangements should direct them to the Grants Officer at the appropriate stage of the award process.

25. For the Phase I/SOI submission, is it expected to only include a summary budget? Is it recommended to include a high-level org chart with the Phase I submission.

The SOI does not require a summary budget or a detailed budget breakdown. A full budget narrative and detailed cost breakdown are not requested until Phase 2. Similarly, an organizational chart is not a required component of the SOI and is not mentioned in the SOI content requirements. Applicants should prioritize the five-page narrative content, since annexes are limited to four pages total and reviewers will only evaluate the narrative up to the specified page limit. If an applicant believes an org chart would meaningfully clarify partner roles within the five-page/four-annex limit, it may be included as one of the permitted annexes, but it is not expected or scored as a required element.

26. Is there an amount an organization must justify that he has managed in the past before to apply as Principal Recipient?

The APS does not establish a minimum prior grant management dollar threshold as an eligibility requirement. Instead, organizational capacity is assessed qualitatively as part of the merit review.

The APS evaluation criteria include "Organizational Capacity and Record on Previous Grants," which asks the SOI to "demonstrate the organization's expertise and previous experience in administering programs," without specifying a required dollar amount. Separately, prior to making an award, the Department conducts a risk review considering financial stability, management systems and standards, history of performance, audit reports, and ability to effectively implement. Applicants of any size or funding history may apply; however, organizations should be prepared to substantiate their capacity to responsibly manage the specific award amount they are requesting, proportionate to their proposed scope of work.

27. Can an organization proposed a project for the total amount 5, 400, 000 $ or this amount is for 03 projects? The budget of 5, 400, 000 $ is for one year or for 3 years?

The total estimated funding available under Addendum G is up to $5,400,000, subject to the availability of funds, with up to three awards anticipated. The final size and number of awards will be determined based on the results of the SOI review process and Phase 2. Applicants should propose a budget that is reasonable and appropriate to the proposed scope and period of performance.

28. Please confirm that the funding envelope of $5,400,000 is for the entirety of the 5 years.

The total estimated funding available under Addendum G remains up to $5,400,000, subject to the availability of funds. Final funding levels and budget periods will be determined during the award process and are subject to availability of funds. The funding amount reflects the total funding available for the initial award(s). The period of performance for the proposed project must be five years or less. Additional funding may be added, subject to the availability of funds, contingent on strong performance. Applicants are not expected to address every intervention listed in the Addendum and should propose a focused, feasible approach that is responsive to the Addendum objective and appropriate to the available funding. The final number and size of awards will be determined based on the results of the SOI review process and Phase 2.

29. Please confirm that activities should be conducted at the national level.

While certain interventions target national-level systems and institutions, Addendum G includes considerations for sub-national implementation, as illustrated by references to regional Public Health Emergency Operations Centers, district-level Rapid Response Team training, and district-level institutional strengthening in priority districts. Applicants should design activities at the level(s) most appropriate to addressing the specific gap(s) their proposal targets, which may span national, regional, and/or district levels within Cameroon.

30. The single objective spans workforce, laboratory, supply chain, surveillance, IPC, border health, and digital health under a $5.4M ceiling. Are highly specialized proposals, e.g. those focused exclusively on digital health and data interoperability, anticipated, or does GHSD expect each award to span multiple intervention areas?

Applicants should propose the scope they judge most appropriate, not solely to cover specific gaps, but to advance Cameroon's broader trajectory toward sustainable, country-led health security resilience by 2030. Addendum G does not prescribe a required breadth of coverage; the applicant is best positioned to determine whether a specialized or integrated approach will most effectively contribute to that outcome, provided the proposal is clearly justified and responsive to Addendum priorities.

31. For the One Health data linkage component, is the expectation a shared platform across human and animal health ministries, or data exchange between ministry-owned systems? Is there a designated GRC digital health coordinating body with authority to mandate cross-ministry data standards?

Applicants should design their proposed approach based on what already exists in-country, what most directly addresses the most critical documented needs related to One Health data linkage, and the current institutional and technical context in Cameroon, including existing ministry-owned systems and the current state of cross-sector coordination. Proposals should clearly identify which GRC counterparts the applicant intends to engage directly and should account for the current absence of a fully mandated cross-ministry governance mechanism when designing their approach.

32. For outcomes: how would they prefer we present direct vs indirect outcomes? The outcomes we are able to measure will depend significantly on who our partners are for this work re: system strengthening (BAO’s contribution) and health outcomes (delivery org). Should outcomes include:

health, cost, efficiency, etc.? The list could be extensive under a single objective.

Applicants have flexibility to present outcomes in the manner that most clearly and credibly reflects their proposed approach, partnership structure, and what their organization and partners are positioned to deliver and measure. Given the five-page narrative limit, applicants should prioritize the outcomes most central and most credibly attributable to their specific proposed activities.

Addendum H: Cote d'Ivoire Q&A

1. Multi-objective SOIs. Applicants may address one or more of the four objectives. Does the five-page

/ 2,500-word limit (§D) apply per SOI regardless of the number of objectives addressed, and does GHSD have a preference between focused single-objective and integrated multi-objective concepts

The five-page limit applies for each SOI, regardless of the number of objectives.

2. Objective 1 infrastructure. Are the capital elements named under Objective 1 — the Bingerville

Central Virology Laboratory P3 upgrade, three mobile laboratories, and rehabilitation of three regional animal laboratories — within scope for funding under this Addendum, or delivered through the parallel government-to-government mechanism with the recipient providing surrounding technical assistance? If in scope, should applicants budget for construction and equipment procurement

Organizations may propose infrastructure, equipment, and related technical-assistance activities that are responsive to Objective 1. At the SOI stage, the Department is assessing the overall merit, responsiveness, and feasibility of proposed concepts rather than making determinations regarding the allowability of specific budget line items or the final division of costs between APS and government-to-government mechanisms. Applicants should clearly describe the proposed scope, assumptions, and relationship to other anticipated investments. Detailed budget and cost-allowability considerations will be addressed during subsequent phases, if applicable.

3. Objective 3 workforce transition. Objective 3 describes absorbing implementer-employed staff into MSHPCMU positions and aligning salaries to the Government of Côte d'Ivoire scale from FY27. Are transition costs — for example severance, salary-differential bridging, or retraining — allowable under an award, and what division of responsibility does GHSD anticipate between recipient and government?

Applicants should propose and justify a feasible workforce-transition approach that is responsive to Objective 3, including anticipated roles for the recipient and the Government of Côte d’Ivoire, major milestones, and measures to support sustainability. At the SOI stage, the Department is assessing the overall concept rather than making determinations regarding the allowability of specific transition costs. Detailed staffing, budget, cost-allowability, and government-responsibility arrangements will be addressed during subsequent phases, if applicable.

4. Coordination with existing mechanisms. How should proposed projects interface with current PEPFAR (HIV), PMI (malaria), and Global Fund activities in Côte d'Ivoire to avoid duplication and support integration, and are current implementers of those programmes eligible and encouraged to apply?

Applicants should demonstrate awareness of relevant U.S. government, Government of Côte d’Ivoire, Global Fund, and other partner-supported activities and explain how the proposed approach would complement rather than duplicate those investments. Current implementers may apply, provided they meet the eligibility requirements described in Section B.1 of the APS. All SOIs will be evaluated according to the criteria outlined in Section F of the APS.

5. Leahy vetting. Objective 1 references equipping mobile laboratories for the armed forces health service. Does support reaching the armed forces health service trigger Leahy vetting (§E.5.b), and what pre-submission steps should applicants anticipate?

Activities that constitute assistance to foreign security forces will be subject to applicable Leahy vetting and other relevant U.S. government requirements. Applicants are not required to complete Leahy vetting before submitting an SOI but should clearly identify any proposed engagement with the armed forces health service. Organizations invited to subsequent phases will receive additional guidance and may be required to provide information necessary to complete applicable vetting before assistance is furnished.

6. MOU period. Addendum H cites the implementation period as both December 2025–December 2030 and December 2025–September 2030. Which end date should applicants use to bound the project period and phased milestones?

September 30, 2030.

Applicants should consider the implementation period end date of September 30, 2030.

7. Controlling calendar and portal. Do the Addendum H dates (questions 17 July 2026; SOI 15

September 2026) supersede the quarterly-window schedule in §E.4, and on what dates will the grants.gov / MyGrants submission window for this Addendum open and close?

As listed in Addendum H, the SOI submission window closes on September 15, 2026 at 1700 PM

EDT GMT-4.

8. Consultative design. Given the Addendum's reference to consultative program design, does GHSD anticipate that SOIs under this Addendum will generally proceed through co-design before any Phase 2 invitation?

Consultative program design is one of the possible outcomes of an SOI. The Department retains flexibility in whether or not to utilize that optional phase and how consultative program design is conducted if used.

9. Per-award funding. Addendum H sets total funding at up to $50,000,000 across up to three awards.

Does the main APS per-award range of $500,000 to $250,000,000 (§A.1) apply unchanged to this Addendum, and does GHSD anticipate a preferred award size or range for individual awards?

The total estimated funding available under Addendum H is up to $50,000,000, subject to the availability of funds, with up to three awards anticipated. The Department has not established a preferred funding amount or range for individual awards beyond the parameters stated in the APS and Addendum. Applicants should propose a budget that is reasonable and appropriate to the proposed scope and period of performance. Final award sizes will be determined based on the results of the SOI review process and Phase 2.

10. Funding instrument. Does GHSD anticipate awards under this Addendum as grants or as cooperative agreements with substantial involvement (§A.1, §C)? The distinction affects the monitoring and decision-rights structure applicants should design toward.

As stated in the APS, GHSD retains the right to use of both instruments: traditional grants, as well as cooperative agreements. Additionally, GHSD retains the right to use fixed amount awards.

11. Definition of "local." Addendum H emphasises local Ivoirian, faith-based, and community-based organisations, while §B.1 admits U.S. and foreign entities without a local-registration condition. Is local status a formal eligibility requirement for this Addendum, a scoring preference, or a partnering expectation, and how is "local" defined (place of incorporation, Ivoirian ownership or control, or in-country registration)?

Eligibility requirements are described in Section B.1 of the APS. Eligible local, national, regional, international, and other qualifying organizations may apply, consistent with the APS eligibility requirements. All SOIs will be evaluated based on the published evaluation criteria outlined in Section F of the APS.

12. Objective 4 – Facility Network: Could GHSD provide, or indicate whether it will provide, a detailed list of the faith-based and community-based facilities referenced under Objective 4, including their names, locations, and facility type where available?

A detailed list of faith-based and community-based facilities in Cote d’Ivoire is available at the

MSHPCMU.

13. Eligibility of Lead Applicant under Addendum H: Could GHSD clarify whether international organizations are eligible to apply as the lead/prime applicant under Addendum H, consistent with the broader eligibility provisions of the Annual Program Statement, or whether the lead applicant must be a local Ivoirian organization?

Eligibility requirements are described in Section B.1 of the APS. Eligible local, national, regional, international, and other qualifying organizations may apply as prime applicants, consistent with the APS eligibility APS requirements. All SOIs will be evaluated according to the criteria outlined in Section F of the APS.

14. Objective 1 lists interventions “including but not limited to” laboratory-network, diagnostic, and infrastructure components (connected laboratory network, three mobile laboratories, Bingerville P3 upgrade, regional animal laboratories). Will an SOI that addresses a defined subset of Objective 1 — real-time and multi-channel disease-data collection, surveillance-system interoperability, and PHEOC operational readiness — be evaluated as fully responsive, or is coverage of the laboratory-infrastructure components expected within any Objective 1 award?

Objective 1 has been revised to exclude activities related to rehabilitation and equipping of laboratories as this is covered under lab strengthening by a lab partner.

15. Are the digital-surveillance and emergency-operations-coordination elements of Objective 1 considered a stand-alone fundable scope, or does GHSD expect them to be bundled with laboratory and diagnostic strengthening?

Activities under Objective 1 should exclude equipping and upgrading laboratories as these are covered under the laboratory strengthening strategy (please see the amended Addendum which has been re-posted). The scope of Objective 1 should therefore be treated as stand-alone given that equipping and rehabilitation will no longer be part of this objective.

16. Are consortia or prime–subrecipient arrangements permitted at the SOI stage? If so, should partners be named, and how are the respective capacities of consortium members assessed?

Applicants may propose consortium, prime–subrecipient, partnership, or other collaborative implementation arrangements where appropriate. Applicants should identify proposed partners where known and clearly describe their anticipated roles and responsibilities. Formal partnership agreements are not required at the SOI stage. The proposed implementation structure and the relevant capacity and experience of participating organizations will be considered under the evaluation criteria outlined in Section F of the APS.

17. May an applicant address Objective 1 jointly with a laboratory / diagnostics partner so the full objective is covered across the team?

Objective 1 has been revised to exclude Capital expenditures, construction, and major equipment procurement as this is covered under lab strengthening by a lab partner.

18. May a non-local organization serve as prime with a local partner, or must the prime applicant itself qualify as local?

Eligible local, national, regional, international, and other qualifying organizations may apply as prime applicants consistent with Section B.1 of the APS. A non-local organization may serve as the prime applicant and may propose partnerships with local Ivoirian organizations. All SOIs will be evaluated according to the criteria outlined in Section F of the APS.

19. What weight is given to documented endorsement from the Government of Cote d’Ivoire (MSHPCMU / INHP) at the SOI stage? Is a letter of support expected, beneficial, or not considered until a later phase?

Organizations are not required to submit letters of support, endorsements, or formal agreements from Government of Côte d’Ivoire institutions at the SOI stage. Applicants should nevertheless demonstrate an understanding of relevant government priorities and explain how the proposed approach would support government ownership and sustainability. Formal coordination arrangements may be developed during consultative program design or Phase 2, if applicable.

20. How should applicants evidence coordination with existing actors (WHO, Africa CDC, WAHO/OOAS, the 7-1-7 Alliance / Resolve to Save Lives, AFENET, the national FETP, and Institut Pasteur de Cote d’Ivoire) to demonstrate complementarity and avoid duplication?

Applicants should demonstrate awareness of relevant government, regional, international, and partner-supported activities and explain how the proposed approach would complement rather than duplicate existing efforts. Applicants are not required to submit formal coordination agreements at the SOI stage. The SOI should provide sufficient information for reviewers to understand the proposed coordination approach, anticipated partner roles, and areas of complementarity.

21. Under what circumstances would an Objective 1 SOI be routed to the consultative program design process referenced in the Addendum and APS Section F, and what would that imply for timeline and for adjusting scope after submission?

Consultative program design is one possible outcome of the SOI review process. The Department retains flexibility in determining whether to use this optional phase based on the nature of the proposed concept and program-design needs. If used, consultative program design is intended to be a structured, time-bound process during which the proposed technical approach, geographic scope, partnership structure, budget, and other design elements may be refined.

Participation in consultative program design does not guarantee an invitation to Phase 2 or an award.

22. For digital-platform and community-reporting investments, what evidence of a domestic financing and ownership pathway is expected within the five-year period? Does GHSD anticipate Government of Cote d’Ivoire commitments toward recurrent costs (hosting, connectivity/telecom, staffing)?

In the MOU agreement, the Government of Côte d'Ivoire has pledged to provide co-financing to achieve the planned objectives. While exact allocation across activities remained to be detailed, the ultimate goal is for the government to assume most or all recurrent costs within the MOU period.

23. Are there specific U.S., bilateral (MOU), or Ivorian data-governance, privacy, consent, or data-localization requirements that apply to population-facing community-reporting data collected under this program?

Yes, there is a law (N° 2013-450) on the protection of personal data adopted by the Government of Côte d'Ivoire in 2013, as well as a decree (N° 2021-915) adopting the security policy for information systems in public administration that address these requirements.

24. Given “up to 3 awards” and “up to $50,000,000” total: is there an indicative per-award ceiling or expected range for an Objective 1 award, and may a single applicant be awarded for a single objective?

The Department has not established an indicative funding range for individual objectives or awards beyond the parameters stated in the APS and Addendum H. Applicants should propose a budget that is reasonable and appropriate to the proposed scope and period of performance. An applicant may propose an award focused on a single objective. Final award sizes and distribution across objectives will be determined based on the results of the SOI review process and Phase 2.

25. Please confirm the required SOI structure, page limit, and mandatory sections for this Addendum, and whether any Objective 1-specific attachments (e.g., partner letters, capability statements) are expected at the SOI stage.

Applicants should follow the submission requirements and formatting instructions outlined in Section D of the APS and the formatting clarifications provided in this Q&A. The five-page or 2,500-word limit applies to the narrative portion of each SOI regardless of the number of objectives addressed. There are no additional Objective 1-specific attachments required at the SOI stage. Letters of support, formal partnership agreements, and separate capability statements are not required.

26. The Addendum identifies multiple health systems priorities, including HIV, malaria, maternal and child health, and global health security. At the SOI stage, does GHSD anticipate supporting concepts from international partners that focus on a subset of these priorities where applicants have comparative technical strengths, or is it seeking concepts that address a broader cross-section of the MOU's health priorities?

Organizations may propose concepts addressing one or more objectives or a defined subset of health priorities. Applicants are not required to address every health priority identified in the Addendum. The SOI should clearly explain how the proposed scope reflects the organization’s comparative strengths and contributes to achievement of the selected Addendum objective or objectives.

27. Could GHSD clarify whether applicants are encouraged to leverage and strengthen existing government systems and prior U.S. Government-funded investments, where appropriate, rather than proposing entirely new implementation approaches or models, provided the proposed activities complement rather than duplicate existing efforts?

Applicants may propose approaches that leverage and strengthen existing government systems and prior U.S. government or partner-supported investments where appropriate. Organizations should clearly explain how the proposed approach would complement rather than duplicate existing efforts, address identified gaps, and support integration, sustainability, and Government of Côte d’Ivoire ownership.

28. Does GHSD anticipate making awards that focus on a single objective, or is there a preference for integrated approaches that address multiple objectives within a single application? How would GHSD define a successful transition to country ownership by 2030, and what key indicators or benchmarks will be used to assess progress toward this objective?

Organizations may propose concepts addressing one or multiple objectives. The Department has not established a preference for single-objective or integrated multi-objective SOIs; applicants should propose and justify the approach best suited to achieving the selected objective or objectives. Applicants should also describe a clear pathway toward country ownership, including proposed transition milestones, institutional responsibilities, sustainability measures, and indicators appropriate to the concept. Specific performance and transition requirements may be further refined during subsequent phases.

29. The Memorandum of Understanding (MOU) is expected to conclude in 2030, while awards under this solicitation may extend through 2031. The Statement of Interest (SOI) does not specify the anticipated timing for Phase 3 activities under Objective 3. Should applicants assume that Phase 3 is expected to begin toward the end of 2030, aligning with the conclusion of the MOU and continuing through the final year of the award?

Applicants should not assume a prescribed start date for Phase 3 beyond the sequencing described in Addendum H. Organizations should propose and justify a realistic, phased implementation and transition schedule that is consistent with the proposed award period and supports achievement of the Objective 3 outcomes. Specific timing and milestones may be further refined with the Department and Government of Côte d’Ivoire during consultative program design or Phase 2, if applicable.

30. Would GHSD consider allowing a five-page limit in lieu of the 2,500-word limit for the Statement of Interest; especially with font size being less for footnotes, captions, tables and charts.

Applicants should follow the formatting requirements in Section D of the APS. The SOI narrative must not exceed five pages. The Table Listing of Critical Details and permitted annexes, tables, charts, diagrams, and other visual materials are treated as described in the formatting clarifications provided in Round 1 and Round 2a Q&A.

31. Would GHSD permit the use of a…