FINAL SIGNED Global Health Security (GHS) new activity summary - FE 11.14.24.pdf

Issue Date: November 14, 2024 Deadline for Questions: December 6, 2024 Closing Date: January 6, 2025 Closing Time: 10:00am (Guatemala time)

Subject: Notice of Funding Opportunity (NOFO)

Request for Application (RFA) Number 72052025RFA00002

Program Title: USAID/Guatemala Global Health Security Activity

Federal Assistance Listing Number: 98.001 - Foreign Assistance for Programs Overseas

Greetings, The United States Agency for International Development (USAID) is seeking applications for a Cooperative Agreement from qualified entities to implement the USAID/Guatemala Global Health Security Activity. Eligibility for this award is not restricted.

USAID intends to make an award to the applicant who best meets the objectives of this funding opportunity based on the merit review criteria described in this NOFO, subject to a risk assessment. Eligible parties interested in submitting an application are encouraged to read this NOFO thoroughly to understand the type of program sought, application submission requirements, and selection process.

To be eligible for award, the applicant must provide all information as required in this NOFO and meet eligibility standards in Section B of this NOFO. This funding opportunity is posted on www.grants.gov and may be amended. It is the responsibility of the applicant to regularly check the website to ensure they have the latest information pertaining to this NOFO and to ensure that it has been downloaded from the internet in its entirety. USAID bears no responsibility for data errors resulting from transmission or conversion process. If you have difficulty registering on www.grants.gov or accessing the NOFO, please contact the Grants.gov Support Center at 1- 800-518-4726 or via email at support@grants.gov for technical assistance or if you need assistive technology and are unable to access any material on this site.

Unless an exception in 2 CFR 25.110 applies, applicants must comply with 2 CFR 25 requirements to obtain a Unique Entity Identifier (UEI) and register in the System for Award Management (SAM.gov), as applicable. See Section E, Submission Requirements and Deadlines, for more http://www.grants.gov/ mailto:support@grants.gov information. The registration process may take many weeks to complete. Therefore, applicants are encouraged to begin registration early.

Please send any questions to the point(s) of contact identified in Section A.4. The deadline for questions is shown above. Responses to questions received prior to the deadline will be furnished to all potential applicants through an amendment to this notice posted to www.grants.gov.

Issuance of this NOFO does not constitute an award commitment on the part of the Government nor does it commit the Government to pay for any costs incurred in preparation or submission of comments/suggestions or an application. Applications are submitted at the risk of the applicant. All preparation and submission costs are at the applicant’s expense.

Thank you for your interest in USAID programs.

Sincerely, Anthony R. Raneses Supervisory Agreement Officer

NOFO TABLE OF CONTENTS

SECTION A: BASIC INFORMATION

SECTION B: ELIGIBILITY

SECTION C: PROGRAM DESCRIPTION

SECTION D: APPLICATION CONTENT AND FORMAT

SECTION E: SUBMISSION REQUIREMENTS AND DEADLINES

SECTION F: APPLICATION REVIEW INFORMATION

SECTION G: AWARD NOTICES

SECTION H: POST-AWARD REQUIREMENTS AND ADMINISTRATION

SECTION I: OTHER INFORMATION

ANNEX 1 - SUMMARY BUDGET TEMPLATE

ANNEX 2 - STANDARD PROVISIONS

ANNEX 3 - ABBREVIATIONS AND ACRONYMS

ANNEX 4 - BRANDING AND MARKING PLAN

SECTION A: BASIC INFORMATION

1. Executive Summary

The Guatemala Global Health Security (GHS) Activity is designed to provide specialized and targeted technical support in critical areas to key stakeholders in Guatemala. This initiative aims to enhance health system capabilities, promoting resilience and autonomy in preventing, detecting, mitigating and responding to the health and economic impacts of emerging infectious disease outbreaks. The priority areas for technical support will be determined annually, following a collaborative and consultative process involving key stakeholders and USAID. This approach ensures that the Activity remains at the forefront of addressing evolving and emerging health security challenges across Guatemala. The objectives of this Activity are:

Objective 1 “Prevent” - Strengthen health systems capacity to build resilience against future health threats.

Objective 1 aims to build long-term One Health systems resilience to prevent the negative impacts of future health threats. The Activity will provide tailored and targeted technical support at the national or sub-national level (department, district, and community) that lead to strengthened management structures and systems and an effective policy environment.

Objective 2 “Detect & Mitigate” - Enhance Guatemalan health systems capacity to rapidly respond, control and mitigate the impacts of emerging infectious disease outbreaks.

The prompt and accurate detection and reporting of infectious disease outbreaks are crucial for promoting health security through controlling their progression and preventing large-scale outbreaks and epidemics. Under this objective, key areas for technical support include the strengthening of national laboratories, surveillance systems, and the development of human resources and related workforce capacities.

Objective 3 “Respond” - Enhance Guatemala’s capacity to effectively respond to emergent health threats and public health emergencies For countries to effectively respond to infectious disease events, it is crucial to have multi-sectoral emergency measures in place. These measures include coordination mechanisms, emergency operations centers, communications infrastructure, and agreements among multi-sectoral partners in animal and human health, environment, security, law enforcement authorities, and other sectors. They also encompass frameworks for deploying and managing medical and non-medical countermeasures. Key areas in this category include Emergency Preparedness, Emergency Response Operations, Linking Public Health and Security Authorities, Medical Countermeasures and Personnel Deployment, and Risk Communication. Additionally, managing infectious disease threats at points of entry is vital for controlling international spread.

The Activity will provide tailored and targeted technical support at national or subnational levels in Guatemala to strengthen capacities in responding to public health emergencies.

2. Estimate of Funds Available and Number of Awards Contemplated

USAID intends to award one Cooperative Agreement pursuant to this Notice of Funding Opportunity (NOFO). Subject to funding availability and at the discretion of the Agency, USAID intends to provide $40,000,000 in total USAID funding over a five (5) year period.

3. Start Date and Period of Performance for Federal Awards

The anticipated period of performance is 5 years. The estimated start date will be March 30, 2025.

4. Agency Point of Contact

Anthony R. Raneses, Supervisory Agreement Officer Carolina Villegas, Senior Acquisition and Assistance Specialist email: guatemalaproposals@usaid.gov

5. Acquisition and Assistance Ombudsman

The A&A Ombudsman helps ensure equitable treatment of all parties who participate in USAID’s acquisition and assistance process. The A&A Ombudsman serves as a resource for all organizations who are doing or wish to do business with USAID. Please visit this page for additional information: https://www.usaid.gov/work-usaid/acquisition-assistance-ombudsman.

The A&A Ombudsman may be contacted via: Ombudsman@usaid.gov

6. Authorized Geographic Code

The geographic code for the procurement of commodities and services under this program is

937. Except as may be specifically approved in advance by the Agreement Officer, all commodities and services that will be reimbursed by USAID under this award must be from the authorized geographic code specified in this NOFO, and must meet the source and nationality requirements set forth in 22 CFR 228.

7. Selection of Instrument

USAID/Guatemala explored existing procurement mechanisms at USAID/Washington and in the region. This includes both Leaders with Associates and IDIQs in Washington, for which there are no current mechanisms with a global health security focus nor that have the breadth to cover all proposed activities. In addition, the regional IDIQ mechanism managed and administered by the regional mission in El Salvador was considered and it was determined that the current IDIQ https://www.usaid.gov/work-usaid/acquisition-assistance-ombudsman https://www.usaid.gov/work-usaid/acquisition-assistance-ombudsman https://www.usaid.gov/work-usaid/acquisition-assistance-ombudsman holders did not have the breadth of institutional capabilities that may be needed to successfully implement the proposed Activity, putting at risk USAID investments in global health security of not achieving results.

The principle purpose of the Activity is to financially support the recipient to achieve and sustain strengthened health system capabilities by supporting government- and locally-led solutions that will build resilience and self-reliance to prevent, mitigate and respond to the health economic impacts of emerging infectious disease pandemics. Therefore, USAID/Guatemala will use a cooperative agreement as the legal instrument reflecting a grantor-grantee relationship between the Agency and the recipient for the activity, since the principal purpose of the Agency’s intended relationship with the recipient is to transfer Federal financial assistance to the recipient in accordance with the criteria stated in FGCAA Section 6305 for use of a cooperative agreement. It is important that the recipient and its partner organizations act as independent entities and do not implement programs as direct agents of the U.S. Government. The U.S.

Government's interests will be best served by supporting and being substantially involved in the program, but not by directly controlling it.

SECTION B: ELIGIBILITY

1. Eligible Applicants

Eligibility under this Notice of Funding Opportunity (NOFO) is not restricted..

Faith-based organizations are eligible to apply for federal financial assistance on the same basis as any other organization and are subject to the protections and requirements of Federal law.

Additionally, USAID welcomes applications from organizations that have not previously received financial assistance from USAID.

The Recipient must be a responsible entity. The Agreement Officer (AO) may determine if a pre-award survey is required to conduct an examination that will determine whether the prospective recipient has the necessary organization, experience, accounting and operational controls, and technical skills – or ability to obtain them – in order to achieve the objectives of the Activity and comply with the terms and conditions of the award. Applicants must have established financial management, monitoring and evaluation processes, internal control systems, and policies and procedures that comply with established U.S. Government standards, laws, and regulations. In accordance with ADS 303.3.9.1, the apparently successful applicant(s) may be subject to a responsibility determination assessment (Pre-award) by the Agreement Officer (AO).

The applicant is reminded that the U.S. Executive Orders and U.S. law prohibits transactions with, and the provision of resources and support to, individuals and organizations associated with terrorism. It is the legal responsibility of the Recipient to ensure compliance with these Executive Orders and laws.

Interested applicants may submit only one application in response to this notice. Multiple applications from the same prime applicant organization will not be accepted. Applications will not be accepted from individuals.

2. Cost Sharing

USAID has established a required minimum recipient cost share of 15% for the award. Such funds may be provided directly by the recipient; other multilateral, bilateral, and foundation donors; host governments; and local organizations, communities and private businesses that contribute financially and in-kind to implementation of activities at the country level. This may include contribution of staff level of effort, office space or other facilities or equipment which may be used for the program, provided by the recipient. For guidance on cost sharing in federal financial assistance see 2 CFR 200.306. Applicants may refer to Section D, Application Content and Format, regarding requirements for the submission of letters or other documentation to verify commitments to meet cost-sharing requirements.

SECTION C: PROGRAM DESCRIPTION

This funding opportunity is authorized under the Foreign Assistance Act (FAA) of 1961, as amended. The resulting award will be subject to 2 CFR 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, and USAID’s supplement, 2 CFR 700, as well as the additional requirements found in Section H.

GLOBAL HEALTH SECURITY ACTIVITY - Guatemala

INTRODUCTION & PURPOSE

New and emerging infectious disease outbreaks threaten the hard-won development progress made by host country governments. Viruses are “spilling over” from animals to humans with increased frequency, and overuse of antibiotics in human and animal health systems are contributing to an increased threat of antimicrobial resistance (AMR). Further, climate change is degrading ecological systems, changing the modalities by which animals, the environment, and human communities interact across geographies, which creates new and more frequent opportunities for zoonotic spillover events and emerging infectious diseases outbreaks of epidemic and pandemic potential.

In Guatemala, achieving health security remains a substantial challenge. The country's health systems – encompassing human, animal, and environmental health – are inadequately equipped to identify and manage emerging infectious disease threats effectively. There is also a significant gap in developing the capacities essential for global health security. The Guatemala Global Health Security (GHS) Activity is designed to provide specialized and targeted technical support in critical areas to key stakeholders in Guatemala. This initiative aims to enhance health system capabilities, promoting resilience and autonomy in preventing, detecting, mitigating and responding to the health and economic impacts of emerging infectious disease outbreaks. This Activity is scheduled for a five-year duration with an estimated budget of $40 million.

A. BACKGROUND

US Government & Global Health Security Achieving global health security requires that all nation-states be capable of preventing, detecting, and responding, promptly and effectively, to health security risks and public health emergencies of local and international concern. The United States Government is committed to assisting its partners in achieving international global health security standards, thereby aiding those in need, while also protecting national security both in the US and abroad.

Through its global health security portfolio, USAID provides direct technical support to 50 countries, aiming to help those countries achieve ‘demonstrated capacity’ in various priority technical areas of health security by 2025, as assessed by rigorous health security analyses, such as the WHO/PAHO Joint/Voluntary External Evaluation tool, which was completed in 2023 in Guatemala. USAID’s GHS programming is focused on filling critical gaps in ten priority technical areas, including building sustainable, resilient, and coordinated “One Health” capacities that address human, animal, and environmental health. Collaborating with host governments, USAID works with diverse multi-sectoral partners to strengthen governments’ preparedness and capabilities to prevent infectious disease outbreaks, detect threats early, and respond rapidly and effectively when outbreaks occur.

In the Latin America and Caribbean (LAC) region, GHS programming offers a timely opportunity to strengthen and expand USAID health sector programming. The GHS initiative builds upon efforts to bolster health systems' resilience initiated during the COVID-19 pandemic and complements previous regional efforts to prevent and address priority infectious diseases, such as malaria, Zika, and HIV/AIDS.

Drivers of Emerging Infectious Diseases in Latin America and the Caribbean The LAC region is globally recognized for its biodiversity, hosting nearly sixty percent of all terrestrial, freshwater, and marine species. Over one-third of the world’s forests are in this region, including the Amazon rainforest, which alone accounts for 10% of global biodiversity.

Since 1970, however, LAC has experienced a 94% decline1 in monitored wild species, largely due to land-use change, habitat loss from deforestation, agricultural intensification, and the expansion of farmland into previously natural habitats, as well as natural resource extraction.

The risk of emerging zoonotic diseases increases with habitat and biodiversity loss, coupled with heightened human exposure due to encroachment into these habitats. Climate change further compounds this risk by expanding suitable habitats for many pathogens. These factors2, coupled with high migration rates throughout the region foster the rapid spread of outbreaks3 when they occur, significantly driving the emergence of infectious diseases in Latin America and the Caribbean.

Infectious diseases, as demonstrated by the COVID-19 pandemic, do not respect national borders. Unprecedented increases in migration across the LAC region, including within and through Guatemala and Central America, also poses a potential health security risk. GHS programming can help identify infectious disease outbreaks early before they spread across borders, in addition to strengthening national public health systems (e.g. lab systems, surveillance, risk communication) to ensure countries are able to shoulder the increased demand for health services in areas affected by high migration.

Moreover, the COVID-19 pandemic served as a profound reminder of the impact that novel and emerging pathogens can have on human health and global economies. It highlighted the critical

1 WWF (2022) Living Planet Report 2022 – Building a nature- positive society. Almond, R.E.A., Grooten, M., Juffe Bignoli, D. & Petersen, T. (Eds). WWF, Gland, Switzerland.

2 Palomares Velosa JE, Riaño Sánchez S, Martínez Marín A, Cediel Becerra NM. Prevention of exposure to zoonoses in rural Latin America: Social ecological factors in a diverse regional context. One Health. 2022 Oct 11;15:100444. doi:

10.1016/j.onehlt.2022.100444. PMID: 36277084; PMCID: PMC9582569.

3 Tasker A, Braam D. Positioning zoonotic disease research in forced migration: A systematic literature review of theoretical frameworks and approaches. PLoS One. 2021 Jul 26;16(7):e0254746. doi: 10.1371/journal.pone.0254746. PMID: 34310626;

PMCID: PMC8312951.

need to strengthen the capacities of countries to prevent, detect, and respond to emerging infectious disease (EID) threats. The Latin America and Caribbean (LAC) region, which comprises only 8% of the world's population, faced a disproportionate burden of COVID-19, accounting for 15% of infections and nearly 30% of global deaths4. This situation presents an opportunity for the Central America region to bolster the capacities and resilience of its governments in addressing EID threats5, thereby averting future outbreaks with pandemic potential.

Additionally, the risk of EIDs is heightened by the increasing interactions between humans, wildlife, and livestock. This includes risks posed by human encroachment into natural environments and the amplified movement of populations due to travel and migration. Notably, approximately 75% of new EIDs are zoonotic, originating from animal sources, predominantly wildlife pathogens. The frequency and severity of viruses spilling over from animals to humans are escalating, underscoring the need for vigilant monitoring and response strategies in managing these health threats.

Health security in Guatemala faces significant challenges, as identified in a recent analysis conducted by USAID/Guatemala. This analysis reveals critical gaps in the One Health sector, particularly in the national implementation of a One Health approach. Despite widespread understanding of One Health principles across various government sectors, issues such as inadequate cross-sectoral communication for national emergency preparedness, health security, national planning, protocol enforcement, limited environmental sector involvement, and a pressing need for capacity building at sub-national levels persist. These measures aim to enhance Guatemala's proficiency in managing global health security threats.

Guatemala's unique environmental and demographic context further complicates its health security outlook. The country's rich biodiversity, a crucial natural asset, also increases the risk of zoonotic diseases due to close human-wildlife interactions, particularly in the under-served Western Highlands and Peten regions. Human encroachment into wildlife habitats, particularly in rural areas and within indigenous communities, not only disrupts ecological balance but also creates new pathways for disease transmission from animals to humans.

The nation's human, animal, and environmental health systems are challenged by limited resources, infrastructural deficiencies, and a need for improved disease surveillance and response mechanisms. These challenges are more acute in rural areas, where healthcare access is limited and animal health systems are less developed, heightening the vulnerability of these communities to emerging health threats.

The diverse Guatemalan population, with a significant rural segment often engaged in agriculture and living in close contact with livestock, faces increased risks of zoonotic disease transmission. Additionally, the migration of people from rural to urban areas and across borders, 4 Schwalb A, Armyra E, Méndez-Aranda M, Ugarte-Gil C. COVID-19 in Latin America and the Caribbean: Two years of the pandemic. J Intern Med. 2022 Sep;292(3):409-427. doi: 10.1111/joim.13499. Epub 2022 Apr 22. PMID: 35411985; PMCID:

PMC9115176.

5 ones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL, Daszak P. Global trends in emerging infectious diseases.

Nature. 2008 Feb 21;451(7181):990-3. doi: 10.1038/nature06536. PMID: 18288193; PMCID: PMC5960580.

as Guatemala is a transit country for migrants from other countries and has high outward migration of Guatemalans towards the United States, adds layers of complexity to health security. Importantly, high migration rates can facilitate the spread of infectious diseases, challenging existing public health surveillance and response systems.

Addressing these challenges requires a comprehensive approach that considers the intricate relationship between human health, animal health, agriculture, environmental stewardship, and socio-economic factors. Key steps include strengthening Guatemala's health systems, enhancing diagnostic, surveillance and response capabilities in both human and animal health sectors, and promoting sustainable practices to protect biodiversity. Moreover, targeted efforts to improve healthcare access in rural areas, coupled with community engagement and education, are essential for a robust defense against infectious diseases.

In response to these challenges, the Activity aims to consolidate and amplify these efforts. It focuses on enhancing cross-sectoral collaboration, boosting emergency preparedness, and building capacity at national and sub-national levels. The Activity is strategically positioned to significantly strengthen the country's resilience against health security threats. This includes enhancing disease surveillance, response mechanisms, and the sustainable management of Guatemala's rich biodiversity.

B. ACTIVITY GOAL, OBJECTIVES & RESULTS

In response to the challenges outlined above, USAID/Guatemala designed this new Global Health Security Activity. The overarching goal of the flagship Guatemala Health Security Activity (hereinafter referred to as the Activity) is to provide tailored and targeted technical support in areas of highest need, in partnership with key government, civil society, private sector and community actors and entities across Guatemala to strengthen One Health systems capabilities to build resilience and self-reliance to prevent, detect, mitigate, and respond to the health and economic impacts of emerging infectious disease outbreaks.

To realize the primary aim of the Activity, a comprehensive suite of technical assistance and interventions will be strategically structured around three core GHS objectives: (1) Prevent, (2) Detect and Mitigate, and (3) Respond to emerging health threats in Guatemala. This framework not only structures the planned approach by priority area, but also provides detailed insights into each objective, along with illustrative results that would demonstrate success within these initiatives. The Activity aims to offer a dynamic and adaptable ‘menu’ for support - a range of technical support options aligned with each objective to best respond to emerging health threats in Guatemala. This adaptability and ability to choose from a range of potential technical options to best fit the need, positions the Activity as the flagship health security initiative funded by USAID/Guatemala. To promote responsiveness and relevance of the Activity to the contextual environment, the priority areas for technical support will be determined annually, following a collaborative and consultative process involving key stakeholders and USAID. This approach ensures that the Activity remains at the forefront of addressing evolving and emerging health security challenges across Guatemala.

Objective 1 “Prevent” - Strengthen health systems capacity to build resilience against future health threats.

To prevent health threats, including outbreaks of epidemic and pandemic potential, a health system that is well prepared for emergencies and provides high-quality, routine services, and strong, interoperable veterinary, environmental and public health infrastructure that can address both endemic and emerging health threats is required. Objective 1 aims to build long-term One Health systems resilience to prevent the negative impacts of future health threats. The Activity will provide tailored and targeted technical support at the national or sub-national level (department, district, and community) that lead to strengthened management structures and systems and an effective policy environment. The following describes in further detail results to be achieved under Objective 1.

Result Area 1.1 Strengthened Capacities to Prevent Antimicrobial Resistance

AMR poses a substantial and evolving threat to disease control and health security. Decisive and comprehensive action to prevent the emergence and spread of AMR requires strong surveillance and laboratory capacity; enhanced infection prevention and control; uninterrupted access to essential antimicrobials of assured quality; regulation and promotion of appropriate use of antimicrobials in human medicine, veterinary medicine, food production; and development and appropriate use of new antimicrobial agents, vaccines and diagnostic tools.

Illustrative results include:

● Effective multi sectoral coordination on AMR and the national action plan,

● An effective AMR surveillance system is operational and routinely used to prevent AMR,

● Use of antimicrobial medicines in human health is optimized, and,

● Use of antimicrobial medicines in human and animal health and agriculture is optimized.

Priority areas of technical support for year 1 of the Activity include the formal development and adoption of a national strategic plan for prevention of AMR, identification of priority areas of technical support needed to strengthen national surveillance for AMR, and initiation of targeted support.

Result Area 1.2 Strengthened Capacities to Prevention Zoonotic Disease Transmission in Human Populations in prevented

Functional animal health, public health systems and environmental health work individually and collaboratively together through documented mechanisms of coordination and operational frameworks using a “One Health” approach and based on international standards, guidance and best practices to minimize the transmission of zoonotic diseases to human populations.

● Surveillance system to monitor priority zoonotic diseases is routinely used,

● Response system is in place for responding to emergence of zoonotic diseases, and,

● An effective system for sanitary animal production practices is routinely used

Priority areas of technical support for year 1 of the Activity include the formal development and adoption of a national strategic plan for surveillance of zoonotic diseases and establishment of a coordination mechanism across sectors.

Result Area 1.3. Biosafety and Biosecurity capacity is Strengthened

A comprehensive, sustainable and legally embedded national oversight programming for biosafety and biosecurity is essential to support health security. This includes a trained cadre of biological risk management experts and the ability to safely secure, store, dispose of and contain biological agents found in laboratories and biotechnology research facilities.

Illustrative results include:

● Comprehensive national biosafety and biosecurity systems are in place, and,

● Biosafety and biosecurity training and practices in all relevant sectors (including human, animal and agriculture)

Priority areas of technical support for year 1 of the Activity includes a comprehensive review of current national policies and plans related to biosafety and biosecurity systems in place and proposed recommendations for priority interventions.

Result Area 1.4 - Strengthening Infection Prevention and Control Systems

Optimal infection prevention and control (IPC) requires effective systems for safe healthcare delivery and prevention of healthcare-acquired infections, adhering to WHO recommended IPC measures from the national to the facility level.

Illustrative results include:

● IPC National Policies and Measures: Regularly reviewed and updated per WHO IPC standards, and,

● IPC Coordination Mechanisms: Established at national and sub-national levels and ready for operationalization.

OBJECTIVE 2 “Detect & Mitigate” - Enhance Guatemalan health systems capacity to rapidly respond, control and mitigate the impacts of emerging infectious disease outbreaks.

The prompt and accurate detection and reporting of infectious disease outbreaks are crucial for promoting health security through controlling their progression and preventing large-scale outbreaks and epidemics. Under this objective, key areas for technical support include the strengthening of national laboratories, surveillance systems, and the development of human resources and related workforce capacities.

The Activity will offer specialized and targeted technical assistance designed to bolster the capabilities of Guatemalan institutions in detecting, identifying, reporting, and investigating health threats in both human and animal populations. The following describes in further detail results to be achieved under Objective 2.

Result Area 2.1 - Strengthening of National Laboratory Systems

The effective utilization of a comprehensive national laboratory system, encompassing all relevant sectors, is vital for the safe and accurate detection of pathogens causing epidemic diseases and chemical threats.

Illustrative results include:

Establishment of an Efficient Specimen Referral and Transport System: Implementing a system that ensures safe, timely, and effective transportation of specimens to laboratories for analysis,

● Implementation of National Laboratory Quality Standards: Ensuring that national laboratory quality standards are established and consistently applied at all levels, enhancing the reliability and accuracy of laboratory results,

● Enhancement of National Laboratory Testing Capacity: Strengthening the capacity of national laboratories to perform critical testing processes and procedures, thereby improving their ability to detect and identify pathogens efficiently, And,

● Operationalization of a National Diagnostic Network System: Developing and maintaining an effective national diagnostic network that is routinely utilized for disease detection, surveillance, and communication of results.

Result Area 2.2 - Strengthening of Early Warning Surveillance Systems

A robust public health surveillance system, capable at both national and sub-national levels, is crucial for analyzing and linking data. This system is essential to identify potential events of concern for public health and health security.

Illustrative results include:

● Implementation of an Early Warning Surveillance System: Establishing and routinely utilizing a system that can promptly detect and alert health authorities about potential public health threats.

● Effective Event Verification and Investigation Processes: Developing and regularly employing mechanisms for the verification and investigation of health events, ensuring rapid and accurate response to potential threats.

● Regular Use of Surveillance Information and Data Across All Levels and Sectors: Ensuring that surveillance data is consistently utilized for decision-making and response planning in all relevant sectors and at all administrative levels.

● Integration of Surveillance Systems Across Human and Animal Health: Enhancing surveillance systems to effectively monitor health events in both human and animal populations, facilitating a comprehensive approach to disease detection and response.

By achieving these results, the Activity aims to significantly improve the capacity of Guatemala to detect and respond to emerging infectious disease threats promptly and effectively, thereby mitigating their impact on public health and security.

Result Area 2.3 A sufficient and adequately trained human resource strategy development, ready to be mobilized in response to health threats.

The establishment of a well-trained, coordinated, and occupationally diverse multi-sectoral workforce is essential for the effective prevention, detection, and response to emerging infectious disease pandemics. This workforce should be capable of handling various tasks and interventions, including health promotion, occupational health safety and security, and providing appropriate care to those affected.

● Implementation of a Multisectoral Health Workforce Strategy: Developing and executing a comprehensive health workforce strategy that encompasses all relevant sectors and cadres of public health professionals. This strategy should be subject to annual reviews and updates to ensure its continued relevance and effectiveness.

● Establishment of Policies and Procedures for Sustainable Human Resources: Putting in place robust policies and procedures to maintain sustainable and appropriate human resources across all relevant sectors. These policies should align with the provisions of the International Health Regulations and ensure readiness to detect, assess, notify, report, and respond to public health events.

● Regular Competency-Based Training Programs: Conducting regular training programs based on national or internationally recognized competency standards. These programs should aim to continuously enhance the skills and knowledge of the health workforce, ensuring they are well-prepared to respond to health emergencies.

By achieving these results, the Activity will significantly contribute to building a resilient health system equipped with a skilled workforce ready to rapidly respond, control, and mitigate the impacts of emerging infectious disease pandemics. This approach not only strengthens immediate response capabilities but also contributes to the long-term sustainability and preparedness of the health system.

OBJECTIVE 3 “Respond” - Enhance Guatemala’s capacity to effectively respond to emergent health threats and public health emergencies

For countries to effectively respond to infectious disease events, it is crucial to have multi-sectoral emergency measures in place. These measures include coordination mechanisms, emergency operations centers, communications infrastructure, and agreements among multi-sectoral partners in animal and human health, environment, security, law enforcement authorities, and other sectors. They also encompass frameworks for deploying and managing medical and non-medical countermeasures. Key areas in this category include Emergency Preparedness, Emergency Response Operations, Linking Public Health and Security Authorities, Medical Countermeasures and Personnel Deployment, and Risk Communication. Additionally, managing infectious disease threats at points of entry is vital for controlling international spread.

The Activity will provide tailored and targeted technical support at national or subnational levels in Guatemala to strengthen capacities in responding to public health emergencies. The following describes in further detail results to be achieved under Objective 3.

Result Area 3.1 - Strengthening Health Emergency Management and Coordination Systems

For effective emergency response operations, multi-sectoral actors at national and sub-national levels need to be well-coordinated, with a clear understanding of priority risks and readiness to lead and implement timely, effective, and efficient emergency responses.

Illustrative results include:

● Establishment of National Risk Profiles: Based on multi-sectoral, multi-hazard risk assessments and readiness plans, which are annually reviewed, updated, and communicated across all key sectors,

● Operational Emergency Operation Centers: With established activation, operation, and deactivation processes that are routinely tested at all levels, and,

● Trained Surge Staff for Emergency Operations Centers: Ensuring that national and intermediate emergency operations centers have trained surge staff ready to sustain operations across multiple shifts for extended periods.

● Emergency Logistics and Supply Chain Management Systems: Established and routinely tested systems to be effectively operationalized at all public health levels when needed.

Result Area 3.2 - Establishing and Operationalizing Risk Communication and Community Engagement (RCCE) Strategy

Building capacity for RCCE interventions is crucial for an immediate and effective response to acute infectious disease outbreaks, involving multi-level, multi-sectoral, and multifaceted approaches.

● Operational RCCE Systems and Resources: Across all levels and relevant sectors, including community-led readiness and response interventions,

● Integration of RCCE into Emergency Response Systems: With national-level collaboration supporting intermediate and community levels to use socio-behavioral and epidemiologic data for tailored local risk communication,

● Systematic Use of Evidence and Data: For continuous improvement of RCCE interventions,

● Whole-of-Government Approach in Risk Communication: Involving all actors, including international and national partners, media, and influencers,

● Community Involvement in Emergency Response: Active participation in planning, design, and implementation of interventions, and,

● Risk Communication in Areas of Animal-Human Encroachment: Addressing specific risks associated with these interfaces.

Through these efforts, Objective 3 aims to significantly enhance the capacity of Guatemala to respond effectively to public health emergencies, mitigating the impacts of infectious disease outbreaks and other health threats, while ensuring a coordinated, comprehensive approach to health security.

C. GEOGRAPHIC FOCUS

The Activity will be implemented primarily in under-resourced, high-need areas within Guatemala, including priority areas within the USAID portfolio, such as the Western highlands, Alta and Baja Verapaz, and the Peten/Biosphera Maya area. The Activity will focus on the national and subnational regions aforementioned and remain flexible to priority geographies for health security. The geographic target area may change as needs evolve over the course of the life of the Activity, including shifting of geographic focus within Guatemala. Depending on availability of funds and prioritization by USAID/Guatemala, the geographic scope may expand to include other countries in the region.

D. TARGET GROUPS & BENEFICIARIES

The Activity will tailor interventions and technical support as required to successfully reach specific target populations based on the need, including but not limited to, public health managers at national and sub-national levels; indigenous communities and other vulnerable communities, addressing their unique needs, contexts and health seeking behaviors. The Activity will incorporate specific strategies to support populations that are hard to reach by health services.

E. OTHER CONSIDERATIONS

Sustainability

A key objective of USAID development assistance is to support sustainable health systems at all levels. USAID intends that development assistance will build upon existing interventions being implemented in the same geographic target area to be “value added” with a concerted effort to develop technical competence, human capacity, and management systems. USAID aims to increase the delivery of services and technical assistance through local organizations - both governments and non-governmental/private sectors - and to eventually transition programs to national, provincial and district financing, planning and management processes. In support of this, the Activity will take into consideration all opportunities to partner with and build the capacity of local organizations and actors who may be able to lead key aspects of the Activity upon its conclusion.

Youth & Indigenous Populations

Technical assistance supported through this Activity will engage relevant constituents in the design and implementation of global health security interventions, particularly those that may occur at the community level to ensure programming, such as information, education and communication related interventions will take into account youth and indigenous peoples considerations (e.g., youth appropriate language and concepts, cultural and ancestral knowledge, Mayan languages) in their formulation and eventual implementation. In addition, during national or sub-national level policy and strategic planning interventions, representatives from youth and indigenous peoples population groups will be included to ensure that policy and planning frameworks include as appropriate youth and indigenous peoples considerations.

Activity monitoring will include disaggregation of key population groups specific to youth and indigenous peoples, as applicable.

Gender Considerations

Globally, gender-based violence and gender inequality impact health outcomes across key and priority populations and impede efforts to achieve sustained development results. The Activity is grounded within the United States government strategies and policies that stress the importance of addressing gender inequality and gender based violence within health development programs to achieve strategic goals, including the National US Strategy on Gender Equity and Equality (2021), the USAID Gender Equality and Women’s Empowerment Policy (Gender Policy 2023), as well as the U.S. Strategy to Prevent and Respond to Gender-Based Violence Globally (2022). The USAID Gender Equality and Women’s Empowerment Policy advances equality between women and men, boys, and girls, and empowers women and girls to participate.

F. Expected Performance Indicators, Targets, Baseline Data, and Data Collection

After the activity has been awarded, a detailed activity monitoring, evaluation and learning plan (Activity MEL Plan) will be developed by the implementer, in close consultation with USAID.

The Activity MEL Plan will include a detailed description of indicators, targets, baseline data, and data collection methods. USAID intends the activity to be subject to rigorous monitoring and evaluation, in order to (a) ensure the intended results and impact are being generated, and (b) inform activity management if and when course corrections may be necessary. The recipient may also conduct periodic analyses to better understand certain aspects and issues within the award’s domain. Performance monitoring and evaluation will be conducted by the implementing partner.

G. Substantial Involvement

USAID plans to award one Cooperative Agreement pursuant to this NOFO. A Cooperative Agreement allows USAID to exercise ‘substantial involvement’ (active involvement by USAID in certain programmatic elements during the performance of the activity). The anticipated substantial involvement for this award is limited to the elements listed below:

A. Approval of the Recipient’s Annual Implementation Plans (Annual Work Plans) by the AOR;

B. Approval of Specified Key Personnel and any changes in Key Personnel by the AO;

C. Approval of the sub-awards manual and all sub-awards by the AO.

D. Agency and Recipient Collaboration or Joint Participation - Approval of the Recipient’s

Monitoring, Evaluation and Learning (MEL) Plans by the AOR;

E. The Recipient will coordinate all activities with the AOR and other USAID technical offices.

All coordination with key governmental entities will be done in close coordination with USAID AOR. The Chief of Party must participate in the partners meetings.

F. The AOR will have authority to modify submission due dates for Plans and Reports. Changes will be communicated to the Recipient in writing; and

G. Agency’s Authority to immediately halt an activity if the recipient does not meet detailed performance specifications (for example, construction specifications).

H. Nature of the Relationship between USAID and the Recipient

The principal purpose of the relationship with the Recipient under the subject Activity is to transfer funds to accomplish a public purpose of support or stimulation of the “Guatemala Health Security” Activity, which is authorized by Federal statute.

The successful Recipient will be responsible for ensuring the achievement of the activity objectives and related results and the efficient and effective administration of the award through the application of sound management practices. The Recipient will assume responsibility for administering Federal funds in a manner consistent with underlying agreements, activity objectives, and the terms and conditions of the Federal award. The Recipient using its own unique combination of staff, facilities, and experience, has the primary responsibility for employing whatever form of sound organization and management techniques may be necessary in order to assure proper and efficient administration of the resulting award.

SECTION D: APPLICATION CONTENT AND FORMAT

1. General Content and Form of Application

Preparation of Applications:

Each applicant must furnish the information required by this NOFO. Applications must be submitted in two separate parts: the Technical Application and the Business Application.

This subsection addresses general content requirements applying to the full application.

Please see subsections 2 and 3, below, for information on the content specific to the Technical and Business Applications. The Technical Application must address technical (e.g., programmatic) aspects only while the Business Application must present the budget and budget narrative, address risk, and include required standard forms and certifications.

Both the Technical and Business Applications must include a cover page containing the following information:

● Name of the organization(s) submitting the Application;

● Unique Entity Identifier (UEI) of the organization;

● Identification and signature of the primary contact person (by name, title, organization, mailing address, telephone number and email address) and the identification of the alternate contact person (by name, title, organization, mailing address, telephone number and email address); also state whether the contact person is the person with authority to sign and award for the prime applicant organization, and if not, that person should be listed.

● Activity name

● Notice of Funding Opportunity number

● Name of any proposed sub-recipients or partnerships (identify if any of the organizations are local organizations, per USAID’s definition of ‘local entity’ under ADS 303.

● The Cover Page must be signed by the individual with the authority to sign and award on behalf of the organization

Any erasures or other changes to the application must be initialed by the person signing the application. Applications signed by an agent on behalf of the applicant must be accompanied by evidence of that agent’s authority, unless that evidence has been previously furnished to the issuing office.

Applicants may choose to submit a cover letter in addition to the cover pages, but it will serve only as a transmittal letter to the Agreement Officer. The cover letter will not be reviewed as part of the merit review criteria. Applications must comply with the following:

● USAID will not review any pages in excess of the page limits noted in the subsequent sections. Please ensure that applications comply with the page limitations.

● Unless otherwise noted, the Technical and Business Applications and all supporting documents must be submitted in English.

● Use standard 8 ½” x 11”, single sided, single-spaced, 12 point Calibri font, 1” margins, left justification and headers and/or footers on each page including consecutive page numbers, date of submission, and applicant’s name.

● 10 point font can be used for graphs and charts. Tables however, must comply with the 12 point Calibri requirement.

● Submitted via Microsoft Word or PDF formats, except budget files which must be submitted in Microsoft Excel.

● The…