Foa_Content_of_CDC-RFA-GH21-2106.pdf

Centers for Disease Control and Prevention

Center for Global Health

Technical Collaboration to Strengthen and Expand Capacity to Detect, Prevent, Respond and Mitigate the Effects of Public Health Threats of National and Global Importance with the

Ministry of Public Health (MoPH) in the Kingdom of Thailand

CDC-RFA-GH21-2106

07/05/2021

Table of Contents A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Application and Submission Information

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

Part I. Overview Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA- GH21-2106. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Technical Collaboration to Strengthen and Expand Capacity to Detect, Prevent, Respond and Mitigate the Effects of Public Health Threats of National and Global Importance with the Ministry of Public Health (MoPH) in the Kingdom of Thailand C. Announcement Type: New - Type 1:

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52- 2.pdf. Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr- 46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-GH21-2106

E. Assistance Listings Number:

93.318,93.067 F. Dates:

1. Due Date for Letter of Intent (LOI):

https://www.grants.gov/ https://www.grants.gov/ https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html

The LOI date will generate once the Synopsis is published if Days or a Date are entered.

2. Due Date for Applications:

07/05/2021 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

N/A

G. Executive Summary:

1. Summary Paragraph The purpose of this Notice of Funding Opportunity (NOFO) is to work with the recipient to strengthen and expand capacity to assess, prevent, prepare for and mitigate public health threats of national and global importance in Thailand and the Southeast Asia region. This NOFO includes important human infectious diseases, with special attention to the following: HIV/AIDS including strategic information, prevention, and quality improvement / quality management for care and treatment of advanced HIV disease and co-infections, sexually transmitted diseases, malaria, antimicrobial resistance infections, emerging and re-emerging infectious diseases, zoonotic diseases, vaccine-preventable diseases such as influenza, or other diseases with pandemic potential. Activities under this NOFO may also address environmental health issues, chronic diseases, birth defects and developmental disabilities, cross-cutting issues of maternal and child health, public health preparedness and response, laboratory and biosafety, infection and injury prevention and control, and prevention of transboundary infectious disease transmission. CDC will work collaboratively with the recipient to contribute to three specific goals: 1) Health Impact: Improve the health and well-being of people in Thailand, the Southeast Asia region, and the world; 2) Health Security: Improve the capacity to prevent, prepare, detect and respond to infectious disease, other emerging public health threats, and public health emergencies; and 3) Health Capacity: Strengthen and sustain public health capacity, infrastructure, management, and monitoring.

a. Eligible Applicants:

Single

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$ 60,000,000

e. Average One Year Award Amount:

$ 9,500,000

f. Total Period of Performance Length:

g. Estimated Award Date:

https://www.grants.gov/

September 01, 2021

h. Cost Sharing and / or Matching Requirements:

No Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview

CDC is working through its strong partnerships to increase global health impact and assure the implementation and evaluation of public health programs will result in the prevention and control of diseases and subsequently apply the knowledge gained to other settings. The Thailand MoPH is the key stakeholder to enable CDC to execute its global health strategies and other public health priorities in Thailand and the Southeast Asia region. Over the past several years, a variety of public health approaches implemented by CDC and Thailand MoPH have successfully prevented new infections, improved care and treatment of existing diseases, and strengthened the capacity to collect and use surveillance data.

Despite advances, major challenges still persist. Over the past four decades, Thailand has undergone significant social, economic, and demographic changes. Demographic changes have resulted in an increasingly aging population structure, as well as increased exposure to non-communicable disease (NCD) risk factors, such as poor diet, sedentary lifestyle, tobacco consumption and harmful use of alcohol. The top three causes of deaths (cardiovascular disease (CVD), cancer, and injury) in Thailand are all NCDs. Infectious diseases continue to be serious public health issues impacting Thailand and the Mekong region-extending globally as more people travel. Overall HIV incidence has decreased, but incidence and prevalence remain high among key populations, particularly men who have sex with men (MSM) and transgender (TG) women and sex workers in larger urban areas.

An estimated 2.4 million migrants live in Thailand. Migrants and other mobile populations have less access to healthcare and bear a higher burden of diseases of public health importance such as TB and malaria, posing increasing strain on health systems. Emerging infectious diseases such as COVID-19 can easily spread across international borders, with continued efforts needed to enhance early detection and support control measures to prevent pandemics. The ability to achieve HIV epidemic control in Thailand is constrained by a health system that does not provide an integrated continuum of HIV prevention, HIV testing and counseling (HTC), care, treatment of HIV and co-infections (tuberculosis, sexual transmitted infections, hepatitis infections), and support services that respond to the needs of people living with HIV (PLHIV) including priority populations (PPs) such as, MSM, TG and People Who Inject Drugs (PWID)) and their partners. Overcoming this requires implementation of standards for innovations in HIV prevention, same-day, high-quality, patient-friendly HTC including offline to online HTC, index testing and self-testing, with immediate referral of PLHIV and priority populations to care and initiate same-day/rapid anti-retroviral therapy (ART), promote retention to treatment and continuity of care, targeting PPs in priority provinces, accompanied by greater capacity of health care workers (HCWs) and laboratory staff to implement, monitor and continuously improve these HIV services. In addition, systemic public health responses should be established to control new infections in priority areas where PLHIV with recent infections are identified.

Reducing the burden of disease and improving public health in Thailand requires a multifaceted approach. In the next five years, this umbrella cooperative agreement will facilitate collaboration within CDC and across the Thailand MoPH, emphasize the critical role of multi-sector and regional collaboration in core domains of public health to avoid duplication of effort and produce sustainable improvements in areas of public health importance for both the United States and Thailand.

b. Statutory Authorities Public Health Service Act, Sections 301(a)[42 U.S.C. 241(a)], 307 [42 U.S.C. 2421] and section 317(k)(1) and (2) (42 U.S.C.247b(k)(1) and (2), as amended as well as under Public Law 108-25 (the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria At of 2003) [22 U.S.C. 7601, et seq.] and Public Law 110-293 (the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008) [42 U.S.C. 300cc-40a et seq];

GHSA: Public Health Service Act sections 301(a) and 307, as amended,42 U.S.C. §§ 241 and 242l; Public Health Service Act sections 307 and 317(k)(1) and (2), (42 U.S.C. and 247b(k)(1) and (2), as amended.

PEPFAR Funding:

This program is authorized under Public Law 108-25 (the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003) [22 U.S.C. 7601, et seq.] and Public Law 110-293 (the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008), and Public Law 113-56 (PEPFAR Stewardship and Oversight Act of 2013).

The President’s Emergency Plan for AIDS Relief (PEPFAR) has called for immediate, comprehensive and evidence-based action to turn the tide of global HIV/AIDS. The overarching purpose of this NOFO is to fund activities to prevent or control disease or injury and improve health, or to improve a public health program or service.

c. Healthy People 2030 This NOFO supports Healthy People 2030, Global Health Goal: Improve health by preventing, detecting, and responding to public health events worldwide.

https://health.gov/healthypeople/objectives-and-data/browse-objectives/global-health

d. Other National Public Health Priorities and Strategies https://health.gov/healthypeople/objectives-and-data/browse-objectives/global-health

This announcement supports the Department of Health and Human Services’ (HHS) Global Health Strategy: http://www.globalhealth.gov/global-programs-and-initiatives/global-health-strategy/

This NOFO aligns with the current CDC strategic priorities including CDC’s Global Health Strategy, which focuses on: improving the health and well-being of people around the world;

improving capabilities to prepare for and respond to infectious diseases, other emerging health threats and public health emergencies; and maximizing the potential of CDC’s global programs to achieve public health impact. http://www.cdc.gov/globalhealth/strategy/

CDC has been a leader in improving global health security (GHS) for many decades and plays an important role in the Global Health Security Agenda. This NOFO is in-line with these priorities.

http://www.cdc.gov/global health/security/cdc.html

PEPFAR Funding:

Under the leadership of the Office of the U.S. Global AIDS Coordinator (OGAC), as part of PEPFAR, the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention (HHS/CDC) works with host countries and other key partners to assess the needs of each country and design a customized program of assistance that fits within the host nation's strategic plan and partnership framework in a manner consistent with the purposes of this NOFO.

HHS/CDC focuses primarily on two or three major program areas in each country. Goals and priorities include the following:

Achieving primary prevention of HIV infection through activities such as expanding confidential counseling and testing programs linked with evidence-based behavioral change and building programs to reduce mother-to-child transmission;

Improving the care and treatment of HIV/AIDS, sexually transmitted infections (STIs), and related opportunistic infections by improving STI management; enhancing laboratory diagnostic capacity and the care and treatment of opportunistic infections; interventions for intercurrent diseases impacting HIV infected patients including tuberculosis (TB); and initiating programs to provide anti-retroviral therapy (ART);

Strengthening the capacity of countries to collect, use, and share surveillance data and manage national HIV/AIDS programs by expanding HIV/STI/TB surveillance programs and strengthening laboratory support for surveillance, diagnosis, treatment, disease monitoring, and HIV screening for blood safety; and

Developing, validating, and/or evaluating public health programs to inform, improve, and target appropriate interventions, as related to the prevention, care and treatment of HIV/AIDS, TB, and opportunistic infections.

In an effort to ensure maximum cost efficiencies and program effectiveness, HHS/CDC also supports coordination with and among partners and the integration of activities that promote Global Health Initiative principles. As such, recipients may be requested to participate in the following programmatic activities:

Implement a woman- and girl-centered approach;

Increase impact through strategic coordination and integration;

http://www.globalhealth.gov/global-programs-and-initiatives/global-health-strategy/ http://www.globalhealth.gov/global-programs-and-initiatives/global-health-strategy/ http://www.cdc.gov/globalhealth/strategy/ http://www.cdc.gov/global%20health/security/cdc.html

Strengthen and leverage key multilateral organizations, global health partnerships, and private sector engagement;

Encourage country ownership and invest in country-led plans;

Build sustainability through investments in health systems;

Improve performance metrics, monitoring and evaluation and the quality of related data;

and Promote research, development, and innovation to develop a body of knowledge, enhance awareness and increase the skills and abilities of stakeholders (research is not supported by this NOFO).

PEPFAR defines national HIV epidemic control as the point at which the total number of new infections falls below the total number of deaths from all causes among HIV-infected individuals (the classic R0 to Ri approach to infectious diseases), with both declining. This definition of epidemic control does not suggest near-term elimination or eradication of HIV as may be possible with other infectious diseases, but rather suggests a decline of HIV-infected persons in a population, achieved through the reduction of new HIV infections when mortality among people living with HIV (PLHIV) is steady or declining, consistent with natural aging. Critically, however, a country will not be able to maintain epidemic control if program efforts are not sufficiently sustained and new infections are allowed to rebound or death rates to increase.

Effective December 1, 2018 and continuing throughout the five-year project period established under this NOFO, in addition to the specific activities listed in the Strategies and Activities section of this NOFO, all CDC PEPFAR cooperative agreements resulting from this NOFO may address the following activities, where and when appropriate, that focus U.S. government resources and activities toward achieving and sustaining the HIV/AIDS epidemic:

Optimize HIV testing and treatment strategies to reach undiagnosed populations living with HIV, especially young adults, men, and key populations. These strategies may include or build upon traditional methods and activities related to outbreak detection, investigation, and response. Responding to recent infections or ongoing patterns of transmission will be prioritized.

Focus on prevention among children, adolescents, young adults, and members of vulnerable and key populations.

Support surveillance activities and programs, along with information systems, that improve understanding of HIV epidemiology, remaining gaps, and informed future programming.

Support efforts to maintain quality for laboratory systems and activities, including diagnostics and viral load measurement.

Actively use epidemiologic, program, and financial/cost data to ensure implementation of high quality, cost-effective programs to improve partner performance and increase epidemiologic impact.

Support country-led, sustainable programming by working with and implementing activities through indigenous partners, including faith communities and faith-based organizations (FBOs), HIV network organizations and community-based organizations (CBOs) directly servicing communities and populations at-risk and most affected by HIV to build local capacity.

Strengthen policy and financial contributions by partner governments in the HIV/AIDS response.

Support activities, interventions, and programs to find, treat, and prevent TB among PLHIV and to identify and treat HIV among people infected with TB.

Support efforts to prevent, detect, respond, and treat infectious and non-infectious diseases that impact PLHIV and populations affected by HIV.

In addition, PEPFAR is committed to protecting children from abuse, exploitation and neglect in order to decrease their vulnerability to HIV/AIDS. Consistent with underlying authorities, PEPFAR seeks to ensure that children and youth obtaining services through PEPFAR programming are also protected from abuse, exploitation, and neglect in CDC PEPFAR-supported programs.

To that end, because activities to be funded under this NOFO may involve children or personnel coming into contact with children, Recipients of CDC PEPFAR funds agree to ensure compliance with host country and local child welfare and protection legislation or international standards, whichever gives greater protection, and with U.S. law, where applicable. Further, Recipients of CDC PEPFAR funding are strongly encouraged to: 1) have in place policies and procedures that prohibit recipient personnel from engaging in child abuse, exploitation, or neglect; 2) consider child safeguarding in project planning and implementation to determine potential risks to children that are associated with project activities and operations; 3) apply measures to reduce the risk of child abuse, exploitation, or neglect, including, but not limited to, limiting unsupervised interactions with children; prohibiting exposure to pornography; and complying with applicable laws, regulations, or customs regarding the photographing, filming, or other image-generating activities of children; 4) promote child-safe screening procedures for personnel, particularly personnel whose work brings them in direct contact with children; and 5) have a process for ensuring that personnel and others recognize child abuse, exploitation, or neglect, report allegations, investigate and manage allegations, and take appropriate action in response to such allegations. It is also strongly encouraged that Recipients include the above provisions in any applicable code of conduct for its personnel implementing PEPFAR-funded activities.

e. Relevant Work This NOFO builds on CDC’s previous cooperative agreements and over 40 years of Collaboration with the Thailand MoPH to prevent and control HIV/AIDS, health information management systems, surveillance, tuberculosis, opportunistic infections, malaria, influenza, and other emerging infectious diseases; improve refugee and migrant health; translate local findings into global advances; detect and respond to emerging and re-emerging health threats and share important lessons and knowledge from Thailand's experience with other countries. Supporting U.S. public health investments in Thailand sustains public health gains already made, increases health security for U.S. citizens from country-specific, regional and global threats, maintains a strong platform for regional and global investigation, and fosters health diplomacy.

2. CDC Project Description

a. Approach Bold indicates period of performance outcome.

CDC-RFA-GH21-2106 Logic Model: Technical Collaboration to Strengthen and Expand Capacity to Detect, Prevent, Respond and Mitigate the Effects of Public Health Threats of National and Global Importance with the Ministry of Public Health (MoPH) in the Kingdom of Thailand.

Bold indicates period of performance outcome

Strategies and Activities

Short-term Outcomes

Intermediate Outcomes

Long-Term Outcomes

The activities below will be funded in various content areas including Global HIV/AIDS and TB, Influenza, Global Health Protection, Non-Communicable Diseases, and Immigrant, Refugee and Migrant Health.

Focus Area 1:

Enhance workforce capacity in epidemiology, laboratory practices, strategic information and program management for disease prevention and control.

Focus Area 2:

Enhance the quality of public health services and systems for target populations.

Focus Area 3:

Enhance multi-sectorial and multi-disciplinary capabilities to

Increased knowledge and skills among public health and multi-disciplinary workforce in disease prevention and control, and quality of care and treatment.

Increased coordination among public health and multi-disciplinary workforce to prevent, detect, and respond to outbreaks and public health emergencies.

Increased capacity by health providers to provide quality treatment and laboratory services according to the national and/or international standards.

Improved accuracy and reliability of

Increased number of provinces with a public health surveillance system able to quickly detect, respond to, prevent, and recover from health emergencies.

Improved data and programs related to vaccine, treatment, and prevention/control policies.

Improved quality of treatment and laboratory services provided to patients with HIV/AIDS, STIs, TB, malaria and influenza, and persons at high risk of infections.

Increased access and routine use of data for evidence-informed program and policy planning, target setting, and quality improvement.

Improved coordination and communication efforts for public

Improved outbreak prevention, detection, and response.

Increased coverage of HIV diagnosis, HIV prevention, ART retention with viral suppression for priority populations towards the Ending AIDS targets (95-95- 95).

Increased infection control and coverage rates for vaccine preventable diseases.

Reduced morbidity among migrants and other travelers.

Developed sustainable projects for Global Health Security in Thailand.

Established public health policies for chronic disease prevention and control.

anticipate, prevent, detect and respond to public health threats.

Focus Area 4:

Implement Global Health Security preparedness for public health threats in the Asia region to enhance capabilities across multiple sectors.

surveillance and monitoring and evaluation (M&E) data/ systems to monitor infectious, non- infectious disease and potential public health threats.

Increased capacity by public health leadership to use strategic information for HIV prevention and treatment continuity.

health threats, including malaria, influenza, zoonotic diseases, chronic diseases, HIV/AIDS, STIs and TB control in Asia region.

i. Purpose The purpose of the NOFO is to focus on improved health impact, health security, and health capacity contributing to continued improvements in the health and well-being of people in Thailand, the Southeast Asian region, the United States, and the world; to strengthen the existing public health system in Thailand with sustainable capacity to deliver comprehensive, effective, and high-quality public health-related services and interventions; and to improve healthy security capabilities to prevent, prepare, detect, and respond to emerging situations.

ii. Outcomes Intended results of activities under this NOFO will ultimately lead to improvement in the health and well-being of people in Thailand; and make contributions to improved health and well-being in the region. The recipient is expected to demonstrate measurable progress toward addressing the following key short, intermediate and long-term outcomes depicted in the logic model and listed below:

Short-Term Outcomes:

Increased knowledge and skills among public health and multi-disciplinary workforce in disease prevention and control, and quality of care and treatment.

Increased coordination among public health and multi-disciplinary workforce to prevent, detect, and respond to outbreaks and public health emergencies.

Increased capacity by health providers to provide quality treatment and laboratory services according to the national and/or international standards.

Improved accuracy and reliability of surveillance and monitoring and evaluation (M&E) data/ systems to monitor infectious, non- infectious disease and potential public health threats.

Increased capacity by public health leadership to use strategic information for HIV prevention and treatment continuity.

Intermediate Outcomes:

Increased number of provinces with a public health surveillance system able to quickly detect, respond to, prevent, and recover from health emergencies.

Improved data and programs related to vaccine, treatment, and prevention/control policies.

Improved quality of treatment and laboratory services provided to patients with HIV/AIDS, STIs, TB, malaria and influenza, and persons at high risk of infections.

Increased access and routine use of data for evidence-informed program and policy planning, target setting, and quality improvement.

Improved coordination and communication efforts for public health threats, including malaria, influenza, zoonotic diseases, chronic diseases, HIV/AIDS, STIs and TB control in Asia region.

Long-term Outcomes:

Increased coverage of HIV diagnosis, HIV prevention, ART retention with viral suppression for priority populations towards the Ending AIDS targets (95-95-95).

Increased infection control and coverage rates for vaccine preventable diseases.

Reduced morbidity among migrants and other travelers.

Developed sustainable projects for Global Health Security in Thailand.

Established public health policies for chronic disease prevention and control.

iii. Strategies and Activities

To achieve these outcomes, the NOFO will concentrate on strategies and activities that fall in to four Focus Areas:

Focus Area 1: Enhance workforce capacity in epidemiology, laboratory practices, and program management for disease prevention and control

Focus Area 2: Enhance the quality of sustainable public health services and systems Focus Area 3: Enhance multi-sectorial and multi-disciplinary capabilities to anticipate, prevent, detect and respond to public health threats Focus Area 4: Implement Global Health Security preparedness for public health threats in the Asia region to enhance capabilities across multiple sectors.

The applicant must provide a clear and concise description of the strategies and activities they will use to achieve the project period outcomes. Whenever possible, the applicant should use evidence-based program strategies. Applicant may propose additional strategies and activities to achieve the outcomes. Applicant should select existing evidence-based strategies that meet their needs or describe the rationale for developing and evaluating new strategies or practice-based innovations. Activities will be identified by focus area and include more specific outcomes within each section; all of which will lead up to achieving the overarching outcomes (section above). Activities may address more than one focus area and will be based on the best available evidence and practice in public health, education, and allied fields. Collaboration and coordination of activities will be essential to accelerate progress toward intended outcomes. Program M&E is an integral component of day-to-day work under this NOFO. Activities should be planned with incorporating the results of program evaluations into operational disease prevention and control programs, ensure the sharing of expertise and lessons learned nationally, regionally and internationally, and use the results to develop science-based health policies and guidelines wherever possible.

Strengthening of effective coordination and communication is an essential element that will cross each of the focus areas.

Within the broad focus areas, short-term, long-term and subject matter-based activities will be identified. All activities will lead to strengthening of the existing public health system in Thailand with sustainable capacity to deliver effective, and high-quality public health-related services and interventions. Program-specific activities will support the overall strategies for CDC to maximize its resources, provide unified assistance and avoid duplication.

Focus Area 1: Enhance workforce capacity in epidemiology, laboratory practices and program management for disease prevention and control.

The focus of this strategy is to increase the number of competent public health personnel to serve the entire population at all levels of the health system (i.e., national, provincial, district). Trained and skilled public health personnel maintain good surveillance data, detect public health threats early, and provide rapid response to effectively control and prevent future outbreaks or other threats at national, provincial and district levels. Trained personnel can effectively monitor and evaluate programs and know how to use data and evidence for public health action and effective decision making.

Activities in this focus area are expected to contribute to the overarching outcomes identified above and the following: a strengthened public health workforce in Thailand; improved laboratory services and systems, enhanced information sources and systems to inform public health action, and improved communication and coordination of action and services to support and sustain the public health workforce. Activities in this focus area should lead to improved human resources for preparedness and response to public health threats and improved, sustainable capacity for public health action in Thailand.

It is expected that activities in this section will assist in building the capacity of public health professionals, including laboratory personnel, MoPH personnel, university and graduate level select students and others (e.g., those who implement activities) to design and implement evidence-based programming (program planning, implementation, data collection, evaluation, and analysis); conduct public health surveillance and epidemiological assessments relevant to risk factors and disease, premature death, and quality of life; develop public health laboratory systems and diagnostic capacity; carry-out epidemiological analyses that support national and regional disease prevention and control efforts; and administer and manage public health programs (including personnel, financial and administrative management).

Overarching activities to meet this focus area during the five-year period include:

Strengthen public health workforce including the International Field Epidemiology Training Program (IFETP), fellowships, mentorships, supportive supervision, experiential learning, training of trainers and other evidenced based training activities

Developing standard curriculum, guidelines and SOPs Supporting workgroups and technical advisory committees

Year 1 programmatic activities may include, but are not limited to:

Global HIV & TB (DGHT):

Conduct trainings for health care workers (HCWs) on -MSM sensitivity training - Common questions in virtual clinic online - SOP for virtual clinic online

Enhance capacity of health care workers to promote PEPFAR supported interventions including improve quality and coverage of HIV viral load, and HIV drug resistance testing, HIV self-test, same-day/rapid ART initiation, enhance adherence counseling, treatment literacy, lost-to-follow up case management, differentiated service delivery, TLD transition, TB preventive treatment implementation, and TB Urine LAM implementation through training, supervision, and continuous quality improvement (QI) systems

Provide training with regular supervision, coaching, and mentorship in Continuous Quality Improvement (CQI) processes for health care providers in priority provinces to promote good practices for same-day/rapid ART initiation, HIV testing including CD4, viral load (VL), an HIV drug resistance testing

Conduct capacity building for community based organizations (CBOs) and HCWs in M&E including community-led monitoring, HIV testing promotion, peer referral, mobile HIV testing using rapid tests, HIV case management, program management including implementation and management and operations; Capacity building with Civil Society Organizations (CSOs) may be included

Build human capacity for analysis and interpretation of HIV strategic information to identify programmatic bottlenecks, areas where programmatic improvement is needed, and promote routine use of data as evidence to facilitate rapid scale-up of PEPFAR-supported high impact interventions that align with national strategies.

Capacity building and strengthening of laboratory quality improvement and data utilization to improve efficiency of HIV care and treatment and VL testing

Strengthen provincial-level laboratory program management on HIV testing, care and treatment through the provincial laboratory committees and technical working groups to monitor and manage program activities

Support coordination among laboratories and VCT clinics in hospitals to promote 95- 95-95 goals

Strengthen laboratory network to facilitate program implementation and quality improvement activities through site assessment and supervision

Influenza (Flu):

Develop and enhance capacity among Thai healthcare personnel to address influenza and other emerging infectious diseases

Global Health Protection (DGHP):

Integrate One-Health track in the IFETP Enhance laboratory biosafety and capacity Support Global Health Security Agenda workforce development priorities Enhance capacity at national and provincial levels on Non Communicable Diseases

(NCD) epidemiology

Integrate non-communicable disease track in the IFETP Capacity building for behavior risk factor surveillance system in Thailand Provide training on disease surveillance, epidemiological analysis and data management, across multiple sectors, focused in areas at higher risk of disease emergence or introduction

Enhance public health informatics capacity at the national and sub-national level including for emergency response

Strengthen laboratory capacity for rapid diagnostics of emerging, zoonotic and anti-microbial resistant infections

Support efforts to develop scientific communication capacities through formal training and mentoring

Immigrant, Refugee and Migrant Health (DGMQ):

Improve the capacity of the MoPH to detect and respond to diseases of public health importance among migrants and travelers at ports of entry and within migrant communities

Focus Area 2: Enhance the quality of sustainable public health services and systems

The health system includes all activities intended to promote, restore, or maintain health. The health system includes the people, institutions, and resources, arranged together in accordance with established policies and practices, to protect and improve the health of the population served. Thus, health systems strengthening refers to the process of identifying and implementing necessary changes in policy and practice to better respond to persistent or emerging challenges. This work includes any array of initiatives and strategies that improve function of the health system. Recipient is encouraged to promote networks among different levels of health facilities and communities.

Strategies and activities under this focus area are expected to contribute to the overarching outcomes (identified in section above) as well as the following outcomes: improved use of evidence-based programs and services, improved public health surveillance, improved health management information system, improved M&E of programs and services, and improved communication and coordination of programs and services. Activities ultimately should lead to improved use of data to inform public health action and services; and improved quality of programs and services across the health system.

It is expected that activities under this section will strengthen health systems at national, provincial and district level, strengthen (and link) surveillance systems to identify and address public health priorities, promote and strengthen integrated and multidisciplinary approaches to quality health services, enhance efforts to build health management information systems and data management capacity, promote continuing program QI, promote use of best practices, and support host country to identify successful programmatic interventions that have potential to be replicated and scaled-up in priority areas. Activities will strengthen and support effective linkages within the health setting and create enabling environments in order to reach priority populations.

Overarching activities to meet this focus area during the five-year period include:

Implementing feasibility studies and other assessments aimed at aligning resources and programming to best available evidence

Improving quality control and quality assurance for surveillance systems Supporting for integrated disease and risk factor surveillance at national and provincial levels Strengthening program management and monitoring and evaluation to improve programs and services Strengthening health management information system Strengthen public health laboratory systems and processes and the national and provincial levels Improving management and coordination

Year 1 programmatic activities may include, but not limited to:

Global HIV & TB (DGHT):

Implementing and evaluating the feasibility of the HIV test, treat and prevention program model, particularly among MSM and Transgender women in Thailand including demand creation (for testing, for PrEP, for Treatment) and peer outreach and web-based HIV testing promotion, index partner testing for targeted testing for higher positivity yield, special HIV testing promotion events, implementation and integration of HIV self-testing as part of a comprehensive HTC services

Expanding HIV testing among MSM and TG women (e.g., via highly targeted mobile testing or online react to offline testing) as well as with same-hour screening and same-hour testing administered by community partners and same-day confirmation by Government-run facilities

Improve the quality of care across the continuum of care cascade, and address stigma and discrimination from the national level through policy development to the local level by using community meetings, peer outreach, and a web-based presence

Strengthening the QI of HIV Treatment and Care and co-infections (tuberculosis, STIs, hepatitis infections) programs including support case managers, same-day and rapid ART initiation, promote retention to treatment, reduce mortality rate, promote TB, STI, hepatitis infections screening, prevention and treatment among PLHIV, promote TLD transition and differentiated service delivery; Strengthening a harmonized and streamlined monitoring and evaluation system to describe ongoing interventions, characteristics, and outcomes across various stakeholders and different levels of HIV program implementation and HIV populations (i.e., MSM and TG women). Include community monitoring in the M&E process for a comprehensive M&E system.

Improved and sustainable management and coordination for effective implementation through building capacity of the decentralized provincial surveillance and monitoring and evaluation network

Strengthen program monitoring at site level to improve quality of laboratory information systems to improve HIV services

Strengthen hospital health management systems, HIV surveillance systems, program monitoring and evaluation, data visualization and dissemination systems, build human capacity for HIV program monitoring and evaluation, data utilization for program improvement and policy advocacy.

Increasing capacity building and strengthening of laboratory quality improvement and data utilization to improve efficiency of HIV care and treatment

Strengthen laboratory program management in each province on HIV testing, care and treatment through the provincial laboratory committees and technical working groups to monitor and manage program activities

Increased coordination among laboratories and VCT clinics within the hospital to achieve 95-95-95 goals.

Advanced detection of people with newly acquired infections through state of the art HIV Recency testing and implementation of a public health response based on case finding and care/treatment programmatic results to prevent new infections and improve overall HIV program

Strengthening HIV and STI laboratory quality assurance programs to monitor the quality of laboratory services

Influenza (Flu):

Enhance surveillance for vaccine preventable infections Improve quality control and quality assurance for surveillance systems Improve scope of diagnostics for respiratory disease outbreaks

Global Health Protection (DGHP):

Advancing hospital infection control systems to detect, prevent and contain emerging infectious diseases Developing antimicrobial stewardship programs in animal and human sectors Introducing robust comparable population-based indicators for use in antimicrobial resistance surveillance Strengthening surveillance for antimicrobial resistant infections in select provinces Enhancing surveillance for acute febrile illnesses, including emerging and zoonotic infections, in border areas of Thailand Improving health informatics systems for disease surveillance including interoperability of information systems and enhanced display of near-real time data Support One Health surveillance and response to zoonotic diseases in human, livestock and wildlife

Non-Communicable Diseases (NCD):

Development of national cancer screening program Improving quality of existing and brand-new cancer registry Strengthening NCD and Injury surveillance systems for targeting and designing NCD and injury prevention and control

Immigrant, Refugee and Migrant Health (DGMQ):

Evaluate and improve the sensitivity and/or specificity of disease reporting in migrant populations

Focus Area 3: Enhance multi-sectorial and multi-disciplinary capabilities to anticipate, prevent, detect and respond to public health threats

This focus area includes building capacity to identify and respond to a wide range of emerging infections, including respiratory syndromes, diarrheal diseases, foodborne illnesses, zoonotic diseases, and others, through integrated disease surveillance, prevention, and control activities.

Activities are expected to contribute to the overarching outcomes discussed previously, as well as outcomes specific to this focus area: fully implement the International Health Regulations and other relevant global health frameworks (including Global Health Security Agenda); improve response and control of outbreaks and other public health emergencies;

improve exchange of information and coordination between sectors and disciplines; and strengthen investigative and response capacity in Thailand and the region. Ultimately, activities will lead to longer-term outcomes including reduced burden and impact of public health emergencies; improved preparedness to public health threats, and reduction of outbreak risks at their source.

Overarching activities to meet this focus area during the five-year period include:

Enhance public health emergency management and risk communication Strengthening public health systems to assess and reduce outbreaks risks at source Strengthen systems for response and containment to public health emergencies Strengthen multi-sectoral workforce capability to investigate and respond to outbreaks and other public health emergencies

Year 1 programmatic activities may include, but not limited to:

Global HIV & TB (DGHT):

Design, demonstrate, and evaluate innovative, scalable, and more effective approache s for HIV epidemic control on technical assistance and coordination of capacity building for public health facilities to promote and support scale-up of HCT, care, and treatment and building HCW capacity and strengthening laboratory and strategic information (surveillance, monitoring, and evaluation) services in collaboration with national, sub-national, international, non-governmental stakeholders including CSOs, BMA, National Health Security Office, Social Security Scheme Office, Thai AIDS Society, UN agencies and other US agencies.

Influenza (Flu):

Increase Thailand’s laboratory capacity to prepare and respond to pandemic influenza or other infections through improved quality control and enhanced biosafety

Strengthen event-based surveillance systems to detect respiratory disease outbreaks more quickly

Global Health Protection (DGHP):

Development of improved surveillance and laboratory capacity for the detection of zoonotic pathogens at the human-animal interface Strengthening systems to advance Global Health Security especially those related to emergency preparedness and management, including supporting interoperable emergency operations centers

Developing enhanced quality assurance and biosafety programs for emerging infectious diseases including antimicrobial resistant organisms at the national, sub-national and regional level

Assessing newer technologies, including advanced molecular diagnostic systems, for use in public health surveillance and outbreak detection activities

Support network of One Health professionals in national and sub-national surveillance and rapid response

Establishing and strengthening NCD response system at national level

Immigrant, Refugee and Migrant Health (DGMQ):

Improved surveillance of disease outbreaks in migrant populations to improve the ear ly detection of emerging infections Support border health strengthening work to detect and prevent transboundary infectious diseases

Focus Area 4: Implement Global Health Security preparedness for public health threats in the Asia region to enhance capabilities across multiple sectors

Promoting and sustaining engagement between sectors is a priority on the path to improved population outcomes in public health and allied fields. Although this partnership includes a long history of collaboration across sectors in Thailand and in the region, well-coordinated planning and implementation remains a challenge amidst competing priorities and demands on resources across countries in the region and amongst sectors in Thailand. Thailand has taken a leadership role on two of the 11 Global Health Security Agenda Action Packages— National Laboratory Systems and Workforce Development—and a contributing role on a third Action Package—Anti-Microbial Resistance. This leadership role will provide opportunities to strengthen regional collaboration across the three action packages. In the next five years, this cooperative agreement will emphasize the critical role of multi-sector and regional collaboration in core domains of public health to avoid duplication of effort and produce sustainable improvements in identified focus areas.

Activities are expected to contribute to the overarching outcome mentioned in the above section and also lead to specific outcomes to meet this focus area include enhanced connectedness and relationship among partner organizations, improved exchange of information and resources, and improved coordination and delivery of programs and services. Ultimately, activities will lead up to longer term outcomes including strengthened health security at borders and points of entry.

Overarching activities to meet this focus area during the five-year period include:

Create shared opportunities for technical assistance and consistent exchange of information in the country and region

Enhance screening and referrals at border areas and points of entry Improve the assessment of health care available to migrant persons and other vulnerable populations with diseases of public health importance Strengthen prevention and response to cross-border outbreaks and transmission of disease Contribute to the base of evidence on multi-sectoral approaches to health security

Year 1 programmatic activities may include, but not limited to:

Global HIV & TB (DGHT):

Global Capacity Building and Global Technical Assistance including capacity strengthening workshops for M&E, study visits and trainings, with dissemination of experiences and lessons learned from Thailand on the HIV/AIDS response, stigma & discrimination reduction program to the region

Assist a network of hospitals that provide ART along the Lao-Thai border to increase HIV testing, implement QI systems for ART use, and maintain PLHIV in the continuum of care cascade at those sites

Educate HIV-infected migrants about HIV prevention Introduce technical knowledge and experiences on governmental health fund allocation for HIV Capacity building and technical assistance to strengthen and improve the quality of

HIV and HIV related testing in the region Capacity building for laboratories in quality management in the region to provide quality laboratory services according to international laboratory standards HIV monitoring, program response and surveillance systems

Global Health Protection (DGHP):

Strengthening applied and field epidemiology training in South and Southeast Asia region Strengthening laboratory capabilities in the region Strengthening regional collaborations for emergency response, disease surveillance and information systems, infection control and antimicrobial resistance containment, across human, livestock and wildlife sectors

Establishing a center of excellence for injury prevention and…