Foa_Content_of_CDC-RFA-GH21-2107.pdf

Centers for Disease Control and Prevention

Center for Global Health

Technical Collaboration to Strengthen Bangkok Metropolitan Administration Capacity to Detect, Prevent, Respond, Monitor, and Mitigate The Effects of Public Health Threats In The Kingdom of Thailand.

CDC-RFA-GH21-2107

07/06/2021

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- GH21-2107. 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 Bangkok Metropolitan Administration Capacity to Detect, Prevent, Respond, Monitor, and Mitigate The Effects of Public Health Threats 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-GH21-2107

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:

07/06/2021 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 Bangkok Metropolitan Administration (BMA), Kingdom of Thailand to strengthen and expand capacity to assess, prevent, prepare for and mitigate public health threats in Bangkok and its surrounding areas. Bangkok is the capital of Thailand and its largest city, with a population of over 10 million people. Bangkok’s population density and status as an economic and migratory hub for Thailand amplify its role in public health efforts globally.

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, tuberculosis, vaccine-preventable diseases, 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. Activities should be based on the best available evidence and practice in public health, education, and allied fields. Collaboration and coordination of activities across multiple sectors and platforms to accelerate progress toward intended outcomes are essential.

a. Eligible Applicants:

Single

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$ 5,000,000

e. Average One Year Award Amount:

$ 1,000,000

f. Total Period of Performance Length:

g. Estimated Award Date:

September 01, 2021

h. Cost Sharing and / or Matching Requirements:

https://www.grants.gov/

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 For more than 20 years, BMA and CDC have collaborated to strengthen public health infrastructure and capacity in Bangkok. These efforts have helped control the spread of HIV and other infectious diseases, increased access to quality diagnosis, care, and treatment for communicable and non-communicable diseases, and strengthened surveillance and use of evidence to guide public health decision-making and financing in the Bangkok area.

This NOFO will complement efforts by BMA and its national and international partners to prevent, monitor, assess, and mitigate public health threats in the Bangkok Metropolitan area. It will do this through (a) assessment of existing health behaviors, health care services and systems in Bangkok; (b) design, development, and implementation of standard procedures and practices for high-quality services by BMA health facilities and laboratories; and (c) capacity building and mentorship of BMA health care workers, laboratory staff, strategic information (SI) experts, and program managers to implement, monitor, and continuously improve the quality of those procedures and practices so as to enhance prevention, detection, response, and preparation for public health threats.

Demographic changes in Thailand 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. Antimicrobial resistance (AMR) is a rapidly growing public health threat in Thailand. Rising gram-negative bacterial resistance and antibiotic overuse have led to development of a National Strategic Plan to prevent and control AMR. Thailand has identified AMR as one of the national public health priorities.

In 2019, the estimated number of people living with HIV (PLHIV) in Thailand is 470,000, with approximately 17% (78,866) of them living in Bangkok. Overall HIV incidence in Thailand has decreased, but incidence and prevalence remain high among key populations, particularly in larger urban areas such as Bangkok and among men who have sex with men (MSM), transgender (TG) women, and sex workers. Among MSM, HIV prevalence in Bangkok declined from 20% in 2014 to 10% in 2018. Based on the Asian Epidemic Model, the estimated number of new HIV infections in Bangkok were 1,063 (22%) of the 4,855 new HIV infections in Thailand in 2020.

The ability to achieve HIV epidemic control in Bangkok is constrained by multiple health systems that do 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) men who have sex with men (MSM), Transgender (TG) women and their partners and People Who Inject Drugs (PWID). Overcoming this requires implementation of standards for same-day, high-quality, patient-friendly HTC including online to offline testing, index testing, and self-testing, with immediate referral of PLHIV and PP to care and initiate same-day/rapid anti-retroviral therapy (ART), promote retention to treatment and continuity of care, accompanied by greater capacity of health care workers (HCWs) and laboratory staff to implement, monitor, and continuously improve these HIV services. In addition, systematic public health responses should be established to control new infections in priority areas where PLHIV with recent infections are identified.

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 This announcement supports the Department of Health and Human Services’ (HHS) Global Health Strategy which articulates three strategic goals that support HHS’ global health vision of a healthier, safer world: 1) protect and promote the health and well-being of Americans through global health action; 2) provide leadership and technical expertise in science, policy, programs and practice to improve global health; and 3) advance United States interests in international diplomacy, development, and security through global health action.

http://www.globalhealth.gov/global-programs-and-initiatives/global-health-strategy/

This NOFO aligns with the current CDC strategic priorities including strengthening surveillance, epidemiology and laboratory services; supporting public health activities; increasing global https://health.gov/healthypeople/objectives-and-data/browse-objectives/global-health file:///C:/Users/ovx5/Desktop/http:/www.globalhealth.gov/global-programs-and-initiatives/global-health-strategy/ health impact; increasing impact on public health policy; and preventing illness, injury disability and death.

This NOFO supports 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. CDC’s strategy is rooted in science and based on three concepts long embedded in the agency’s mission to protect public health worldwide: 1) Prevent, 2) Detect, 3) Respond. This NOFO is in-line with these priorities.

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

PEPFAR:

Under the leadership of the U.S. Global AIDS Coordinator, as part of the President's Emergency Plan, 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.

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, HIV self-test linked with evidence based behavioral change, pre-exposure prophylaxis, and building programs to integrate services to reduce HIV/coinfections (sexually transmitted infections (STIs), tuberculosis and hepatitis infections);

Improving the care and treatment of HIV/AIDS, STIs and related opportunistic infections by improving STI diagnosis and 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 same-day/rapid anti-retroviral therapy (ART) and promote treatment continuity;

Strengthening the capacity to collect and use HIV program surveillance data to manage Bangkok 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;

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; and file:///C:/Users/ovx5/Desktop/http:/www.cdc.gov/globalhealth/strategy/ file:///C:/Users/ovx5/Desktop/http:/www.cdc.gov/global%20health/security/cdc.html

Establishing best practices and continuous quality improvement learning and coaching network in Bangkok to replicate high quality HIV ending AIDS interventions and services to other hospitals in Bangkok, support hospitals with poor performance, and to acknowledge hospitals that achieve ending AIDS goal to obtain HIV/STI disease specific certification and integrate these activities into routine hospital quality system for sustainability.

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

Implement a woman- and girl-centered approach;

Increase impact through strategic coordination and integration;

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 metrics, monitoring and evaluation; and Promote research, development and innovation (research is not supported by this NOFO)

This announcement is only for non-research activities supported by CDC. Recipients may not use funds for research. Certain activities that may require human subjects review due to institutional requirements but that are generally considered not to constitute research (e.g., formative assessments, surveys, disease surveillance, program monitoring and evaluation, field evaluation of diagnostic tests, etc.) may be funded through this mechanism. If research is proposed, the application will not be reviewed. For the definition of research, please see the CDC Web site at the following Internet address:

http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf

e. Relevant Work This NOFO builds on CDC’s previous cooperative agreements and over 20 years of Collaboration with BMA to prevent and control HIV/AIDS, tuberculosis, 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 Bangkok's experience with other countries. Supporting U.S. public health investments in Bangkok 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-GH21-2107 Logic Model: Technical Collaboration to Strengthen Bangkok Metropolitan Administration Capacity to Detect, Prevent, Respond, Monitor, and Mitigate The Effects of Public Health Threats In The Kingdom of Thailand.

file:///C:/Users/ovx5/Desktop/http:/www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf file:///C:/Users/ovx5/Desktop/http:/www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf

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.

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

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

Enhance multi-sectorial and multi-disciplinary capabilities to anticipate, prevent, detect and respond to public health threats.

Strengthen multi-sector collaboration for disease and

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

Increased coordination to prevent, detect, and respond to outbreaks and public health emergencies.

Increased capacity 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 to monitor infectious, Non-infectious disease and potential public health threats.

Increased number of sites/ health facilities 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 coordinated and communication efforts for public health threats, including malaria, influenza, zoonotic

Improved outbreak prevention, new infections/ case 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).

Reduce new HIV-infections and death among people living with HIV

Increased infection control and coverage rates for vaccine preventable diseases, and reduced AMR.

Reduced morbidity among migrants and other travelers.

outbreak control.

Increased capacity to use strategic information for HIV prevention and treatment continuity.

Implement Global Health Security preparedness for public health threats while enhancing capabilities across multiple sectors.

diseases, HIV/AIDS, STIs, and TB control.

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 Bangkok and its surrounding urban areas; to strengthen the existing public health system in Bangkok 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 Bangkok, 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 overarching outcomes depicted in the logic model.

Short-Term Outcomes:

Increased coordination to prevent, detect, and respond to outbreaks and public health emergencies.

Increased capacity 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 to monitor infectious, Non- infectious disease and potential public health threats.

Increased capacity to use strategic information for HIV prevention and treatment continuity.

Implement Global Health Security preparedness for public health threats while enhancing capabilities across multiple sectors.

Intermediate Outcomes:

Increased number of sites/ health facilities 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 coordinated and communication efforts for public health threats, including malaria, influenza, zoonotic diseases, HIV/AIDS, STIs, and TB control

Long-Term Outcomes:

Improved outbreak prevention, new infections/ case 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).

Reduce new HIV-infections and death among people living with HIV Increased infection control and coverage rates for vaccine preventable diseases, and reduced

AMR.

Reduced morbidity among migrants and other travelers.

iii. Strategies and Activities To achieve these outcomes, the NOFO will concentrate on four broad strategies (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 and sustainability of 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: Strengthen multi-sector collaboration

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

Bangkok 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 Bangkok; 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 Bangkok.

It is expected that activities in this section will assist in building the capacity of public health professionals, including laboratory personnel, BMA 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 Bangkok 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:

Enhance program monitoring and evaluation of programs in Bangkok Increase use data and evidence for public health action and decision-making in BMA Enhance laboratory infrastructure and practice in Bangkok

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

Global HIV & TB (DGHT):

Enhance capacity of health care workers to promote PEPFAR-supported interventions including improve quality and coverage of HIV viral load, HIV drug resistance testing, HIV self-testing, index testing, same-day/rapid ART initiation, enhance adherence counseling, treatment literacy, lost-to-follow up case management, differentiated service delivery, Tenofovir, Lamivudine, and

Dolutegravir (TLD) transition, TB Preventive Treatment implementation, TB Urine LAM implementation through training, supervision, and continuous quality improvement (QI) systems in Bangkok

Strengthen implementation of HIV surveillance and program monitoring to ensure data quality; promote use of SI data to analyze PLHIV targets, monitor HIV care cascade, identify gaps, and support QI in Bangkok

Improve demand creation for HIV testing, PrEP, recruitment, treatment cascade improvement concepts, PEPFAR-supported strategies that align with country goals, and setting targets in Bangkok

Establishing operational and informational linkages between national HIV and TB management information systems and BMA

Influenza (Flu):

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

Global Health Protection (DGHP):

Enhance laboratory biosafety and capacity Support Global Health Security Agenda workforce development priorities Enhance capacity on Non-Communicable Diseases (NCD) epidemiology Capacity building for behavior risk factor surveillance system in Bangkok Strengthen capacity in AMR prevention, detection, and response Enhance capacity to assess and improve mitigation strategies for COVID-19 and other infectious diseases Provide training on disease surveillance, epidemiological analysis and data management, across multiple sectors, focused in areas at higher risk of disease emergence or introduction

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 BMA to detect and respond to diseases of public health importance among migrants and travelers in Bangkok

Focus Area 2: Enhance the quality and sustainability of 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 monitoring and evaluation 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 in Bangkok, strengthen (and link) surveillance systems to identify and address public health priorities, promote integrated and multidisciplinary approaches to quality, sustainable 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:

Align resources and programming to best available evidence Enhance and integrate disease and risk factor surveillance in Bangkok Implement and use monitoring and evaluation to improve programs and services Identify weaknesses and improve health management information system Strengthen public health laboratory systems and processes

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

Global HIV & TB(DGHT):

Strengthening the Quality Improvement of HIV Treatment and Care and co-infections (TB, STI, hepatitis infections) Programs including support case managers, same-day and rapid ART initiation, promote retention to treatment, reduce mortality rate, promote TB, STI, hepatitis screening/prevention and treatment among PLHIV, promote TLD transition and differentiated service delivery.

Assess the implementation of and identify barriers to online to offline HIV testing, IV index testing and self-test implementation services in Bangkok

Target expansion of access to HTC with same-hour screening and same-hour testing administered by community partners and same-day confirmation by Government-run facilities

Assess the cost effectiveness of PrEP implementation and other innovative prevention models

Expand HIV index, self-testing, recency testing among key populations, use of additional social networking strategy to enhance effectiveness of index testing and recency testing, improve the quality of care across the continuum of care cascade, and address stigma and discrimination using community meetings, peer outreach, and a web presence

Develop a public health response based on case finding, recency testing, and care/treatment programmatic results to prevent new infections and improve overall HIV program

Promote laboratory continuous QI activities for HIV diagnosis, treatment, and care by strengthening laboratory quality management systems and laboratory accreditation

Strengthening of a harmonized and streamlined monitoring and evaluation system to describe ongoing interventions, characteristics, and outcomes across various stakeholders/ entities, and different levels of HIV program implementation and HIV populations (i.e., MSM, TG women, PWID)

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 capacity and 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 Improving health informatics systems for disease surveillance including interoperability of information systems and enhanced display of near-real time data Building capacity to assess knowledge, attitudes, and behaviors to monitor adherence to policy and evaluate programs Support One Health surveillance and response to zoonotic diseases in human, livestock and wildlife

Non-Communicable Diseases (NCD):

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 po pulations

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 Bangkok. 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 multi-sectorial and multi-disciplinary capabilities to anticipate, prevent, detect and respond to public health threats

Strengthen systems to assess and reduce outbreaks risks at source Strengthen systems for response and containment to public health emergencies Enhance public health emergency management and risk communication 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):

Collaborate with local and national stakeholders, including MOPH, National Health Security Office, Social Security Scheme Office, civil society organizations and other United States agencies, Universities, Thai AIDS Society to design, demonstrate, and evaluate innovative, scalable, and more effective and sustainable approaches for HIV epidemic control

Influenza (Flu):

Increase Bangkok’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 Establishing and strengthening NCD response system

Immigrant, Refugee and Migrant Health (DGMQ):

Improved surveillance of disease outbreaks in migrant populations to improve the early d etection of emerging infections

Focus Area 4: Strengthen Multi-sector and Regional Collaboration

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 Bangkok and in Thailand, well-coordinated planning and implementation remains a challenge amidst competing priorities and demands on resources amongst sectors in Bangkok. In the next five years, this cooperative agreement will emphasize the critical role of multi-sector 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.

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

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 outbreaks and transmission of disease Create shared opportunities for technical assistance and consistent exchange of information in Bangkok and across the country 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):

Conduct global capacity building and technical assistance activities including capacity building workshops for promoting monitoring and evaluation, study visits and trainings, and dissemination of experiences and lessons learned from the BMA

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

Capacity building and technical assistance to strengthen and improve the quality of HIV related testing

Capacity building for laboratories in quality management in the region to provide quality laboratory services according to international laboratory standards

Influenza (FLU):

Develop regional networks for vaccine effectiveness evaluations

Global Health Protection (DGHP):

Strengthening laboratory capabilities Strengthening collaborations for emergency response, disease surveillance and information systems, infection control and antimicrobial resistance containment, across human, livestock and wildlife sectors

Immigrant, Refugee and Migrant Health (DGMQ):

Develop and maintain surveillance systems for infectious diseases of public health importance in migrant and displaced populations in the region

Develop and strengthen health networks and partnerships with communities and civil society to better prevent, detect and respond to public health threats among displaced persons and migrant populations.

In furtherance of the underlying purposes of this NOFO, Recipient is expected to provide copies of and/or access to all data, software, tools, training materials, guidelines, and systems developed under this NOFO to Ministry of Health and other relevant stakeholders, including HHS/CDC, for appropriate use consistent with underlying authorities.

1. Collaborations

a. With other CDC programs and CDC-funded organizations:

CDC possesses acknowledged expertise to address the challenges of global health and works in concert with domestic and international partners to improve health and well-being around the world. CDC’s Center for Global Health (CGH) is responsible for technical work conducted by global programs within the Center, including immunizations, HIV/AIDS, tuberculosis elimination, disease detection and response, health systems and laboratory strengthening, malaria and other parasitic diseases. Many other CDC programs contribute expertise and engage in global health work, including the control of HIV, sexually transmitted diseases, tuberculosis, opportunistic infections and hepatitis infections; antimicrobial resistance; bacterial and viral respiratory infections; vector-borne diseases; rabies; and viral hemorrhagic fevers. CGH facilitates collaborations among these programs and in many cross-cutting areas such as maternal and child health, infectious and non-communicable diseases, outbreak responsiveness, and water and sanitation.

Recipient will collaborate with CDC Thailand subject matter experts and the Project Officer on project management and technical oversight of project activities under each technical area and on development and implementation of the evaluation performance management plan. The project officer for this award will provide all relevant contacts and coordinate discussions with the award Recipient. Recipient will seek post-award consultation with in-country staff, if applicable, and the appropriate other technical leads for proposed projects.

It is expected that the recipient will engage with internal and external stakeholders (noted below) who contribute to the goals identified in the announcement during development and implementation of activities and the evaluation performance plan.

Recipient is expected to collaborate with various CDC Divisions and Programs to ensure that the activities and materials meet CDC standards, maximize resources, avoid duplication, and concur with CDC published recommendations and disease specific information.

b. With organizations not funded by CDC:

Recipient is expected to collaborate with key partners including other U.S. Government stakeholders (the United States Agency for International Development (USAID), U.S.

Department of State, Health and Human Services Office of Global Affairs, and National Institutes of Health), as well as United Nations Children's Fund (UNICEF), World Health Organization (WHO), Thailand Ministry of Public Health (MOPH), local universities, Thai Red Cross and other local and international civil societies who are working in Thailand. Recipient should work closely with all stakeholders in the development of the evaluation performance measurement plan (later defined in this announcement) including program managers from MOPH Departments, service delivery stakeholders (e.g., hospital health care providers, laboratory technicians, peer counselors), and other technical assistance stakeholders.

2. Target Populations Target populations will be defined by programmatic area. Applicants should state in their funding requests whether and how target populations will be addressed.

Influenza: populations at high-risk for influenza-associated morbidity and mortality include individuals aged ≥65 years, individuals with chronic underlying medical conditions, young children aged six months to two years, pregnant women, and healthcare personnel.

Malaria: populations for malaria activities should include people living or working in epidemiologically defined areas of malaria transmission. Sub-population target groups within these malaria transmission zones should include those most at-risk for severe disease e.g.

children under five years of age and pregnant women.

HIV/AIDS: Target population beneficiaries include PLHIV (adults, adolescents and children), MSM, TG women, partners of PLHIV, health care workers, laboratorians, PWID, and other public health personnel who will engage PPs and PLHIV in geographic areas where those populations are concentrated.

Non-communicable disease (NCD) and injury interventions populations include general populations groups (all age groups), high risk populations, and populations with NCDs and injuries.

Immigrant, Refugee and Migrant Health: Displaced persons, migrants and persons who travel internationally.

Other target populations: Include children less than five years of age at risk for respiratory diseases and vaccine preventable diseases including diphtheria, pertussis, and measles; and all age groups at risk for food and water borne diseases specifically salmonellosis and Hepatitis B and C, emerging infections, vector-borne diseases, antimicrobial resistant infections, and non-communicable diseases including road traffic injuries, cancer, hypertension, and diabetes.

a. Health Disparities Not Applicable

iv. Funding Strategy Multiple programs are contributing to this award and there will be multiple funding streams available for different strategies and activities.

Since this award will cover multiple programs (Global HIV/AIDS, Influenza, Global Health Protection, NCD, Migrant Health, etc.), please ensure that every project has complete information and addresses all elements. Please upload additional projects in the appendix section. Applicant should title each project to keep them separate and easy to review.

PEPFAR Funding:

Applicants to this NOFO are encouraged to apply to the Approximate Total Fiscal Year Funding/Average One Year Award Amount/Approximate Average Award amount. Applications must not exceed this amount.

Component Funding: It is required that all PEPFAR-funded cooperative agreements be formulated for component funding. Please review the following key points about component funding:

Component funding must be setup at the time of the application.

Each component must be a discrete set of activities with an associated budget. Distinguishable component budget narratives are required. Setting up components based on time (i.e., quarterly) is an appropriate distinction of activities, provided activities are clearly outlined.

Applicants should submit the SF-424A as part of their application which shows all components for the budget period and the amounts should exactly match what is being requested for funding. Each component has its own approved amount and cannot be funded above the established amount. The combined total of all components must total the requested amount.

If more than 4 components are proposed, multiple SF-424s will be needed.

Any component that is not funded at the time of new award may be deemed “Approved but Unfunded (ABU)”. There is no guarantee that all components will be funded in a budget period as ABU components are subject to the availability of funds or effective statute.

o Components do not have to be awarded in order. All ABU components are eligible to receive funding once (and if) funds become available.

o If funding becomes available, multiple components can be funded through the same funding action (single NOA).

o If funding is awarded for an amount less than the ABU component approved amount, it is not possible to fund the difference at a later time. Components can only be funded once.

If, during the funding confirmation, the Program Office approves a budget that differs from what was submitted at the time of application (reflected in the budget markup), a revised budget may be required in addition to the technical review…