Foa_Content_of_CDC-RFA-GH21-2177.pdf

Centers for Disease Control and Prevention

Center for Global Health

Protecting and Improving Health Globally: Building and Strengthening Public Health Systems, Capacity and Security - Advancing Regional Health Security for Prevention and Control of

Communicable & Non-Communicable Diseases in the Caribbean

CDC-RFA-GH21-2177

07/25/2021

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- GH21-2177. 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:

Protecting and Improving Health Globally: Building and Strengthening Public Health Systems, Capacity and Security - Advancing Regional Health Security for Prevention and Control of Communicable & Non-Communicable Diseases in the Caribbean 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)).

New Type 1

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-GH21-2177

E. Assistance Listings Number:

93.318 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

F. Dates:

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

05/26/2021

2. Due Date for Applications:

07/25/2021 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 project is to build capacity and improve compliance with International Health Regulations (IHR 2005) among the countries of the Caribbean Region, in five major areas:

1. Workforce development in the areas of surveillance/epidemiology, public health laboratories, outbreak and epidemic response. Surveillance/epidemiology includes Field Epidemiology Training Programs (FETP), continuing professional education and other activities.

2. Public Health Laboratory Strengthening, including increased testing for priority pathogens, biosafety/biosecurity, and quality management system monitoring and evaluation.

3. Public Health Surveillance Systems, which may include needs assessment, development and/or enhancement of surveillance processes, structures, and information systems.

4. Public Health Diplomacy, including development of national public health institutes (NPHI), and facilitation of countries’ compliance with IHR and Global Health Security (GHS) targets.

5. Emergency Response to COVID-19 and other public health threats

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 30, 2021 https://www.grants.gov/

h. Cost Sharing and / or Matching Requirements:

No Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview The U.S. Government’s (USG) Global Health Security Agenda (GHSA) envisions a world safe and secure from global health threats posed by infectious diseases—where it is possible to prevent or mitigate the impact of naturally occurring outbreaks and intentional or accidental releases of dangerous pathogens, rapidly detect and transparently report outbreaks when they occur, and employ an interconnected global network that can respond effectively to limit the spread of infectious disease outbreaks in humans and animals, mitigate loss of life and reduce economic impact. CDC works with partners to accelerate progress toward a world safe and secure from infectious disease threats and to promote global health security as an international security priority. Key barriers to progress in the Caribbean region have prevented all countries from fully meeting the IHR priorities, limited disease surveillance systems, institutional and logistic barriers to adequate delivery of services and interventions, emergence of new pathogens, limited border public health security measures and insufficient human resource capacity.

Over the past decade CDC has worked with the Caribbean Region to address numerous emerging disease outbreaks including Zika, Chikungunya, HIV and most recently COVID-19. This NOFO specifically seeks to enhance global health security in the Caribbean region and build capacity to swiftly respond to future emerging public health threats.

This NOFO aligns with both CDC and national goals for the Caribbean Region. The cooperative agreement partner/s will work with regional countries to focus on four Global Health Security (GHS) strategies: (1) improve public health workforce capacity (2) strengthen laboratory systems, (3) enhance disease surveillance systems and (4) improve public health diplomacy.

Ultimately, these efforts will contribute to each country’s compliance with the International Health Regulations (IHR). Additionally, this NOFO aims to increase collaboration among Caribbean Region countries for improved regional surveillance and laboratory systems, enhance existing integrated public health networks, and develop international-caliber public health surveillance and response systems to serve as regional resources. Activities to support these priorities will require assessment of capabilities, capacities, infrastructure, and training needs, with implementation through mentoring and technical assistance.

In addition to the four core GHS Strategies (Component 1) listed above, this NOFO will support activities when a disease outbreak or other public health emergency reaches a scale that requires a moderate (Component 2, Rapid Response to Small Scale Infectious Disease Outbreaks or Other Public Health Emergencies) or substantial response (Component 3, Rapid Response to Large- Scale Infectious Disease Outbreaks or other Public Health Emergencies). Finally, this NOFO supports activities to combat COVID-19 and other emerging infectious disease threats (Component 4, Emerging Infectious Disease Threats [EIDT]). Applicants must apply for all four components.

b. Statutory Authorities

This program is authorized under Section 307 of the Public Health Service Act [42 USC 242l] and Section 301(a) of the Public Health Service Act [42 USC 241(a)].

c. Healthy People 2030 This project supports the following Healthy People 2030 topic areas:

Global Health Public Health Infrastructure Health Care Access and Quality Infectious Disease Emergency Preparedness

d. Other National Public Health Priorities and Strategies Activities funded through this cooperative agreement must align with the following United States Government (USG) and HHS/CDC strategies and policies:

CDC’s strategy for improving global health security (GHS), based on three concepts embedded in the agency’s mission to protect public health worldwide: 1) Prevent 2) Detect 3) Respond https://www.cdc.gov/globalhealth/security/index.htm

The Department of Health and Human Services’ (HHS) Global Health Strategy https://www.hhs.gov/about/agencies/oga/about-oga/why-hhs-works-globally/hhs-global-strategy/index.html

International Health Regulations (2005) and supporting policies and frameworks https://www.who.int/topics/international_health_regulations/en/

e. Relevant Work This NOFO builds upon past activities accomplished under GH001205, GH001860, and GH001627 which aimed to build a strong regional public health infrastructure, enhance surveillance capacity, and maintain strong subject matter expertise in the Caribbean.

2. CDC Project Description

a. Approach Bold indicates period of performance outcome.

Component 1: Core Global Health Security Priorities Strategies Short-Term Outcomes

(1-3 years) Intermediate Outcomes (3-5 years)

Long-Term Outcomes (5 years or more)

Strategy 1:

Workforce Development

Strategy 2:

Laboratory Systems

Increased number of multidisciplinary trained public health workers supported through intermediate and advanced FETP programs

Increased number of FETP residents trained that have participated in outbreak investigations and responses

Improved technical

Cadre of individuals in each regional country trained by CDC and capable to independently prevent, detect and respond to public https://health.gov/healthypeople/objectives-and-data/browse-objectives/global-health https://health.gov/healthypeople/objectives-and-data/browse-objectives/public-health-infrastructure https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality https://health.gov/healthypeople/objectives-and-data/browse-objectives/infectious-disease https://health.gov/healthypeople/objectives-and-data/browse-objectives/emergency-preparedness https://www.cdc.gov/globalhealth/security/index.htm https://www.hhs.gov/about/agencies/oga/about-oga/why-hhs-works-globally/hhs-global-strategy/index.html https://www.hhs.gov/about/agencies/oga/about-oga/why-hhs-works-globally/hhs-global-strategy/index.html https://www.who.int/topics/international_health_regulations/en/ health threats

Improved sustainable funding and policies to adopt FETP and CE into national budget

Improved analytical data sharing among countries resulting in improved regional Health Security.

Countries in the region have prioritized diseases and pathogens with laboratory testing capacity, surveillance systems, and routine reporting to public health authorities with commensurate public actions

Improved interconnected regional network that can respond rapidly and effectively to biological threats of international concern

Strengthening

Strategy 3:

Surveillance Systems Strengthening

Strategy 4:

Improving Public Health Diplomacy

Increased number of PH staff participating in continuing education courses

Regional laboratory surveillance protocols and guidelines developed in support of a regional epi/lab surveillance networks

Adoption of regional plan for biosafety and biosecurity

Strengthened indicator/case- and event-based surveillance systems

Increased number of assessments conducted and countries in which direct TA conducted for ESS

National Action Plans for priority areas developed and operationalized

Increased IHR 2005 compliance among regional countries capacity of PH staff and professional networks

Improved timeliness of detection and control of infectious diseases including HAIs and

AMR

Improve functional capacity of regional labs

Improved capacity to detect, monitor, and respond to priority pathogens

Increased number of countries with functioning, multi-disease ESS used for routine reporting

Increased number of countries in the region with established, functioning NPHIs

Improved performance of countries in the Region as IHR role models, thus providing TA to other countries in region who are not IHR 2005 compliant

Components 2, 3 and 4: Rapid Response to Small-Sale and Large-Sale Infectious Disease Outbreaks or other Public Health Emergencies and Emerging Infectious Disease Threats Strategies Short-Term

Outcomes

Intermediate

Long-Term Outcomes

Strategy 1:

Intensify active surveillance, case finding, contact tracing, monitoring and other outbreak response measures at local levels

Strategy 2:

Strengthen capabilities for epidemiologic and laboratory analysis and program evaluation

Strategy 3:

Intensify social mobilization, community and professional education and engagement.

Strategy 4:

Improve outbreak case management and infection control

Strategy 5:

Strengthen non-outbreak related public health activities that are impacted by the outbreak

Strategy 6:

Decreased time to deploy healthcare workers to respond and control the spread of infectious diseases

Strengthened coordination and robust emergency preparedness and response capacities

Improved disease outbreak case management and infection control

Shortened time to detect highly infectious disease outbreaks through active surveillance and case finding

Reduced transmission of highly infectious diseases in clinical and community settings

Increased awareness, knowledge, and support for local disease outbreak response and prevention efforts at the community level

Reduced time to resume public health activities that have been interrupted or slowed due to outbreak response

Improved access to health services by individuals in outbreak affected areas

Increased capacity of countries for early warning, risk reduction and management of national and global health risks

Sustained improvements in timeliness of achieving outbreak/epidemic/pandemic control

Reduced morbidity and mortality attributed to disease outbreaks or other public health threats

Reduced spread of infectious outbreaks into other countries

Improved preparedness for potential future outbreaks and other highly infectious diseases

Components 2, 3 and 4: Rapid Response to Small-Sale and Large-Sale Infectious Disease Outbreaks or other Public Health Emergencies and Emerging Infectious Disease Threats Strategies Short-Term

Intermediate

Long-Term Outcomes

Strengthen capabilities for preparedness and response to highly infectious diseases

Rapid identification of and containment of highly infectious disease outbreaks

i. Purpose The purpose of this NOFO is to strengthen the Caribbean Region’s capacity to prevent, detect, and respond to public health threats. It seeks to build upon previous work in support of the Global Health Security Agenda (GHSA) priorities and compliance with International Health Regulations (IHR 2005). The NOFO seeks to address key public health problems facing the Caribbean Region with a focus on workforce development, laboratory systems, surveillance systems, public health diplomacy, and emergency management and response.

ii. Outcomes Component 1: Core Global Health Security Priorities Strategy 1: Workforce Development Short-Term Outcomes:

Increased number of multidisciplinary trained public health workers supported through intermediate/advanced FETP programs

Increased number of PH staff participating in continuing education courses

Long-Term Outcomes:

Cadre of individuals in each regional country trained by CDC and capable to independently prevent, detect and respond to public health threats

Improved sustainable funding and policies to adopt FETP and CE into national programming and budget

Strategy 2: Laboratory Systems Short-Term Outcomes:

Regional laboratory surveillance protocols and guidelines developed in support of a regional epi/lab surveillance networks

Adoption of regional plan for biosafety and biosecurity

Intermediate Outcomes:

Improved timeliness of detection and control of infectious diseases including HAIs and

AMR.

Improve functional capacity of regional labs.

Strategy 3: Public Health Surveillance Systems Short-Term Outcomes:

Strengthened indicator/case- and event-based surveillance systems Increased number of assessments conducted and countries in which direct TA conducted for ESS

Intermediate Outcomes:

Improved capacity to detect, monitor, and respond to priority pathogens.

Increased number of countries with functioning, multi-disease ESS used for routine reporting

Strategy Area 4: Public Health Diplomacy Short-Term Outcomes:

Increased IHR 2005 compliance among regional countries

Intermediate Outcomes:

Improved performance of countries in the Region as IHR role models, thus providing TA to other countries in region who are not IHR 2005 compliant

Components 2, 3, and 4: Rapid Response to Small Scale Infectious Disease Outbreaks or other Public Health Emergencies and Emerging Infectious Disease Threats (EIDT)

Short-Term Outcomes:

Decreased time to deploy healthcare workers to respond and control the spread of infectious diseases

Strengthened coordination and robust emergency preparedness and response capacities Shortened time to detect highly infectious disease outbreaks through active surveillance and case finding Rapid identification of and containment of highly infectious disease outbreaks

Intermediate Outcomes:

Reduced time to resume public health activities that have been interrupted or slowed due to outbreak response

Increased capacity of countries for early warning, risk reduction and management of national and global health risks

Long-Term Outcomes:

Improved preparedness for potential future outbreaks and other highly infectious diseases

iii. Strategies and Activities

Component 1: Core Global Health Security Priorities Strategy 1: Workforce Development

Conduct FETP training and curriculum development at all levels in coordination with national govts.

Expand continuing education on applied public health (PH) research for public health staff and strengthen existing trained professional networks.

Form partnerships and formulate policies to increase country capacity to support FETP programs

Form partnerships to increase participation in advance level FETP program and ensure sustainability

Conduct assessment to develop plans for regional MOH training plans

Strategy 2: Laboratory Systems

Provide technical assistance to national MOHs to improve laboratory surveillance and capacity to detect priority pathogens

Formulate policies to include detection of AMR and other emerging infections in national labs

Support and strengthen the regional network of public health laboratories to diagnose priority pathogens using standardized protocols with strong biosafety and biosecurity

Develop partnerships with biosafety and biosecurity organizations Create partnerships for national laboratory networks to improve logistics, procurement processes and communication

Strategy 3: Surveillance Systems

Work with MOHs to increase capability to detect and monitor priority pathogens Provide recommendations from surveillance assessments in the region Develop and implement public health electronic surveillance systems (ESS) Create regional partnerships to improve countries capacity to develop and implement public health electronic surveillance systems Develop national action plans for priority areas including: enteric disease, mycotics, acute febrile illnesses and antimicrobial resistance Formulate policies on outbreak response and priority pathogen identification

Priority Area 4: Public Health Diplomacy

Work with countries to support the creation of national public health institutes (NPHIs) in the region

Formulate policies to support the creation of public health institutions in the region Provide technical assistance to countries in the region to implement the International

Health Regulation (IHR 2005) Develop assessment to measure IHR 2005 compliance Create partnerships for countries to conduct GHSA country evaluations

Component 2, 3, and 4: Rapid Response to Small-Scale and Large-Scale Infectious Disease Outbreaks or other Public Health Emergencies and Emerging Infectious Disease Threats

(EIDT)

Strategy 1: Intensify active surveillance, case finding, contact tracing, monitoring, and other critical response efforts at local levels

Conduct and improve ongoing active surveillance, with laboratory confirmation to ensure rapid identification of missed, new or newly imported outbreak cases

Strengthen capacity for general surveillance including support for personnel required for surveillance and epidemiology activities.

Strengthen disease surveillance process at entry points (border posts, airports and maritime ports)

Strategy 2: Strengthen capabilities for epidemiology, laboratory analysis and program evaluation

Improve operational and technical analysis, coordination and monitoring of interventions.

Assess the impact of the epidemic on health care seeking and health care provision.

Strategy 3: Intensify social mobilization, community and professional education and engagement, and psychosocial care for infected persons and their families, where applicable

Conduct intensified social mobilization to enhance awareness and gather support, acceptance, and participation in implementation of containment measures

Develop and conduct communications to contain the outbreaks and enforce the theme of "Staying at Zero Cases."

Develop and disseminate key health risk communication messages.

Strategy 4: Improve outbreak case management and infection control

Disseminate guidance documents on patient management at community and clinical settings.

Improve infection control practices, particularly in facilities that might receive outbreak cases for example, on a border with a country with ongoing transmission

Strategy 5: Strengthen non-outbreak related public health activities that are impacted by the outbreak

Support restoration of priority aspects of the health/public health system such as surveillance and assessment of vaccination coverage for epidemic-prone disease (e.g., measles), that are negatively impacted or stalled due to the outbreak.

Strategy 6: Strengthen capabilities for preparedness and response to highly infectious diseases

Develop/implement partnership mechanisms for a more robust and responsive health emergency workforce.

Train frontline responders on emerging infectious diseases.

Strengthen critical International Health Regulations (IHR) and health systems capacities in affected region.

1. Collaborations

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

Recipient is expected to work with other CDC implementing partners, including non-governmental organizations, universities, Ministries of Health and other host governmental bodies and multi-lateral organizations that receive CDC funds. Recipient(s) should ensure their proposed activities are not duplicating activities already implemented by other CDC-funded organizations.

b. With organizations not funded by CDC:

The recipient will work primarily and directly with partner governments specifically with the Ministries of Health and other government entities who are working towards the objectives of this NOFO. In addition, the recipient(s) will be expected to work with other in-country and global stakeholders, including but not limited to government entities, non-governmental organizations, universities, civil society, the private sector, and other USG agencies.

2. Target Populations The target population for this NOFO include those populations that fall under the following jurisdiction(s): Caribbean Region

The target populations for this NOFO include, but are not limited to, those individuals infected and affected by infectious diseases, or at risk for becoming infected by an infectious disease. The target population for this NOFO may also include at-risk population for non-communicable diseases and/or other public health emergencies.

The work under this NOFO may also target increased capacity at the national and sub-national level to implement activities in alignment with the objectives of this NOFO.

a. Health Disparities Recipients are expected to use epidemiologic, social determinants, and linked laboratory, epidemiological, and surveillance data to identify communities disproportionately affected by infectious diseases or non-communicable diseases in the target areas to ensure that program activities appropriately cover these populations. Recipients should ensure that supported services are accessible and available to all patients regardless of age, sex, race/ethnicity, sexual orientation, gender identity, or socio-economic status in order to achieve the outcomes of this

NOFO.

iv. Funding Strategy This NOFO is divided into four components. Applicants are required to apply for all components and include a separate budget and work plan for each component. The applicant’s application package should be inclusive of all component work plans and budgets; multiple applications will not be reviewed. Applicants are encouraged to submit component budgets toward the year one award ceiling for each component. However, budget proposals for year one may not exceed the year one award ceiling. Please note these amounts are subject to approval and the availability of funds.

Component 1: Core Global Health Security Priorities This is intended to be funded on an annual basis. The estimated year one ceiling for this component is $1,000,000. Future years funding level will be dependent on funding availability.

Component 2: Rapid Response to Small-Scale Infectious Disease Outbreaks or other Public Health Emergencies This is intended to be approved but unfunded (ABU) as a baseline practice. It would be funded to support additional activities needed within a budget period when a disease outbreak or other public health emergency reaches a scale that requires a moderate response. Estimated year one ceiling is $500,000.

Component 3: Rapid Response to Large Scale Infectious Disease Outbreaks or other Public Health Emergencies This is intended to be approved but unfunded (ABU) as a baseline practice. It would be funded to support additional activities needed within a budget period when a disease outbreak or other public health emergency reaches a scale that requires a substantial response. Estimated year one ceiling is $1,000,000.

Component 4: Emerging Infectious Disease Threats (EIDT) This is intended to be an approved but unfunded (ABU) component that will support activities to combat COVID-19 and other emerging infectious disease threats globally, including efforts related to global health security, global disease detection and response, global health protection, global immunization, and global coordination on public health. It would be funded to support additional activities needed within a budget period for COVID-19 and other emerging disease threats. Estimated year one funding amount is $3,000,000.

Emergency Management and Response The ability to respond rapidly and effectively to public health emergencies is a key component of global health security. International public health emergencies including humanitarian crises are by nature unpredictable, requiring fulfilment of changing and often unpredictable needs that vary widely according to context. Consequently, funding for public health emergencies is also unpredictable and based on external factors. In recent years, there has been a sharp rise in the number of people living in regions of the world affected by public health emergencies, including humanitarian emergencies, which has often led to additional funding resources from the USG to respond to these threats. Given this unpredictability and the resulting need for rapid, flexible, and efficient process to award funding under an emergency situation, recipients that are selected for funding under this NOFO will be eligible to receive additional expedited supplemental funding when a public health emergency occurs to scale up activities included within the scope of work of this NOFO.

Definition of public health emergency:

In order to qualify for supplemental emergency funding, one of the following situations must apply:

1. When UN or WHO classifies the emergency as a Level 3 (L3)

2. When the US Congress appropriates funding for an international response related to humanitarian or public health crisis with the words containing “emergency” in the program title. The appropriated funding could be for CDC directly or is transferred to CDC through an Interagency Agreement (IAA) by HHS or another USG Department or Agency

3. When the US government (Congress, White House, National Security Council, etc.)

declares a public health emergency as national security priority

4. When the CDC Director activates the Emergency Operation Center (EOC) in response to an international public health threat

5. When the U.S. Department of State or the U.S. Agency for International Development (USAID) transfer funds to CDC to respond to an international disaster or humanitarian assistance under 2 FAM 060 (International Disaster and Humanitarian Assistance)

If a public health emergency situation meets any one criteria listed above, then selected recipients under this NOFO will be eligible to receive supplemental emergency funding to scale up public health activities included in the scope of work of this NOFO on a single-source basis (i.e. without additional competition) within a 12-month budget period and throughout the 60-month period of performance. There is no limit on the number of emergency supplemental funding that a recipient may receive within a 12-month budget period or the 60-month period of performance under a public health emergency situation. Recipients receiving funds under a public health emergency will be eligible to receive emergency funding without constraint to the period of performance funding ceiling, annual budget period ceiling, or lack of component funding. In addition, applications for funding under a public health emergency will not need a merit review and will only require approval from the CDC Project Officer and Grants Management Officer (GMO) in order to be funded.

All reporting requirements listed under this NOFO still applies to any emergency supplemental funding

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy The applicant should describe how they plan to measure and collect data on the funded activities and bolded outcomes identified in the logic model. The purpose of collecting and reporting these data is to determine the progress toward achieving the NOFO activities and outcomes. The results will also be used for program planning, development and improvement, accountability and reporting, and for sharing with partners and other stakeholders. CDC will work with the recipient throughout the life of this award to ensure that all activities and expected outcomes are in alignment with current USG and the recipient’s strategies and goals. The recipient should dedicate funds made available under this NOFO for evaluation and performance monitoring within each project. The final funding amount will be agreed upon by both CDC and the recipient; however, it should be expected that approximately 3% (of a given project’s funding) will be dedicated to monitoring, reporting, and evaluation activities. CDC and the recipient will agree upon the specific funding amounts within review of each project’s work plan and budget.

Monitoring CDC expects that the work conducted under this NOFO will be structured as a series of discrete projects oriented at achieving elements of the NOFO’s strategic objectives. CDC and the recipient will jointly develop formal performance measures shortly after award based on activities within each project. For each project, these performance measures must include CDC’s Division of Global Health Protection’s Division-wide Indicators (DWIs), as well as other CDC or recipient’s standard indicators relevant to the intended outcomes of the project.

The DWIs include indicators that are required reporting for CDC, such as for OMB, HHS, USG Global Health Security Agenda (GHSA) interagency, and Healthy People. At a minimum, applicants should describe proposed process measures for the strategies and activities in the logic model, and proposed outcome measures for the period of performance outcomes in the logic model.

While recipients will be responsible for reporting on DWIs relevant to proposed strategies and activities, they are not limited to only DWIs listed below. Applicants can, and are encouraged to, propose additional relevant indicators that, combined with relevant DWIs, will be monitored over the life of the NOFO. Recipients will also be encouraged to identify relevant USG GHSA Interagency Metrics, WHO Joint External Evaluation (JEE), and/or Healthy People 2030 standardized metrics and WHO benchmarks.

Technical Area Division of Global Health Protection (DGHP) Division-wide Indicators (DWIs) as of April 2019* WD#1: Number of individuals trained by CDC to prevent, detect and respond to public health threats

WD#2: Number of Field Epidemiology Training Program (FETP) residents trained by CDC that have participated in outbreak investigations and responses WD#3: Number and proportion of subnational jurisdictions per country that have had at least one staff member trained by FETP- Frontline

Workforce Development

(WD)

WD#4: Number of CDC staff ready to provide emergency management and response assistance EMR#1: Number of public health events of international importance monitored and reported

EMR#2: Number of public health events and other global health emergency responses supported by CDC EMR#3: Number of outbreaks investigated and responded to by the country

Emergency Management and Response

(EMR)

EMR#4: Number and proportion of countries with an established Public Health Emergency Operations Center (PHEOC) that have used their PHEOC for a real-world response or simulation

Surveillance Systems (SS) and Laboratory Systems (LS)

SS/LS#1: Number and proportion of country-prioritized diseases and pathogens with laboratory testing capacity, surveillance system, and routine reporting to public health authorities

SS#2: Number and proportion of countries with a centralized national database that includes linked suspect case reports and laboratory data from subnational jurisdictions for the country’s priority notifiable diseases/syndromes LS#2: Number and proportion of designated laboratories that have bio-risk management policies, physical security controls and inventories for potential high consequence pathogens and toxins LS#3: Number of new diagnostic tests established in national or regional laboratories with CDC support LS#4: Number of new strains or pathogens detected or discovered with CDC support LS#5: Number and proportion of countries that have developed a national laboratory specimen referral system and transport networks LS#6: Number and proportion of laboratory facilities, designated in the national action plan for antimicrobial resistance (AMR) or as part of a national surveillance system, that conduct antimicrobial susceptibility testing (AST) and have reported susceptibility data to a designated national body LS #7: Number and proportion of countries that have adopted and implemented a national program of quality management systems

(QMS)

ID#1: Number of countries with a National Public Health Institute (NPHI) that was strengthened with CDC support

Institutional Development (ID) ID#2: Number of countries whose core public health functions

(laboratory, surveillance, workforce development and emergency management and response) are coordinated by the NPHI

* These indicators are subject to change; the latest iteration of the DGHP DWIs should be incorporated into the recipient’s EPMP.

Performance reports will be based on which NOFO activities and outcomes are identified in the logic model. Performance reports will be submitted to CDC in accordance with the requirements listed under this NOFO and overall performance will be reviewed on regular technical calls as well as through joint strategic review meetings.

Evaluation The potential evaluation questions and/or topics below are examples of what the applicant may be expected to answer through evaluation(s). Applicants should include at least 1, but no more than 3 potential evaluation questions, or evaluation topics if specific questions are unknown. It is acceptable to provide only evaluation questions, only evaluation topics, or a combination of both evaluation questions and topic, as needed. Applicants should consider but are not limited to the following areas when developing evaluation questions and/or topics.

Sample Evaluation Topics:

Program evaluations to measure the differences in outbreak responses, or other public health responses, in a country, before and after public health investments (in terms of days of outbreak start, days to outbreak detection, laboratory confirmation of outbreak, days to control outbreak, etc.).

Extent to which enhancements in public health surveillance in a country improved outbreak response (in terms of outbreak(s) controlled, cases averted, and time lags from specimen detection to collection).

Extent to which enhancements of the public laboratory systems, such as addition of a specific laboratory capacity in a country, improved outbreak response (in terms of outbreaks detected controlled, cases averted, and time lags from specimen collection to detection).

Program evaluations to measure if the coverage and capacity of the specimen referral network increased

Final evaluation questions and data sources will be determined together with CDC within six months after the award and will be included in the submission of the evaluation and performance measurement plan (EPMP). Evaluations are expected to align with national, USG, and agency priorities and programmatic gaps, and maybe be reviewed by global action committees. As such, the evaluation topics listed in this announcement may be amended.

Dissemination of Evaluation and Performance Measures: By the end of the period of performance, evaluation and performance measures will yield findings to demonstrate the value of the NOFO. The findings should be disseminated through the Annual Performance Report (APR) and the recipient is expected to pursue additional dissemination in public domains, including in public health journals, including global health journals, conferences and through informal channels (e.g., website, newsletters) where applicable.

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How the applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

Plans for updating the Data Management Plan (DMP) as new pertinent information becomes available. If applicable, throughout the lifecycle of the project. Updates to DMP should be provided in annual progress reports. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data;

data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, the applicant should be directed to:

Describe the type of evaluations (i.e., process, outcome, or both).

Describe key evaluation questions to be addressed by these evaluations.

Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, if applicable, within the first 6 months of award, as described in the Reporting Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach The applicant should succinctly describe their capacity (skills, expertise, experience) to implement the activities proposed under this NOFO. For components 5, 6 and 7, the applicant should detail their ability to carry out emergency operations/coordination. Applicants are encouraged to describe their experience working with the target population, ability to implement project strategies/activities, and their physical infrastructure as it applies to the NOFO.

The applicant should provide as part of their appendix the following documents:

1. Curricula vitae (CVs)/Resumes for positions related to Principal Investigator, Project Director, Business Official, and other key staff related to program planning and implementation, finance, and monitoring and evaluation.

2. Job descriptions (maximum 1 page per job description) for key positions including:

Principal Investigator, Project Director, Business Official, and other key staff related to program planning and implementation, finance, and monitoring and evaluation.

3. Organizational chart (maximum 1 page)

4. Financial management statement that demonstrates experience in managing USG or CDC funds that are similar in size and scope of this NOFO (maximum 1 page).

The above referenced documents to be submitted in the appendix should demonstrate the organization's capacity to address the requirements of the NOFO.

Applicants must title these documents in their appendix as follows: "CVs/Resumes," "Job Descriptions," "Organizational Chart," and "Financial Statement" and upload as a pdf at www.grants.gov.

d. Work Plan The applicant’s application package should be inclusive of all component work plans and budgets; multiple applications will not be reviewed. Each component must have a separate work plan and budget.

Applicant must include a work plan that demonstrates how the outcomes, strategies, activities, timelines, and staffing will take place over the course of the award. Applicants must submit a detailed work plan for the first year of the project, and a high-level work plan https://www.cdc.gov/grants/additionalrequirements/ar-25.html for subsequent years. An example work plan is shown below. Applicants are not required to use this format, as long as the information above is demonstrated.

This NOFO has a required component funding structure. Applicants are required to apply for all components and include a separate budget and work plan for each component

Period of Performance Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities

Process Measure [from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

1.

2.

3.

4.

5.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

Tracking recipient progress in achieving the desired outcomes.

Ensuring the adequacy of recipient systems that underlie and generate data reports.

Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

The recipient(s) will be required to collaborate with CDC in-country offices for technical oversight of project activities to be implemented under this NOFO. For countries where there is no in-country CDC office, the recipient will be required to work with CDC headquarters (HQ) for technical oversight of project activities to be implemented under this NOFO. In addition to the CDC Project Officer, the recipient will collaborate with in-country or HQ contacts, Subject Matter Experts (SMEs), and technical leads. The Project Officer for this award will provide relevant contacts of CDC staff and coordinate discussions with the award recipients.

f. CDC Program Support to Recipients

In a cooperative agreement, CDC staff is substantially involved in the program activities, above and beyond routine grant monitoring. CDC activities for this program include, but are not limited to, the following:

1. Organize an orientation meeting with the recipient for a briefing on applicable U.S.

Government and HHS/CDC expectations, regulations and key management requirements, as well as report formats and contents. The orientation could include meetings with staff from HHS agencies and/or other parts of the USG.

2. Review and make recommendations as necessary to the process used by the recipient to select key personnel and/or post-award subcontractors and/or sub recipients to be involved in the activities performed under this agreement.

3. Provide technical assistance, as mutually agreed upon, and revise annually during validation of the first and subsequent annual work plans. This could include expert technical assistance and targeted training activities in specialized areas, such as surveillance, use of data for program planning purposes, lab programs etc.

4. Provide technical assistance, where applicable, to help the recipient meet U.S.

Government financial and reporting requirements approved by the Office of Management and Budget (OMB).

5. Collaborate with the recipient on designing and implementing the activities listed above, including, but not limited to: the provision of technical assistance to develop program activities, data management and analysis, quality assurance, surveillance program, the presentation and possibly publication of program results and findings, and the management and tracking of finances.

6. CDC offices in-country, where applicable, may assist the recipient in identifying and connecting with other partners working towards the objective of this NOFO and the recipient shall ensure work is not duplicative but complementary and supportive to existing efforts funded by CDC and the rest of the USG.

7. CDC, via project officer, will provide contact for in-country staff, Subject Matter Experts (SMEs) and technical leads from CDC where applicable for the recipient to coordinate activities at the country level.

8. Provide technical assistance or advice on any data collections on 10 or more people that are planned or conducted by the recipient. All such data collections-- where CDC staff will be or are approving, directing, conducting, managing, or owning data-- must undergo OMB project determinations by CDC and may require OMB PRA clearance prior to the start of the project.

9. Provide consultation and scientific and technical assistance based on appropriate HHS/CDC documents to promote the use of best practices known at the time.

10. Assist the recipient in developing and implementing quality-assurance criteria and procedures.

11. Serve as co-authors on manuscripts and dissemination products developed as part of this project.

12. Facilitate in-country planning and review meetings for technical assistance activities.

13. Provide technical oversight for all activities under this award.

14. Ensure the recipient’s Evaluation and Performance Measurement Plan is aligned with the strategic information guidance established by HHS/CDC and USG.

15. Provide ethical reviews, as necessary, for evaluation activities, including from

HHS/CDC headquarters. Evaluations can be process, outcome or impact

a. Process Evaluation: measures how the intervention was delivered, what worked/did not, differences between the intended population and the population served, and access to the intervention

b. Outcome Evaluation: determines effects of intervention in target population(s) (e.g., change in knowledge, attitudes, behavior, capacity, etc.)

c. Impact Evaluation: measures net effects of program and prove of causality

16. Supply the recipient with protocols for related evaluations and/or assessment.

B. Award Information

1. Funding Instrument Type:

CA (Cooperative Agreement) CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism:

U2G

3. Fiscal Year:

4. Approximate Total Fiscal Year Funding:

$ 1,000,000

5. Total Period of Performance Funding:

$ 5,000,000 This amount is subject to the availability of funds.

Estimated Total Funding:

$ 5,000,000

6. Total Period of Performance Length:

year(s)

7. Expected Number of Awards:

8. Approximate Average Award:

$ 1,000,000 Per Budget Period

9. Award Ceiling:

$ 0 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor:

$ 0 Per Budget Period

11. Estimated Award Date:

September 30, 2021

12. Budget Period Length:

12 month(s)

Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government. The total number of years for which federal support has been approved (project period) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period.