LON APS Addendum 07 - C-GET Vietnam.pdf

U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT

ANNOUNCEMENT

CALL FOR CONCEPT PAPERS

USAID CLOSING GAPS TO END TB (C-GET) IN VIETNAM

Addendum No. 07

Under Existing

TB LOCAL ORGANIZATIONS NETWORK (LON) ANNUAL PROGRAM STATEMENT

APS No.: 7200AA19APS00001

ISSUANCE DATE: January 6, 2023

CLOSING DATE OF QUESTIONS: January 20, 2023 (COB Hanoi time)

CLOSING DATE OF CONCEPT PAPERS: February 6, 2023 (COB Hanoi time)

PLEASE NOTE: This is an Addendum to an existing announcement. All interested organizations should carefully review both this addendum AND the full announcement, which can be found here:

Important information contained in the full umbrella APS is not repeated in this specific

Addendum.

This program is authorized in accordance with Part 1 of the Foreign Assistance Act of 1961, as amended.

Through this Addendum to the TB Local Organizations Network (LON) Annual Program Statement

(APS) No. 7200AA19APS00001, the U.S. Agency for International Development (USAID) seeks to capitalize on the expertise, ingenuity, and passion of local organizations working in Vietnam on supporting the Government of Vietnam (GVN) to improve tuberculosis (TB) service quality and accessibility outside of the normal National Tuberculosis Program (NTP) public network at the community and in the private sector.

Subject to the availability of funding, USAID/ Vietnam anticipates supporting one (1) Cooperative Agreement with a total estimated ceiling up to $8,000,000, for up to a five-year period of performance, subject to pending approvals. However, actual funding amounts are subject to availability of funds.

Publishing this Addendum does not commit USAID to make any awards. USAID also reserves the right not to create a co-creation process and request full application from the applicants successful at concept paper stage. Unless otherwise stated herein, all terms and conditions of the LON APS apply.

https://www.grants.gov/web/grants/search-grants.html?keywords=Local%20organizations%20network

I. Problem Statement and country context

Problem statement:

Current TB interventions in Vietnam have been focusing on developing the Vietnam National

Tuberculosis Program (NTP)-public system, leaving services provided by non-NTP facilities, such as at the community level and in the private sector inadequately resourced.

- At the community level: The NTP approach to TB control is largely facility-based and clinically focused. And there is no formal cadre of community-level health workers dedicated to TB efforts

(detection, facility-linkage, close-to-client case management, prevention). The Active Case Finding (ACF) is mainly done through campaigns supported by Development Partner-funded projects. A differentiated and client-focused approach is necessary to increase detection of TB cases (especially household contacts screening), improve treatment management and support, and strengthen the patient referral.

- In the private sector (e.g., non-NTP health facilities, private hospitals, clinics, and pharmacies): Though 10-30 percent of total TB cases are detected and/or treated by the private sector, the availability and reliable quality of data reporting (TB notification, treatment adherence/completion, implementation of national guidelines, etc.) are limited. There is no incentive for the private sector to conduct ACF, patient referral and treatment monitoring. A private sector engagement and collaboration framework is critical to improving quality of care, and disease surveillance and reporting.

To achieve the Government of Vietnam (GVN)’s ambitious goal of ending TB by 2030 in Vietnam, the

NTP and its partners need to address the critical gaps described above. USAID, through this USAID

Closing Gaps to End TB (C-GET) Activity, will support the GVN to improve TB services quality and accessibility outside of the normal NTP public network. With other USAID activities supporting the NTP public network, this Activity will help the GVN to achieve the goal of ending TB. The Activity will focus on (1) delivering community-based services for TB detection, treatment, and prevention; and 2) improving TB services provided by the private health facilities.

Country context:

TB epidemiology: TB is one of the deadliest infectious diseases in Vietnam and the country is classified by the WHO as one of the 30 countries with the highest burden of TB in the world. The estimated incidence of TB in 2020 in Vietnam, documented in the WHO Global Tuberculosis Report 2021, was

172,000 new TB cases (176 per 100,000 people) annually. This burden is not equally shared across provinces, with southern provinces reporting the highest burdens of the disease. However, only about 100,000 TB cases are notified each year, leaving a gap of more than 70,000 estimated undetected and untreated cases annually. The country reports about 90 percent treatment success rate for uncomplicated, drug-susceptible tuberculosis, and about 70 percent treatment success rate for drug-resistant cases.

Drug-resistant TB is an emerging threat. The WHO estimates there were 8,400 cases of drug resistant TB (DR-TB) in 2019, yet Vietnam only diagnosed and managed 3,714 DR-TB cases within the NTP public network of services in 2020, suggesting that most DR-TB cases remain undetected, untreated, and unreported. This gap highlights the urgency of addressing the current rising DR-TB case rates in Vietnam and the need to improve DR-TB diagnosis and treatment.

Latent TB infection (LTBI): The current estimates indicate about 30 percent of the country’s population have LTBI. In March 2020, the Vietnam Ministry of Health (MOH) approved national guidelines on LTBI detection, treatment, and reporting. Despite significant efforts to expand contact investigation and

LTBI detection in 2021, LTBI treatment has only been provided to about 21,521 people with latent TB infection identified, including people living with HIV (PLHIV) and only 5 percent of children (aged < 5 years) of household contacts of bacteriologically confirmed cases. The achievements on LTBI detection and treatment are mainly from the community ACF interventions, while the contribution from the private sector remains suboptimal.

Community TB services: The commune level consists of a public health care network with village health collaborators, augmented by generalist health providers (doctors, doctor assistants and nurses), often with basic levels of technical training and limited support. These staff are implementers for all national health programs at the community level, including the TB program - with main tasks focused on patient registration, TB counseling and education, TB drug delivery, treatment support and monitoring. TB contact investigation, treatment support and other TB-related activities are rarely undertaken by the public health care network and health collaborators. In addition, the commune health system faces many difficulties in high staff turnover rates, low provider motivation, and inadequate in-service training opportunities for health workers. These are critical challenges for better TB service delivery in the community. USAID has been supporting the NTP to strengthen the commune-level TB service delivery through capacity building of the public network. However, this ongoing effort needs to be complemented with additional investments to further extend the reach of TB services by enabling other non-health professionals and groups to provide TB finding, linkage, and treatment support services.

Private Sector TB services: The private sector represents a significant proportion of provided health services in Vietnam. While precise data are not available, it is estimated that between 10-30 percent of total TB cases are handled by the private sector (Vietnam NTP Epidemiological Review, 2019). The

NTP has implemented five models of Private and Public Mix (PPM) to facilitate collaboration between the public and private sector in providing different services to presumptive or confirmed TB patients.

Although these guidelines are in place, there has been limited public-private coordination and collaboration. The data for monitoring quality of care in the private sector (TB treatment adherence and completion, compliance with national clinical guidelines for TB) is not reported consistently. Moreover, private sector facilities do not conduct ACF as it is not profitable, and the NTP is unable to conduct household contact investigation for private sector notifications due to the unavailability of individual patient data from private facilities. A private sector engagement and collaboration framework is crucial to improving quality of care, disease notification and reporting, and prevention.

Local Organization Network Mechanism: The Tuberculosis Local Organizations Network (LON) is a key component of the USAID Global Accelerator to End Tuberculosis. LON focuses on locally generated solutions that tailor USAID’s TB response to patients and communities to meet their diagnosis, treatment, and prevention needs, while addressing stigma and discrimination. It engages and leverages civil society, private sector, communities, and faith-based stakeholders by partnering directly with local entities within TB priority countries to provide accessible services, resulting in increased diagnosis and treatment success rates. Since 2020, USAID/Vietnam has supported a 3-year TB LON

Activity in Vietnam - named USAID Erase TB activity - to address gaps in the existing NTP system.

This activity (1) improves early TB case detection from active case finding in the community and links those who are diagnosed with TB to the NTP appropriate care network; (2) increases service quality and reporting from private sector providers by engaging with private doctors, clinics, hospitals, and pharmacies to facilitate TB screening, collecting TB treatment reports from these providers, verifying them, and sending the results to the NTP to be incorporated into its surveillance system; and (3) reduces the social and financial burden on TB households by educating patient households about TB and providing them with counseling, treatment support and/or financial assistance to cover travel expenses, enabling TB patients to successfully complete their treatment. This activity has delivered promising results and is considered a successful model. By March 2022, about 2,000 private providers (e.g., private hospitals, private clinics, and pharmacies) were engaged; 5,000 TB cases were detected with 100 percent of them linked to treatment; and more than 750 patients were provided with social support. It is critical to continue supporting the NTP to develop and deliver a comprehensive package of TB services at the community level as well as building capacity for the private sector to improve their compliance with the NTP guidelines on TB treatment and reporting.

II. Purpose

In publishing this Addendum, USAID is seeking Concept Papers from eligible local organizations in

Vietnam proposing to address the challenges described in section I above. Information provided in the

Concept Paper should address the objectives and Activity description presented in this section.

A. ACTIVITY GOAL AND OBJECTIVES

Goal: Improve TB services quality and accessibility along the continuum of care at the community and in the private sector.

Objectives: The Activity will meet the following high-level objectives:

1. Objective 1: Develop/Deliver/Implement a comprehensive package for community-based services for

TB detection, treatment, and prevention.

2. Objective 2: Improve TB services provided by the private sector.

The Activity must focus efforts on strengthening private sector and community capacity and linkages to

NTP network to improve TB case notification, high quality TB detection, treatment, and prevention services. The Activity is also to have interventions addressing TB stigma and discrimination and ensuring gender equity in TB services accessibility. These efforts will enable the Activity to contribute to the

Vietnam strategic plan to end TB by 2030.

B. ACTIVITY COMPONENTS

USAID seeks to fund an Activity that addresses the two components/objectives. Detailed interventions under this activity will be collaboratively determined by USAID and the Recipient through annual work plans that coordinate interventions, prevent duplication of effort, and ensure that the interventions are complementary to other ongoing TB activities, both internal and external to USAID/Vietnam.

The Activity will support the advancement of the GVN’s TB targets by scaling and strengthening existing or new models for client-focused high-quality care and improved TB case notification, reporting, treatment, and prevention at the community level and in the private sector.

1. Component 1 - Develop/Deliver and implement a comprehensive package for community-based services for TB detection, treatment, and prevention.

Client-focused prevention (including LTBI interventions) and care at community level have the potential to decrease the treatment burden on patients, avoiding time-consuming and expensive health facility visits, ultimately supporting better health outcomes. This activity must focus on scaling up the existing and/or developing community-based TB intervention models(s) to deliver a comprehensive package of TB detection, treatment, and prevention to reach more people at the community level.

Component 1 implementation must focus on:

● IR1.1: Increase TB case finding in the community: The Activity will implement TB case finding efforts with emphasis on expanding and improving TB contact investigation and screening, and LTBI identification. The Activity is encouraged to have initiatives that improve the effectiveness of both routine and ad-hoc TB screening in the community.

● IR1.2: Improve TB case management services in the community: The Activity will initiate

TB case management models with the active involvement of community groups and individuals with clear roles and responsibilities in improving treatment initiation and adherence.

● IR1.3: Build-up and enhance the involvement of community groups in TB response: The Activity will develop different strategies to improve the involvement of various community groups in implementation of the community-based TB activities. Community participation in TB planning and execution is expected. USAID requires the Activity to develop new approaches and initiatives for community-based TB support groups.

Expected results under this Component 1 may include:

- At least 60% of household contacts of TB patients screened for active or latent TB

- At least 95% of TB detected cases (both DS-TB and DR-TB) are linked to treatment

- At least 70% LTBI detected cases are linked to TPT services

- At least 90% of TB cases are managed by the community agents

2. Component 2 - Improve TB services provided by the private sector.

USAID/Vietnam TB activities have supported the Vietnam health system to improve referral and notification among under-reported TB patients through engagement of private healthcare providers outside of the NTP routine TB care and prevention network. However, the data provided for case notifications is insufficient for effective close contact investigation. Additionally, data suggests that there is a limitation to monitor the quality-of-care in the private sector. The Activity is encouraged to provide technical support to the NTP to update policies and legal frameworks or to develop new PPM model(s) that will better enable private facilities to notify cases and to comply with the national guideline of TB treatment. USAID requires the Activity to propose new approaches and initiatives for maximizing collaboration and contribution from the private sector to increase TB prevention, notification, treatment initiation, follow-up, and reporting.

Component 2 implementation must focus on:

● IR2.1: Improve the private sector’s compliance with the NTP guidelines on TB treatment and reporting: The Activity will support the private facilities to ensure their compliance with

NTP guidelines on TB detection and treatment. The Activity must identify and implement innovative approaches to facilitate private health facilities providing quality TB services.

Additionally, the Activity will support the improvement of data reporting by private providers to the NTP. The notifications must be at the level of individual patient information, allowing for diagnosis and treatment monitoring/analysis, and informing community response as appropriate.

● IR2.2: Develop, implement, and evaluate new models to increase TB case detection, treatment, and prevention in the private sector: The Activity must create, implement, and evaluate new flexible models that enable private facilities to provide public health services, including TB contact investigation and LTBI identification and link them to the treatment and prevention services. TB screening for close contacts of TB patients receiving services at private facilities must be emphasized and set forth as a strategy to increase TB case detection and treatment, and LTBI identification.

Expected results for this Component 2 may include:

- Increased case notification from private health care facilities, and from public non-NTP health care facilities

- Increased % of close contacts of TB patients treated at the private facilities screened for TB

- Increased TB treatment success rate from private facilities

The awardee can propose other illustrative or additional results if they are appropriate. Concrete indicators and targets will be determined after co-creation in consultation with NTP and the awardee.

C. GEOGRAPHIC COVERAGE

The Activity will focus on high-density urban areas in 5 provinces with a high TB burden. The target populations will include existing TB patients, their households, and social contacts; and surrounding vulnerable communities. Priority provinces include 5 provinces (Hanoi, Ho Chi Minh, and 3 other high TB burden provinces which will be determined in consultation with the NTP, relevant stakeholders and

USAID after the award).

III. Eligibility

Local non-governmental entities in Vietnam are eligible to submit a concept paper in response to this Addendum. USAID welcomes concept papers/applications from organizations which have not previously received financial assistance from USAID.

Only local organizations as defined below are eligible for award. USAID defines a “local entity” as an individual, a corporation, a nonprofit organization, or another body of persons that:

(1) Is legally organized under the laws of; and

(2) Has as its principal place of business or operations in; and

(3) Is majority owned by individuals who are citizens or lawful permanent residents of; and

(4) Is managed by a governing body, the majority of who are citizens or lawful permanent residents of the country receiving assistance.

For purposes of this section, ‘majority owned’ and ‘managed by’ include, without limitation, beneficiary interests and the power, either directly or indirectly, whether exercised or exercisable, to control the election, appointment, or tenure of the organization’s managers or a majority of the organization’s governing body by any means.

The recipients must be responsible entities and must have the necessary organizational experience, accounting, operational controls and technical skills, or ability to obtain them in order to achieve the objectives of the project and comply with the terms and conditions of the award.

Concept papers from organizations that do not meet the above eligibility criteria will not be reviewed and evaluated. Individuals are not eligible to apply for this APS.

USAID strongly encourages concept papers from potential new partners to the US government who meet the above eligibility requirements. Such organizations are advised that they will be required to undergo a Pre-Award Responsibility Determination - a pre-award survey to determine fiscal responsibility (i.e., whether the prospective recipient has the necessary organization, experience, accounting and operational controls, and technical skills – or ability to obtain them – in order to achieve the objectives of the project and comply with the terms and conditions of the award).

While for-profit firms may participate, pursuant to 2 CFR 200.400(g) it is USAID policy not to award profit to prime recipients and subrecipients under assistance instruments. However, while profit is not allowed for sub-awards, the prohibition does not apply when the recipient acquires goods and services in accordance with 2 CFR 200.317 -326, “Procurement Standards.” This is discussed more specifically in

ADS 303sai “Profit Under USAID Assistance Instruments” which can be found at this link:

https://www.usaid.gov/sites/default/files/2022-05/303sai.pdf

IV. Additional Considerations

A. Prior to submitting a Concept Paper, applicants should ensure that submissions are in line with the

USAID’s Global Tuberculosis (TB) Strategy 2023-2030. Successful Concept Papers will also align closely with the broader priorities of USAID.

B. USAID is especially interested in promoting new partnerships or projects, as well as existing partnerships that have not been funded by USAID previously.

C. There is no cost share requirement for this Activity.

D. Substantial Involvement: Consistent with ADS 303.3.11, USAID/Vietnam anticipates a close working partnership with the successful Applicant for this activity to assist in achieving the objectives. The specific areas of USAID involvement will include, but are not limited to:

1. Approval of the Recipient’s Annual Implementation Plans by the designated Agreement Officer

Representative (AOR).

2. Approval of specified Key Personnel: Key Personnel positions will be identified and stated in the award.

3. Agency and Recipient Collaboration or Joint Participation: The Recipient must request prior written concurrence from the AOR and obtain approval from the AO before entering into any sub-awards under the performance of this agreement; and

4. Approval of the Recipient’s Monitoring, Evaluation and Learning (MEL) Plan by the AOR

E. The resulting award from this Addendum to the TB LON APS will be administered in accordance with ADS 303mab, Standard Provisions for Non-U.S. Nongovernmental organizations

(http://www.usaid.gov/ads/policy/300/303mab ).

V. Application and Review Process

USAID/Vietnam is responsible for the review process and management of any awards issued under this Addendum.

https://www.usaid.gov/sites/default/files/2022-05/303sai.pdf https://www.usaid.gov/global-health/health-areas/tuberculosis/resources/publications/usaid-global-tuberculosis-strategy-2023-2030 https://www.usaid.gov/global-health/health-areas/tuberculosis/resources/publications/usaid-global-tuberculosis-strategy-2023-2030 https://www.usaid.gov/global-health/health-areas/tuberculosis/resources/publications/usaid-global-tuberculosis-strategy-2023-2030

Concept Papers, Full Applications, and management of any awards issued under this Addendum will be managed in accordance with the process described in the umbrella LON APS announcement. Information provided in the Concept Paper Template described in the umbrella LON announcement should address the objectives and criteria presented herein.

1. Concept Paper Application Content and Template

The Concept Paper must be specific, complete, presented concisely and written in English. The Concept

Paper must demonstrate the Applicant’s capabilities and expertise with respect to achieving the objectives.

Based on the activities proposed by the Applicant, the proposed award size and duration must be specified in the Concept Paper. Proposed award duration can be up to 5 years.

2. POC and Submission Information

All Concept Papers must be submitted by the closing date listed on page 1 of this Addendum.

Submissions received after the specified closing date will not be eligible for review.

Excluding the cover page described below, the Concept Paper must not exceed five (5) pages, using

Times New Roman 12-point font, on standard 8.5” x 11” sized paper, and single spaced with no less than one-inch margins and pages numbered consecutively. 10 - point font can be used for graphs and charts.

Any pages submitted beyond the five-page limit will not be evaluated.

Additional documentation, such as annexes, charts and graphs that exceed the five pages will not be reviewed. USAID will not review any information provided in links in the Concept Paper.

The Concept Paper must be submitted in PDF format.

Concept paper e-mail submissions must include the APS number, Addendum Title: USAID

Closing Gaps to End TB (C-GET) In Vietnam, and applicant’s name in the subject line.

Concept Papers must be submitted by email to the following Agency Point of Contact:

Mr. Patrick Kollars Ms. Hoa Nguyen Agreement Officer Acquisition & Assistance Specialist USAID/Vietnam USAID/Vietnam Email: pkollars@usaid.gov Email: hoanguyen@usaid.gov with copy to LON@usaid.gov.

3. USAID TB LON Concept Paper Template

A. Cover Page – to the extent possible or applicable, please complete the following questions below:

[Note that #1-10 shall be submitted as a cover page, not included in the five-page limit for the Concept

Paper.]

1. Proposed Activity Name/Title: __________________________________________

2. USAID Funding Priority/Strategic Objective/Intermediate Result :

3. Proposed Period of Performance (i.e., start date and end date): ________________

4. Overall Estimate of Funding Requested (in USDs, no less than $1 million, not more than $8 million): ____________________

5. Applicant Organization Name: __________________________________________

6. Applicant Contact Person (name, title, phone, email): ________________________

7. Full Address for Applicant Organization: _________________________________

8. Type of Organization (e.g., non-US, multilateral, private, for-profit, non-profit) date of incorporation, etc.): ____________________________________________________

9. Name(s) of Partner(s) (Applicants that are Implementing Partners will name Resource Partner(s) (if any) here): __________________________________________

10. Country of performance: _________________________________

11. Unique Entity Identifier from System for Award Management (SAM): ___________

Note: USAID may not award to an applicant unless the applicant has complied with all applicable requirements in www.sam.gov to get the Unique Entity Identifier from System for Award Management (SAM). The applicant is required to:

1. Provide a Unique Entity ID for the applicant.

2. Be active in www.sam.gov before the award.

The registration process may take many weeks to complete. If your organization does not have a Unique Entity ID or is not registered in SAM when submitting a concept paper, the applicants are encouraged to begin the process early. If an applicant has not fully complied with the requirements above by the time USAID is ready to make an award, USAID may determine that the applicant is not qualified to receive an award and use that determination as a basis for making an award to another applicant.

B. Concept Introduction: (approximately ½ page) Identify the TB problem you will address, linking it to one or more of the USAID Intermediate Results in Section B, and briefly describe your intervention for tackling this problem. Describe why there is a strategic need for your concept, how it differs from alternatives and any relevant gender specific considerations for the problem or solution.

C. Beneficiaries: (approximately ½ page) Describe the types of benefits the intervention will produce and the types and range of people who will benefit from this intervention. Was the concept designed with end user input? Has it or can it be adapted to reach both women and men? How can the concept be scaled up to reach more people?

http://www.sam.gov/ http://www.sam.gov/

D. Geographic Location: (approximately ½ page) In what location(s) (e.g., province, district, city) are you proposing to operate under this proposed partnership? Describe key elements of and actors in the value chain or intervention in the geographic location(s) in which you propose to work. What are the biggest challenges and opportunities?

E. Intervention approach: (approximately 1½ pages) Building on the introduction, propose a Theory of Change for how this intervention will produce the desired impact in the focus area(s) identified. Briefly describe critical barrier(s) or problem(s), related to the focus area(s) that your concept addresses. Be sure to include information describing why the approach is creative or innovative, how it is potentially scalable, and evidence to support it as a tested solution or as an intervention likely to have a significant development impact, and how it will be sustained. The analysis should consider population demographics, disease burden, geography, and present a reasonable theory of change. The concept paper should demonstrate current knowledge of the primary challenges related to TB implementation within the relevant context, and a strong understanding of the opportunities for and barriers to achieving the project purpose.

F. Intervention results: (approximately 1 page) As specifically as possible, describe the anticipated outputs, outcomes, results and/or impact of the proposed intervention. What are the key, quantifiable metrics related to your project’s performance or expected performance? What is the scale needed to achieve results sufficient to address the problem? What are the baselines that you will measure before the project begins?

G. Partner roles: (approximately ½ page) If applicable, describe and define the role of any other entities in the partnership. This must include a description of how roles will be divided and managed efficiently.

H. Applicant capacity: (approximately ½ page) Describe organizational capacity – technical, managerial, financial, etc. – to carry out the proposed intervention. What is the business model for your innovation?

VI. Evaluation Criteria

The following technical criteria will be considered when reviewing concept papers, and are weighted equally by the Selection Committee:

a. The extent to which the concept paper proposes practical and sustainable strategies with evidence-based, feasible capacity, and appropriate stakeholders in proposed activities to achieve results of the objectives and outcomes described in the Program Description.

b. The extent to which the concept paper demonstrates institutional capability, technical and financial management capacity, and relevant technical expertise needed to achieve the proposed results.

Note: This Addendum serves primarily to outline the goals and priorities of USAID in making an award under the LON APS. More comprehensive information regarding the application and review processes (including Concept Paper submission, co-creation, Full Application, and Evaluation stages) can be found in the umbrella LON APS, located here. Applicants are advised to refer extensively to both documents in preparing Concept Notes.

VII. Questions and Further Assistance

Questions regarding the substance and objectives of this Addendum should be directed to Patrick Kollars at pkollars@usaid.gov with copy to hoanguyen@usaid.gov and lon@usaid.gov no later than the date and time indicated on the cover letter. Any information given to a prospective applicant concerning this

Addendum will be furnished promptly to all other prospective applicants as an amendment to this

Addendum, if that information is necessary in submitting applications or if the lack of it would be prejudicial to any other prospective applicant.

Questions regarding the substance and terms of the LON APS umbrella should be directed to

LON@usaid.gov using the subject line “Question - LON APS Umbrella”.

VIII. Funding Restrictions

a. Construction is not authorized under this award.

b. Except as may be specifically approved in advance by the AO, all commodities and services that will be reimbursed by USAID under this award must be from the authorized geographic code specified in

Section B.4 of the Amendment 5 to the APS and must meet the source and nationality requirements set forth in 22 CFR 228.

[END OF ADDENDUM 07 TO LON APS]

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