Multi_Country Meeting_FOA_COP21 DOP21.pdf

Multi-Country: DHAPP Partnership for Sustainable HIV Epidemic Control

NOTE: Application submissions for this narrative are due by 5pm ET on December 01, 2021.

Submissions received after the deadline will not be considered for funding.

Introduction

The HIV/AIDS epidemic has been devastating and negatively affected many militaries and other uniformed organizations worldwide by reducing military readiness, limiting deployments, causing physical and emotional decline in infected individuals and their families, posing risks to military personnel and their extended communities, and impeding peacekeeping activities. As HIV management improves, many of these impacts are disappearing; however, militaries now need to sustain life-long HIV treatment for their HIV-infected beneficiaries in addition to other long-term chronic disease management issues.

The US Government has a long history of international collaboration and partnerships in the fight against

HIV/AIDS, providing funding, technical assistance, and program support. These collaborations are all contributing to HIV epidemic control.

Over the years, the United States Department of Defense (DoD) HIV/AIDS Prevention Program

(DHAPP) has successfully engaged over 80 countries to control the HIV epidemic among their respective military services. DHAPP is the DoD implementing agency collaborating with the US Department of

State, the Health Resources and Services Administration, Peace Corps, US Agency for International

Development (USAID), and the Centers for Disease Control and Prevention (CDC), in the US President’s

Emergency Plan for AIDS Relief (PEPFAR). DHAPP receives funding for its programs from two sources: a congressional plus up to the Defense Health Program (DHP) and funding transfers from the

Department of State for PEPFAR. Working closely with DoD, U.S. Unified Combatant Commanders, Joint United Nations Programme on HIV/AIDS (UNAIDS), university collaborators, and other nongovernmental organizations (NGOs), DHAPP’s mission is to build capable military partners through military-specific, culturally focused, HIV/AIDS cooperation and assistance.

In the Defense Security Cooperation Agency guidance, the US Secretary of Defense has identified

HIV/AIDS in foreign militaries as a national security issue. Pursuing HIV/AIDS activities with foreign militaries is clearly tied to security interests, regional stability, humanitarian concerns, counterterrorism, and peacekeeping efforts due to the impact of HIV/AIDS as a destabilizing factor in developing societies.

DHAPP employs an integrated bilateral and regional strategy for HIV/AIDS cooperation and security assistance. DHAPP implements bilateral and regional strategies in coordination with respective

Combatant Commands (COCOMs) and Country Support Teams to offer military-to-military HIV/AIDS program assistance using country priorities set by the US Under Secretary of Defense for Policy and by the Office of the Global AIDS Coordinator (OGAC). DHAPP provides strategic information and supports defense forces in HIV prevention, care, and treatment for HIV-infected individuals and their families.

PEPFAR adopted the United Nations Programme on HIV/AIDS (UNAIDS) global 95-95-95 (formerly

90-90-90) goals that state by 2030: 95% of people with HIV are diagnosed, 95% of them are on antiretroviral therapies (ART) and 95% of them are virally suppressed. Despite tremendous efforts, the global 90-90-90 goals were not realized by 2020. Therefore, UNAIDS developed the Global AIDS

Strategy 2021-2026: End Inequalities. End AIDS. This bold approach uses an inequalities lens to close the gaps preventing progress and outlines the 2025 targets: 10-10-10 (less than 10% of persons living with HIV (PLHIV) and key populations (KP) experience stigma and discrimination (S&D); less than 10% of PLHIV, women and girls, and Key Populations at heightened risk for HIV experience gender-based inequalities and Gender-Based Violence (GBV); and less than 10% of countries have punitive laws and policies). In addition to the above-mentioned 95-95-95 treatment goals, there are three more 95% goals including: 95% of people at risk of HIV use combination prevention; 95% of women access sexual and reproductive health services; and 95% coverage of services for eliminating vertical transmission. Lastly, the UNAIDS Global AIDS Strategy established two 90% goals including: 90% of PLHIV receive preventive treatment for TB and 90% of PLHIV and people at risk are linked to other integrated health services.

The PEPFAR Strategy: Vision 2025 will be informed by and closely coordinated with the Global AIDS

Strategy 2021-2026 and the post-2022 Global Fund Strategy to optimize complementarity, value for money, and impact. The next PEPFAR Strategy will also support the international community’s efforts to put countries on track to reach the Sustainable Development Goal 3 target of ending the global AIDS epidemic as a public health threat by 2030, through the attainment of key milestones by 2025.

“Vision 2025,” provides that the United States will achieve sustained HIV epidemic control by supporting equitable health services and solutions, enduring national health systems and capabilities, and lasting collaborations. Specifically, this strategy aims to ensure that, by 2025, all countries it supports have:

1. Reached the global 95-95-95 treatment targets for all ages, genders, and population groups;

countries that have already achieved 95-95-95 will be supported to sustain their progress.

2. Dramatically reduced new HIV infections, particularly in priority populations, including adolescent girls and young women, key populations, and children.

3. Institutionalized granular, targeted, and gender-sensitive data use and systems and community-led approaches to monitor and address new HIV infections, especially among key populations and younger populations.

4. Made significant gains toward tackling societal challenges that impede progress in achieving the global 10-10-10 targets, including reducing the number of countries with punitive laws that target key populations; reducing stigma and discrimination that undermine effective responses; and fighting gender-based inequalities and gender-based violence that put adolescent girls and young women at increased risk for HIV.

5. Developed benchmarks supporting an HIV response that ensures enabling policies are adopted and implemented, and that countries and communities can lead with the capacity to deliver prevention and treatment services through domestic systems.

Call for Proposals

Proposals are requested to support all DHAPP countries to reach sustainable control of the HIV epidemic through the lens of PEPFAR’s Vision 2025 Strategy objectives, the UNAIDS HIV Treatment

95-95-95, Combination Prevention 95, Reproductive Health 95, and Vertical Transmission 95 targets;

TB prevention 90 and Integrated Health 90 targets; and the Inequalities 10-10-10 targets. Candidates are expected to be familiar with and to include means of addressing these objectives in their submitted proposals.

DHAPP supported 50 active programs in FY20, mainly through military-to-military cooperation in addition to support to external organizations to assist with specific program requirements or components of proposed programs. Partners in FY20 included 35 NGOs and universities working in 50 countries.

Budget

PEPFAR activities and services and corresponding budgets and expenditures are uniformly organized into a classification structure referred to as PEPFAR Financial Classifications. In this structure, the PEPFAR funded activities and services are classified systematically as interventions, which is a combination of programs (and sub-programs) and beneficiaries (and sub beneficiaries). Budget and program expenditures are further arrayed according to the cost classification. The below link contains the PEPFAR Financial

Classifications Reference Guide and summaries of these classification definitions.

https://datim.zendesk.com/hc/en-us/articles/360015671212-PEPFAR-Financial-Classifications-

Reference-Guide. The estimate budget for this program announcement in the format of the PEPFAR

Financial Classifications is as follows:

https://datim.zendesk.com/hc/en-us/articles/360015671212-PEPFAR-Financial-Classifications-Reference-Guide https://datim.zendesk.com/hc/en-us/articles/360015671212-PEPFAR-Financial-Classifications-Reference-Guide

Estimated Budget to be used as a Framework Complete budget estimate chart from template **Double click on the table**

Intervention

Number Program Area Beneficiary Cost Purpose Phase 1 Phase 2 Phase 3 Phase 4 Award Total

1 ASP: Human resources for health-NSD Priority Pops: Military & other uniformed servicesMIHTP 430,000 430,000 430,000 430,000 1,720,000

2 ASP: Human resources for health-NSD Non-Targeted Pop: Adults PM Training 250,000 250,000 250,000 250,000 1,000,000

7 -

8 -

9 -

10 -

11 -

12 -

13 -

14 -

15 -

16 -

17 -

18 -

680,000$ 680,000$ 680,000$ 680,000$ 2,720,000$

Technical Narrative

DHAPP is seeking a Recipient to assist with logistical planning for multiple programs/trainings. The field of HIV epidemic control and the approach of the US Government through PEPFAR is rapidly changing.

To ensure that DHAPP-supported staff can keep up with these changes, a number of educational and training approaches are needed to support partner militaries across the globe. These events need to occur both in the United States and internationally. Those who need this information are from partner militaries implementing partners, and DHAPP staff, some of whom have limited infrastructure support. The

Recipient will provide comprehensive services to successfully plan and execute meetings, training programs, workshops and other events. The Recipient will handle budgeting, venue selection, procurement, logistics, evaluations, and other issues as they arise. These meetings range in size from 10 to 100 attendees. The Recipient will be expected to communicate on behalf of DHAPP including but not limited to communication with USG officials, participants and vendors, many of whom will be international. Effective, error-free communication taking cultural and political sensitivities into account is crucial.

The recipient shall prepare a Project Management Plan describing the technical approach, organizational resources and management controls to be employed to meet the cost, performance and schedule requirements for this effort. The Project Management Plan shall detail the products, methods for developing the products, allocation of staff and other resources necessary to produce the products and a timeline for producing the products, if necessary. DHAPP shall receive the revised Project Management

Plan in electronic form. Based on the Project Management Plan, DHAPP will provide approval to move forward on activities planned. The Recipient shall request prior approval on all activities not included in the plan or any modifications to the plan after approval has been given. Resumes of individuals who will be coordinating these meetings must be submitted. If any substitutions are necessary after the grant has been awarded, persons being substituted must possess the same or higher qualification and must be approved by DHAPP.

DHAPP anticipates the recipient to participate in one the following yearly event requirements (detailed below and chosen by the recipient): (1) two San Diego-based Military International HIV Training

Program (MIHTP) courses; (2) one regional MIHTP course; or (3) one Program Manager (PM) training.

San Diego MIHTP

Clinicians from militaries around the world have had the unique opportunity to visit the United States for

30 days to participate in the Military International HIV Training Program (MIHTP) in San Diego, California. Trainees experience in-depth lectures, tour US medical facilities, and take part in rounds and counseling sessions with HIV patients. Trainees are exposed to the most up-to-date advances in HIV epidemiology, prevention and treatment issues. MIHTP involves intense study, collaboration, and coordination. All participants are expected to transfer acquired knowledge to other military HIV care providers in their respective countries. DHAPP anticipates hosting two San Diego MIHTP events each year. DHAPP usually hosts 10-12 students per session, but may be more or less depending on last-minute cancellations or additions. The course is conducted in collaboration with the Naval Medical Center San

Diego (NMCSD) and the University of California, San Diego (UCSD).

Regional MIHTP

To increase the impact of MIHTP, a shortened version is offered outside of San Diego. DHAPP anticipates hosting one regional course per year. This course is two weeks in length and is conducted at a site convenient for a region to be able to send partner military physicians. Prior locations have included

Malawi, Cambodia, Estonia, Guatemala, and Tanzania. The next upcoming site is to be determined, but will likely be in Western Africa. The site is generally a hotel conference center. The participants average

20-30 in number.

Program Manager Training

The Program Manager Training is designed for DHAPP country teams and HQ agencies to review progress towards HIV epidemic control in partner militaries, engage in technical discussions in preparation for annual planning, and review financial, operational and monitoring requirements. The training has both a different focus depending on the program funding of that country team (PEPFAR or

DHP). It, therefore, requires both plenary and breakout sessions to allow a customized delivery of content and interactions. The training is planned to be a one week event conducted in San Diego. There are usually between 60-100 attendees. The meeting generally occurs in January due to other calendar considerations.

Work Plans

The Recipient must submit annual, programmatic and financial, work plans to and the relevant DHAPP

HQ POCs (budget breakdown per activity is required). Work plans should include an activities implementation timeline as well as monitoring and evaluation timeline. A full list of reporting requirements can be found in the base Program Announcement and will be disclosed in the award terms and conditions.