PKG00247743-instructions.pdf

Centers for Disease Control

Center for Global Health

Global Noncommunicable Disease Prevention and Health Promotion

CDC-RFA-GH19-1954

Application Due Date: 03/25/2019

Global Noncommunicable Disease Prevention and Health Promotion

CDC-RFA-GH19-1954

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Assistance Listings (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text 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 Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-GH19-1954. 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:

Global Noncommunicable Disease Prevention and Health Promotion C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-GH19-1954

E. Assistance Listings (CFDA) Number:

93.099 F. Dates:

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

2. Due Date for Applications: 03/25/2019, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

N/A

G. Executive Summary:

1. Summary Paragraph:

Worldwide, non-communicable diseases (NCDs) kill over 35 million people each year, representing nearly two-thirds of the world’s deaths. More than 80 percent of NCD-related deaths are in low- and middle-income countries, where health systems are often not equipped to respond, and nearly a third of those deaths occur before age 60. The enormous social and economic toll of NCDs worldwide calls for an integrated strategic approach to reduce illnesses and deaths due to NCDs globally.

The purpose of this NOFO is to promote health and prevent NCDs across the globe by supporting capacity building, surveillance and surveys, planning and monitoring, and activities that focus on key NCD conditions and risk factors such as cardiovascular disease, nutrition, reproductive health, and tobacco control.

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.grants.gov

a. Eligible Applicants: Single

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 1

d. Total Period of Performance Funding: $25,000,000

e. Average One Year Award Amount: $5,000,000

f. Total Period of Performance Length: 5

g. Estimated Award Date: 08/15/2019

h. Cost Sharing and / or Matching Requirements: N Cost sharing or matching funds are not required for this program. Although there is no statutory match requirement for this NOFO, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview Worldwide, noncommunicable diseases (NCDs) kill over 35 million people each year, representing nearly two-thirds of the world’s deaths. More than 80 percent of NCD-related deaths are in low- and middle-income countries, where health systems are often not equipped to respond, and nearly a third of those deaths occur before age 60. The enormous social and economic toll of NCDs worldwide calls for an integrated strategic approach to reduce illnesses and deaths due to NCDs globally.

NCDs such as cardiovascular disease, cancer, diabetes, and chronic lung disease kill more people globally than infectious diseases. Several NCDs share the common risk factors of tobacco use, unhealthy diets, physical inactivity, and harmful use of alcohol, as well as high blood pressure and high cholesterol.

Surveys, surveillance, and monitoring for non-communicable disease (NCDs) are crucial to provide countries with needed information to develop prevention strategies, programs, and policies; to assess the progress and impact of these efforts; to determine fiscally responsible use of resources; and to identify effective interventions for global dissemination and learning. The capacity to implement NCD surveillance varies greatly around the world and often is inadequate in low and middle-income countries (LMICs).

The purpose of this NOFO is to promote health, provide expertise and training to regions and countries across the globe to prevent and control non-communicable diseases, their risk factors, and related causes through effective regional, national and community health programs in collaboration with the recipient.

Activities that address NCD prevention and control are outlined as separate program-specific components in the NOFO. These components include: Component A: Global Pregnancy and Infant Registries and Birth Defects Prevention (Birth Defects); Component B: International Micronutrient Malnutrition Prevention and Control Program (IMMPaCt); Component C: Global Youth Tobacco Survey (GYTS); Component D: Global Cardiovascular Health Promotion (CVD); Component E: NCD Surveillance and the NCD Global Monitoring Framework and Global Action Plan.

Applicant may choose to apply for one or more components and will do so through a single application.

b. Statutory Authorities Section 301(a) and section 307 of the Public Health Service Act (42 USC 241(a) and 242l)

c. Healthy People 2020 Global health: Improve public health and strengthen U.S. national security through global disease detection, response, prevention, and control strategies https://www.healthypeople.gov /2020/topics-objectives/topic/global-health

d. Other National Public Health Priorities and Strategies This NOFO aligns with the CDC Global Health Strategy, 2012-2015, which includes under Goal 1 (Health Impact: Improve the Health and Well-being of People around the World), Objective 1.8: Reduce Burden of Non-communicable Diseases.

Activities in the NOFO also support the U.S. Department of Health and Human Service’s Global Strategy. Specifically, it aligns with Strategy Objective 1: Enhance Global Health Surveillance and Objective 8: Address the Changing Global Pattern of Death, Illness and Disability. Both objectives specifically mention NCDs as part of their key priorities.

e. Relevant Work This NOFO is the 4th cycle of 5-year global NCD cooperative agreements. Recipient will build on NCD prevention, surveillance and health promotion activities previously carried out under DP09-909 and GH14-1420 cooperative agreements.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

Logic Model: Global Noncommunicable Disease Prevention and Health Promotion The logic model below is a depiction of the NOFO’s general approach. The strategies and outcomes of the logic model are stated broadly to capture the variety of activities and outcomes that are associated with the discrete projects (components) in this NOFO. Activities listed for each component can be associated with one or more strategies presented in the logic model.

https://www.healthypeople.gov/2020/topics-objectives/topic/global-health https://www.healthypeople.gov/2020/topics-objectives/topic/global-health

Strategies and Activities Short-term Outcomes Intermediate Outcomes

Long-Term Outcomes

Surveillance Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation ofNoncommunicable Diseases (NCDs) Generating Evidence Generate scientific evidence and WHO guidelines for developing, implementing and scaling up interventions to prevent NCDs and its risk factors Capacity Building Utilize web-based training, technical exchange and mentorship and training modules to enhance workforce capacity Partnerships Develop and maintain internal, external, bi-lateral and multi-lateral partnerships to leverage existing platforms to address global NCDs.

· Increased evidence of NCD prevalence, trends, and country-level needs in Low to Middle income countries (LMIC’s)

· Strengthened NCD surveillance and information systems

· Increased implementation of effective strategies to prevent and control NCDs

· Development and availability of standard training tools and guidelines to address NCDs

· Enhanced local capacity for NCD surveillance and monitoring, evaluation, and program implementation

· Strengthened collaborations with global partners

· Improved ability to identify and leverage new resources dedicated to addressing the global NCD burden

· Increased awareness of NCDs in LMIC’s

· Improved NCD surveillance and monitoring systems

· LMIC’s with public health strategic plans that address NCDs

· Increased use of evidence-based guidelines, interventions, and programs

· Stronger data to use in setting priorities and decision making

· Increased availability of data on the effectiveness of ongoing prevention activities

· Increased ability to track global progress to address NCDs

· Sustained NCD surveillance systems

· Well- equipped workforce to address NCDs at the country level

· More effective utilization of resources at the country and global level

· Sustained NCD prevention and control programs and initiatives

· Increased recognition by high-level country leadership that NCDs are a critical public health priority

· Decreases in NCDs and its risk factors morbidity and mortality

i. Purpose The purpose of this NOFO is to provide expertise and training to regions and countries across the globe to prevent and control non-communicable diseases, their risk factors, and related causes through effective regional, national and community health programs.

ii. Outcomes As reflected in the logic model, the recipient is expected to show measureable progress made toward short-term, mid-term (intermediate) and long-term outcomes for this five-year project period. Below are the period of performance outcomes by discrete program area:

Component A Global Pregnancy and Infant Registries and Birth Defects Prevention (Birth Defects) Short-term outcomes:

Enhanced local capacity for pregnancy and infant registries, birth defects monitoring, and evaluation

Development and availability of training tools and guidelines to capture adverse maternal and infant outcomes, birth defects and to inform prevention efforts

Increased quantity and quality of data related to adverse pregnancy and infant outcomes, birth defects prevalence, trends, and country-level needs in LMIC’s

Intermediate outcomes:

Increased implementation of effective strategies to prevent adverse pregnancy and infant outcomes, birth defects, especially neural tube defects

Increased awareness of adverse pregnancy and infant outcomes/birth defects in LMIC’s

Peer reviewed publication and dissemination of surveillance data

Long-term outcomes:

Strengthened pregnancy and infant registries/birth defects surveillance and information systems that are integrating into existing Ministry of Health data collection systems

Strengthened collaborations with global partners engaged in promoting health and well-being of pregnant women and infants

Improved data quality and data utilization to inform decision-making for folic acid fortification programs to prevent neural tube defects

Component B Micronutrient Malnutrition Prevention and Control (IMMPaCt) program Long-term outcomes:

o Strengthened and sustained global surveillance systems particularly for nutrition.

o Resources used effectively at country and global levels for sustained prevention and control programs and initiatives, particularly for NCD, primary prevention and improved nutrition.

o Country leadership to demonstrate increased recognition that reducing NCDs and improved nutrition are critical public health priorities.

o Decrease in malnutrition, NCDs and NCD risk factors causing morbidity and mortality.

Component C Global Youth Tobacco Survey (GYTS) Short-term Outcomes:

Strengthened NCD/tobacco surveillance and information systems (across five of the six WHO Regions - The Regional office of the Americas (AMRO) is funded separately)

Increased implementation of effective strategies to prevent and control NCDs (across five of the six WHO Regions – AMRO is funded separately). Specifically strategies related to the prevention and control of tobacco use.

Development and availability of standard training tools and guidelines to address NCDs/tobacco (including the translation of developed trainings into various languages to increase global reach and comprehension);

Enhanced local capacity for NCD/tobacco surveillance and monitoring, evaluation, and program implementation; and

Strengthened collaborations with global partners.

Intermediate Outcomes:

Improved NCD/tobacco surveillance and monitoring systems Stronger tobacco data to use in setting priorities and decision-making.

Long-term Outcomes:

Sustained NCD/tobacco surveillance systems More effective utilization of tobacco resources at the country and global level.

Component D Cardiovascular Disease (CVD) Health Promotion The following short-term outcomes should be achieved:

o Increased evidence of NCD/cardiovascular disease prevalence, trends, and country-level needs in LMIC’s o Strengthened cardiovascular disease surveillance and information systems o Increased implementation of effective strategies to prevent and control cardiovascular disease o Development and availability of standard training tools and guidelines to address cardiovascular disease o Enhanced local capacity for cardiovascular disease surveillance and monitoring, evaluation, and program implementation o Stronger global collaborations

Intermediate Outcomes:

Increased awareness of cardiovascular disease and its risk factors in LMIC’s Improved surveillance and monitoring systems to reduce premature deaths from heart attacks and strokes Stronger data to use in setting priorities and decision making

Long-term outcomes:

Sustained NCD/ cardiovascular disease surveillance systems Increased recognition by high-level country leadership that cardiovascular disease is a critical public health;

Decreases in cardiovascular disease and its risk factors, morbidity and mortality

Component E Noncommunicable Disease (NCD) Surveillance Short-term Outcomes:

o Increased evidence of NCD prevalence, trends, and country-level needs in LMIC’s o Strengthened NCD surveillance and information systems

Intermediate outcomes o Increased awareness of NCDs in LMIC’s o Improved NCD surveillance and monitoring systems

Long-term Sustained NCD surveillance systems

iii. Strategies and Activities While the activities for this NOFO span across many different funding streams and discrete program projects, all the strategies and activities broadly focus on the areas outlined in the logic model.

Component A Birth Defects Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD :

Support surveillance systems to monitor the impact of adverse pregnancy and infant outcomes (with a focus on birth defects) on communities and disseminate data for prevention and evaluation. Where possible, this surveillance capacity for birth defects should be integrated into existing country level data collection systems.

Provide, enhance, and maintain an online regional pregnancy and infant registry/birth defects surveillance system that provides ongoing, systematic collection, analysis, and evaluation of birth defects data

Assess the quality of data sources, including describing how the quality of the data sources is assessed. This could include determining the relative contribution of cases from each source, determining the percent of missing data for key variables, and/or calculation of other quality metrics.

Submit de-identified, de-duplicated individual level data to CDC for analysis via secure transmission, meeting CDC-specified data elements and deadlines. Recipients will complete the necessary requirements to gain access to the CDC secure network.

Provide or enhance and maintain a database that systematically retrieves, manages and analyzes information on vitamin and mineral status among populations globally and provide resources to support this work at country and regional levels.

Generate scientific evidence for developing, implementing and scaling up interventions to prevent NCDs and its risk factors:

Generate scientific evidence on frequency of adverse pregnancy and infant outcomes and birth defects and inform guidelines for developing, implementing and scaling up interventions to prevent birth defects, especially neural tube defects

Provide guidance to countries and regions to support the development, expansion, and implementation of birth defects prevention and surveillance efforts

Develop, implement and disseminate standard approaches for assessment, monitoring systems and communication planning related to pregnancy and infant surveillance, birth defects prevention, particularly neural tube defects

Utilize web-based training, technical exchange and mentorship and training modules to enhance workforce capacity:

Utilize web-based and when necessary, in-person training, technical exchanges, and mentorship to enhance workforce capacity for pregnancy, infant and birth defects surveillance and prevention efforts

Provide resources and tools to develop or enhance surveillance systems and data utilization

Develop and maintain internal, external, bi-lateral and multi-lateral partnerships to leverage existing platforms to address global NCDs.

Develop and maintain internal, external, bi-lateral and multi-lateral partnerships to support pregnancy and infant surveillance, birth defects surveillance, especially neural tube defect prevention globally and in the South-East Asia Region

Component B IMMPaCt Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD :

The recipient will carry out and strengthen global nutrition surveillance including of laboratories that conduct vitamin and mineral analyses. Additional strategies and activities include updating global guidance to improve nutritional status, assessment, and implementation of effective policies and programs; and providing technical support to countries and strengthening partnerships to support improved global nutrition.

Component C

GYTS

Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD:

Support global tobacco prevention and control programs including surveillance, information management, and program approaches for tobacco prevention and control across five of the six Regions

Utilize web-based training, technical exchange and mentorship and training modules to enhance workforce capacity:

In consultation with and technical support from the Global Tobacco Control Branch (GTCB/OSH), collaboratively plan and conduct global training and capacity building of in-country leadership regarding data collection and implementation of the Global Youth Tobacco Survey (GYTS) as well as appropriate interpretation and application of resulting data depending on country need and the permissible use of funds

Generate scientific evidence for developing, implementing and scaling up interventions to prevent NCDs and its risk factors:

Utilize knowledge gained from the country-specific and regional surveillance and training activities to support the development and implementation of national tobacco prevention and control program plans of action

Develop and maintain internal, external, bi-lateral and multi-lateral partnerships to leverage existing platforms to address global NCDs:

Assist in the development and implementation of strategies to engage and galvanize the principal organizations and partners of the United Nations (UN), non-governmental organizations (NGOs) and businesses in support of tobacco prevention and control.

Component D CVD Health Promotion Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD:

Strengthen NCD/ cardiovascular disease surveillance and information systems Develop and disseminate NCD/cardiovascular disease prevention and control guidelines

Develop and disseminate NCD/ cardiovascular disease prevention information, such as evidence of effectiveness, standard and best practices, fact sheets, technical materials, manuscripts, and scientific presentations

Generate scientific evidence for developing, implementing and scaling up interventions to prevent NCDs and its risk factors:

Conduct systematic reviews and review the evidence for effective strategies to prevent and control cardiovascular disease

Utilize web-based training, technical exchange and mentorship and training modules to enhance workforce capacity:

Enhance local capacity and workforce to address cardiovascular disease by strengthening developing training materials, conducting trainings, and enhancing lab capacity

Develop and maintain internal, external, bi-lateral and multi-lateral partnerships to leverage existing platforms to address global NCDs:

Build and strengthen collaborations with local and global partners who express interest in CVD health promotion initiatives

Component E NCD Surveillance Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD:

Evaluate countries capacity for surveillance in NCD’s Conduct a workshops and prioritization exercises in LMIC’s to identify areas for improvement and challenges in NCD surveillance Develop timelines and indicators applicable to NCD surveillance and monitor progress of activities

1. Collaborations

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

N/A

b. With organizations not funded by CDC:

Component A Birth Defects

Recipient shall collaborate with the World Health Organization’s regional office in South East Asia in order to continue to advance ongoing pregnancy and infant monitoring, birth defects surveillance and prevention work in the region.

Recipient shall collaborate with the International Clearinghouse on Birth Defects

Surveillance and Research and other regional (e.g., All India Institute of Medical Sciences) and global experts in birth defects identification, diagnosis, and/or surveillance as appropriate.

Recipient shall foster and maintain collaborations with WHO Country offices and Ministries of Health in countries funded to conduct birth defects surveillance

Recipient may collaborate with global or regional organizations and initiatives, such as the Flour Fortification Initiative, Nutrition International, the Global Alliance for Improved Nutrition, and the United States Agency for International Development, whose work supports prevention of birth defects or monitoring of blood folate concentrations.

Component B IMMPaCt

The recipient may collaborate with country officials and subject matter experts from universities; UN, bilateral or multilateral agencies that work in global nutrition and development; and technical advisory groups to achieve outcomes. These collaborations may be necessary to identify data sources for global nutrition surveillance; in order develop global guidance, recommendation and other technical resources.

Component C

GYTS

Recipient will collaborate with AFRO, EMRO, WPRO, EURO and SEARO, to further the work in regional offices.

Component D and E CVD Health Promotion and NCD surveillance

Recipient is encouraged to build and expand collaborative relationships with strategic partners at the international and regional levels to achieve greater impact and sustainability, avoid duplication of efforts, leverage funds, and expand working relationships between ministries of health and education and WHO and CDC.

Recipient should collaborate with experts at the regional, national, local level located, academic centers, clinical institutions, Ministries of Health and other governmental and non-governmental institutes and organizations whose work centers on prevention of NCDs.

2. Target Populations Component A Birth Defects The target population for the proposed strategies and activities are countries and regions worldwide that are seeking to build and/or expand pregnancy and infant registries, birth defects programmatic and surveillance capacity in support of birth defects surveillance and prevention initiatives. For birth defects surveillance implementation and capacity building activities, the target audiences are clinicians (primarily pediatricians, neonatologists, OB/GYNs, and nurses) and public health professionals who will be responsible for surveillance implementation Inclusion: Recipient is encouraged to collaborate with organizations that serve individuals and families affected by neural tube defects and other birth defects.

Component B IMMPaCt The recipient will not be limited to working only with specific target populations, but may concentrate efforts among those most vulnerable to malnutrition including young children less than five years of age, women of reproductive age and adolescence.

Component C

GYTS

The target population for the proposed strategies and activities are countries and regions worldwide (excluding the AMRO Countries) that are seeking to build and or expand their tobacco control efforts.

Component D and E CVD Health Promotion and NCD surveillance Recipient will carry out activities in LMIC’s in the areas of surveillance, monitoring and evaluation, capacity building and training to reduce deaths related to NCD’s

a. Health Disparities Federal disability rights laws apply to foreign assistance programs. Funded programs should consider including people with disabilities in all aspects of the program (e.g., advisory boards, planning committees, project staff, consultants, etc.), and ensure to the best of their ability that persons with disabilities are not discriminated against in hiring processes, and that facilities and communications are accessible.

The outcomes for IMMPact may benefit all populations worldwide but many products may be focused on those most vulnerable to malnutrition and vitamin and mineral deficiencies including young children less than five years of age, women of reproductive age and adolescents in low-income and middle-income countries. The recipient is also expected to work with any country expressing interest in implementing GYTS and assist in the development of in-country capacity when needed.

iv. Funding Strategy Proposed period of performance funding amount is $25,000,000 with an average of $5,000,000 for each fiscal year. This is a multicomponent NOFO; the amounts of funding for each component are not related and will depend on the availability of funding by each of the CDC offices supporting those activities. The applicant may choose to apply for one or more components through a single application.

Funds should used for personnel, travel, supplies and equipment, or contractual support for proposed activities.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Component A Birth Defects Proposed process measures/outputs (may include):

Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD

Cumulative number of surveys (national, regional or 1st administrative level) with indicators of folate status in the Micronutrients Database of the WHO Vitamin and Mineral Nutrition Information System (VMNIS)

Number of birth defects surveillance training sessions and number of persons trained during the project period

Number/frequency of facility (e.g., hospital) site visits for performance review by national or regional surveillance coordinators

Utilize web-based training, technical exchange and mentorship and training modules to enhance workforce capacity

Number of new tools/documents/publications produced related to pregnancy and infant surveillance and birth defects surveillance and prevention during project period

Proposed outcome measures may include:

Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD

Pre-post test results from surveillance review meeting Regional, country, or facility level formal evaluation reports measuring consistency, completeness, accuracy, and timeliness of birth defects surveillance reporting

CDC may provide technical assistance to the recipient to scale up a process evaluation if requested and may assist in the conduct an outcome evaluation of the South-East Asia Regional Newborn Birth Defects surveillance system. CDC and the recipient shall use evaluation findings to assess the extent to which planned activities have been implemented and to inform program improvements.

Component B

Process measures for strategies and activities may include:

Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD

Continued maintenance and upgrade of the surveillance systems and the number of new surveys or laboratories or intervention indicators entered into the surveillance systems.

Generate scientific evidence and WHO guidelines for developing, implementing and scaling up interventions to prevent NCDs and its risk factors

Number of systematic reviews and summaries of evidence used to develop guidance resources.

Maintaining systems that make available evidence informed interventions and policies that are easily accessible and responding to questions and requests.

Develop and maintain internal, external, bi-lateral and multi-lateral partnerships to leverage existing platforms to address global NCDs

To strengthen partnerships, process measures include joint participation in meetings, working groups, global technical advisory groups and conferences.

Proposed outcome measures may include:

Support surveillance systems through surveys, data collection and reporting, monitoring and evaluation of NCD

Strengthened and improved surveillance systems for nutrition, laboratories and intervention indicators; publications of the global burden of disease for specific nutrition content; publications of resources to improve the quality and quantity of surveillance data.

Generate scientific evidence and WHO guidelines for developing, implementing and scaling up interventions to prevent NCDs and its risk factors

Number of global guidelines and other resources published and downloaded; the number of countries with evidence informed policies and programs.

Review of process measures will inform whether strategies and activities need adjustment in order to achieve NOFO outcomes. These strategies should result in direct products, such as upgrade and sustained surveillance systems, guidelines and other technical resources that global and country leaders can use to make evidence informed decisions to reduce morbidity and mortality.

Component C

GYTS

Sustained NCD surveillance systems:

CDC will work with recipient to demonstrate program impact through process and outcome evaluation of tobacco funded activities. CDC will use process evaluation to assess the extent to which planned activities have been implemented and lead to feasible and sustainable outcomes relating to GYTS implementation, completion and application of results. CDC will use outcome evaluation to assess whether funded activities are leading to intended outcomes.

CDC will work with the recipient to receive feedback from low- and middle-income countries on the utility of the activities and to identify areas for quality improvement. Performance measurement will be determined by the recipient’s ability to meet established timelines and quality indicators.

Component D and E CVD Health Promotion and NCD surveillance CDC will use evaluate recipients achievements and progress towards the objectives of the cooperative agreement. The project as a whole and its components will be subject to ongoing monitoring and evaluation. An annual progress report will be submitted to CDC highlighting activities, achievements, challenges as well as impact within 90 days of the end of the budget period.

Output measures may include:

Utilize web-based training, technical exchange and mentorship and training modules to enhance workforce capacity

Number of regional (or sub regional) workshops conducted and a report for each drafted Training materials developed and disseminated

Generate scientific evidence and WHO guidelines for developing, implementing and scaling up interventions to prevent NCDs and its risk factors:

Generation of data to inform strategies on NCD prevention and health promotion

Develop and maintain internal, external, bi-lateral and multi-lateral partnerships to leverage existing platforms to address global NCDs:

Development of new or strengthening of existing partnerships for CVD program scale up

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 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), if applicable, for accuracy throughout the lifecycle of the project. 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, they 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 Recipient must:

Have experience in program and performance management, evaluation, performance monitoring, financial reporting, management of travel requirements, development of staffing plans, workforce development and training, management of direct assistance, and development of sustainability plans.

Describe how its agency is structured; who will have management authority over the project, and provide an organizational chart that identifies lines of authority.

Describe its experience convening regional Data Analysis, Implementation and Reporting Workshops.

Describe its experience providing expert guidance and consultation to regions and countries on survey planning, implementation, and data analysis and reporting.

Describe its experience coordinating activities with other relevant operating units, agencies, organizations, and individuals to facilitate implementation and sustainability.

Describe its experience developing scientific manuscripts, conference presentations, and other products to facilitate dissemination

Describe its experience securing additional resources in support of implementation and sustainability

Describe potential barriers to successful implementation of required activities and how recipient will overcome the barriers.

https://www.cdc.gov/grants/additionalrequirements/ar-25.html

d. Work Plan The applicant should describe a detailed work plan that covers the period of performance and a high-level plan for subsequent years for each of the program areas. The work plan should describe how the applicant plans to implement all of the activities and achieve NOFO outcomes.

At a minimum, the work plan demonstrates how the outcomes, strategies, activities, timelines, and staffing/collaborations work together. Additional information on performance measures, data sources, and target population can also be included. At the end of the budget year, recipient will be expected to report on the extent to which proposed short-term objectives have been achieved; the progress of any products against established schedules and indicators; the efficiency and effectiveness of project implementation; the short and long term sustainability of the results; and any measurable impact.

Work plans should align with the activities and outcomes described in the logic model. Work plans also need to include the additional components and planning activities listed below:

Work plans also need to include the additional components and planning activities listed below:

Include 5-year project outline with activities in support of the outcomes. Include appropriate strategies, data sources, process measures or milestones for accomplishing tasks, and identify the person responsible for accomplishing the program activities.

Describe administrative roles and functions to support implementation of the award, and assessment processes to ensure successful implementation and quality assurance.

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 CDC will provide ongoing feedback on performance to the recipient during scheduled calls and in-person meetings.

Monitoring and accountability (programmatic and financial) will occur through frequent performance updates; development and review of the status of budget and annual work plans;

and adjustment of work plans as needed to achieve expected outcomes.

Component A Birth Defects 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.

The program’s priority performance measures for tracking progress include the following:

Conference calls (every two weeks when possible, and no less frequently than monthly) with recipient to report on progress, share successes, discuss challenges, and jointly propose solutions

Monthly written update of the work plan to report on progress and any deviations from work plan

Annual kick-off meeting and mid-year review meeting to be held in-person when possible

The CDC will provide ongoing feedback on performance to the recipient during scheduled calls and in-person meetings.

Component B

Monitoring and accountability (programmatic and financial) will occur through joint participation in quarterly update calls; development and review of the status of annual work plans; and adjustment of work plans as needed to achieve expected outcomes.

Component C

GYTS

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

The HHS Grants Policy Administration Manual (GPAM) specifies the following HHS expectations for post-award monitoring for grants and cooperative agreements:

Tracking recipient’s progress in achieving the desired outcomes.

Insuring the adequacy of recipient systems that underlie and generate data reports Creating an environment that fosters integrity in program performance and resultsMonitoring may also include the following activities:

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 objectives within stated timelines.

Working with recipients on adjusting the work plan based on achievement of objectives and changing budgets.

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

Other activities deemed necessary to monitor the award, if applicable.

These may include monitoring and reporting activities as outlined in the Federal Government AAGAM 2.01.101-7 C. 1. and 2. that assists grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk grantees.

Component D and E CVD Health Promotion and NCD surveillance Monitoring and accountability (programmatic and financial) will occur through joint participation in conference calls; review of the status of annual work plans and budget; and adjustment of work plans as needed to achieve expected outcomes.

f. CDC Program Support to Recipients (THIS SECTION APPLIES ONLY TO

COOPERATIVE AGREEMENTS)

Component A Birth Defects

CDC will work with recipient to share strategies and lessons learned to improve pregnancy and infant monitoring, birth defects surveillance and prevention efforts

CDC will provide advice on data sharing and reporting requirements, and help ensure the necessary steps are taken for timely implementation.

Component B IMMPaCT

The IMMPaCt program at CDC as well as other subject matter experts in nutritional health will collaborate with the recipient to achieve the expected outcomes. For example are experts in malaria and infectious diseases, birth defects, or CDC laboratories that specialize in the analysis of vitamins and minerals.

Component C

GYTS

CDC-funded programs (including, but not limited to AMRO) will work closely with the recipient to implement all tobacco strategies and activities, particularly the technical areas including providing expert guidance and consultation and developing scientific manuscripts and other dissemination products.

Component D and E CVD Health Promotion and NCD surveillance

The project officer will work closely with the recipient to implement all strategies and activities, particularly technical areas including providing expert guidance and consultation and developing scientific manuscripts and other products for dissemination.

B. Award Information

1. Funding Instrument Type: Cooperative Agreement CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism: E11 E11 Grants for Public Health Special

3. Fiscal Year: 2019

4. Approximate Total Fiscal Year Funding: $5,000,000

5. Approximate Period of Performance Funding: $25,000,000

This amount is subject to the availability of funds.

Estimated Total Funding: $25,000,000

6. Approximate Period of Performance Length: 5 year(s)

7. Expected Number of Awards: 1

8. Approximate Average Award: $5,000,000 Per Budget Period

9. Award Ceiling: $0 Per Project Period

This amount is subject to the availability of funds.

There is not an overall ceiling or component specific ceiling for this NOFO.

10. Award Floor: $0 Per Project Period There is not an overall floor or component specific floor for this NOFO.

11. Estimated Award Date: 08/15/2019

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. The total period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Direct Assistance Direct Assistance (DA) is available through this NOFO.

Direct assistance (DA) may be used for personnel only. Consistent with the statutory authority cited in this NOFO, an applicant may request that the Centers for Disease Control and Prevention (CDC) or Agency for Toxic Substances Disease Registry (ATSDR) provide direct assistance (DA) as a part of the grant awarded through this notice of funding opportunity. If your request for direct assistance is approved as a part of your award, CDC or ATSDR, in accordance with the cited statutory authority, may reduce the amount of funding provided directly to you as a part of your award by the amount of the DA provided. Any amount by which your award is reduced to provide DA shall be deemed as part of the total award and shall be deemed to have been paid to you, the recipient.

C. Eligibility Information

1. Eligible Applicants Eligibility Category: Others (see text field entitled "Additional

Information on Eligibility" for clarification)

Additional Eligibility Category:

2. Additional Information on Eligibility The World Health Organization (WHO) is the only eligible applicant for this NOFO. No other applications will be solicited.

3. Justification for Less than Maximum Competition The World Health Organization (WHO) has a unique position among the world's health agencies as the technical agency for health within the United Nations with access to all national health promotion and disease prevention programs and potential surveillance sites through its six regional offices located in Washington, DC; Copenhagen, Denmark; Cairo Egypt; Congo;

New Delhi, India; and Manila, Philippines.

WHO is the only international and intergovernmental agency qualified to conduct activities under this cooperative agreement because:

WHO is an international public health agency that works to improve health and living standards globally.

WHO and its Regional Offices are at the apex of global public health organizations and have an exclusive status as the United States government's key partners for global public health.

WHO is uniquely qualified to conduct and coordinate the surveillance activities, policy and programmatic initiatives that have specific relevance to the objectives of this program announcement and which have a potential to advance knowledge that benefits the Unites States.

WHO collaborates with other international organizations and works to accomplish its mission by disseminating information and expertise related to effective school health programs that significantly reduce the leading causes of death, disease and disability among youth.

WHO offers special opportunities for furthering behavioral risk factors surveillance efforts through the use of unique talent resources, populations or environmental conditions in other countries that are not readily available in the United States.

The new activities will build on the following CDC-funded activities.

Upgrade, expand and maintain vitamin and mineral nutrition information systems and other surveillance systems aimed at monitoring the vitamin and mineral and nutritional status of populations globally and used for developing global estimates of deficiency and disease.

Develop nutrition surveillance system models for application in specific countries.

Suppo…