RFI 72067424RFI00007 Western Cape Provincial Care and Treatment.pdf

Request FOR INFORMATION (RFI)

RFI Number: 72067424RFI00007 Date of Issue: March 25, 2024

Closing Date for Responses: April 29 2024 (09:00AM Pretoria, South Africa Time)

Responses to be submitted to: pretoriaapplications@usaid.gov

Subject: USAID Western Cape Provincial Care and Treatment Activity

To: All Interested Respondents/Parties/Organizations:

The United States Government, represented by the United States Agency for International Development (USAID) at its Mission in Southern Africa through the Bilateral Health Office (BHO) is publishing this Request for Information to obtain information and input from all interested entities, US and non-US organizations, on its potential future Western Cape Provincial Care and Treatment Activity. The information will be used to help make planning decisions and may inform activity design to improve future development outcomes.

This Request for Information (RFI) is issued solely for information gathering purposes and is published in accordance with FAR Part 10 and FAR 15.201(e).

Specifically, through this Request for Information (RFI), issued to collect expert industry inputs solely for information-gathering and planning purposes, USAID seeks to enhance the design of the subject Activity. This RFI does not constitute a Notice of Funding Opportunity (NOFO) or a Request for Proposals (RFP). Responses to this RFI are not applications or official proposals and will in no way be deemed to form any binding agreement with the RFI issuing authority. Please do not submit applications, proposals, resumes or promotional materials, as they will be discarded.

Proprietary information should not be sent. USAID may use any information provided without incurring any obligation. USAID reserves the right to, or not to incorporate any, some, or none of the comments received from this RFI into any subsequent solicitations or design documents.

Anticipated Term: TBD Proposed Mechanism(s) Type: TBD

Responses to this RFI should be submitted to USAID via email to pretoriaapplications@usaid.gov with subject line “72067424RFI00007: Western Cape Provincial Care and Treatment Activity” no

72067424RFI00007

USAID Western Cape Provincial Care and Treatment Activity.

later than the date and time stated above.

Only electronic submissions will be accepted. Responses to this RFI must be written in English.

Respondents will only receive an electronic confirmation acknowledging receipt of your response but will not receive individualized feedback on any suggestions. Questions regarding this announcement will not be accepted or answered. Not responding to this request does not preclude participation in any future solicitation, if any is issued. No basis for claims against the U.S.

Government shall arise as a result of a response to this request for information or from the U.S.

Government’s use of such information.

Standard Provision: FAR 52.215-3 Request for Information or Solicitation for Planning Purposes

(OCT 1997)

(a) The Government does not intend to award a contract on the basis of this request or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18 Bid and Proposal Costs, of the Federal Acquisition Regulation.

(b) Although “proposal” and “offeror” are used in this Request for Information, your response will be treated as information only. It shall not be used as a proposal.

(c) This request is issued for the purpose of obtaining information related to a potential Gauteng Provincial Care and Treatment Activity.

This RFI will not be construed as a commitment by the U.S. Government to issue any solicitation, award any grant, or pay for any information submitted as a result of this request. Responders are solely responsible for bearing all expenses associated with preparation and submission of the response to this RFI.

It should be noted that responding to this RFI will not give any advantage to any organization in any subsequent procurement. Any information submitted in response to this notice is voluntary.

Thank you for your interest in USAID programs and we look forward to your responses.

Sincerely, Kerry West Contracting/Agreement Officer USAID/Southern Africa

Request for Information (RFI) USAID/Southern Africa

Bilateral Health Office (BHO) USAID Western Cape Provincial Care and Treatment Activity

PURPOSE:

The purpose of this RFI is to solicit feedback on the technical design of a new Care and Treatment Activity. USAID/Southern Africa is interested in identifying local organizations in Western Cape that may have the technical and institutional capacity to implement the conceptual program or component(s) of the program described in this RFI. There is no commitment that any future solicitations in this area will be limited to local organizations nor is it an indication that USAID/Southern Africa will proceed with procurement of the items contained in this RFI.

Submissions in response to this RFI will be used to:

1) refine the design of the Activity to validate our current assumptions and gain a better understanding of what is needed to close the gap to HIV/TB epidemic control while building a resilient health system and leveraging community, civil society, and private sector partnerships;

and,

2) identify qualified South African organizations with institutional capabilities and/or potential to implement either a broad range of technical interventions in support of achieving HIV epidemic control in the Western Cape Province. This RFI aims to solicit feedback on innovations to further advance work at the provincial and district levels with focus on the Cape Town Metro to achieve HIV and TB epidemic control. Implementation of activities will take a provincial approach to epidemic control, in addition to work being done at the national level. In additional the provincial focus, tasks under this activity should align to the South African National Department of Health (NDoH), the National Strategic Plan and reinforced through agreements between governments of the United States and South Africa as part of the President’s Emergency Plan For AIDS Relief (PEPFAR) Country Operational Planning process.

Respondents are not obligated to provide answers to all questions. They are encouraged to only provide answers to questions where they have experience or where they are confident that their response will add value to USAID/Southern Africa to achieve its purpose regarding this RFI.

The subject RFI has two (2) parts which are as follows:

I) Narrative Statement – This refers to responses to any or all of the eight questions below regarding the attached Activity’s Conceptual Results Framework and its three conceptual objectives; and

II) Capabilities Statement – Which describes the experiences of South African organizations in the Western Cape Province, indicating their technical and institutional capability to potentially be able to implement a program or components of a program as conceptually described in this RFI.

BACKGROUND:

The conceptual goal of this USAID/Southern Africa Provincial HIV/TB Care and Treatment Activity in Western Cape is to support healthy lives for the population of South Africa by achieving and sustaining HIV epidemic control through locally-led solutions that enable access to equitable health care. The Activity is in support of and aligned with the four goals of the South Africa National Strategic Plan (NSP) 2023-2028 and achievement of the UNAIDS “95-95-95” targets to eradicate HIV epidemic by 2030. The ambitious targets call for at least 95% of all people living with HIV to know their HIV status, at least 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy (ART), and at least 95% of all people receiving antiretroviral therapy to have viral suppression.

The Activity reflects the urgency to accelerate and broaden the reach of a comprehensive HIV and TB response within the wider primary and public health systems, and to progressively transition toward long-term ownership and sustainability of this response. The Activity will also be tailored to address health systems challenges at the provincial and district levels. In Western Cape, the Activity will align to the most recent Provincial Implementation Plan on HIV, AIDS, and Tuberculosis. The plan focuses on aligning activities to the province’s data-driven trigger response to these epidemics while implementing a service redesign that includes rolling out community-oriented primary care (COPC), differentiated models of care (DMOC), evolving the provincial counseling strategy (Make Every Contact Count [MECC]), and other policy activities designed to address program needs in a constrained budget setting.

This Activity aims to: 1) close the gaps to HIV and TB epidemic control; 2) sustain health gains by strengthening and improving resilient health systems that align to broad provincial priorities; and

3) leverage community, civil society, and private sector partnerships to improve service delivery and client outcomes. Each component is interlinked to achieve the overall goal.

The Activity’s Conceptual Results Framework is found in Attachment 1. The following describes the three conceptual objectives under the Activity.

Objective 1: Close the gaps to HIV epidemic control.

The main goal of this objective is to achieve population-based viral suppression among people living with HIV (PLHIV) on ART and to prevent further transmission of the virus to ultimately achieve epidemic control (total number of new HIV infections is lower than the total number of deaths from all causes among PLHIV). South Africa has the largest HIV epidemic globally, with a projected 7.91 million PLHIV and 5.99 million on anti-retroviral therapy (ART) in 2024. This reflects an overall HIV prevalence of 13.1% of its population of 61 million people according to the latest census data. While incidence is declining each year, the HIV burden in South Africa continues to grow and has not reached epidemic control. National progress toward the 95-95-95 goals for the total PLHIV population is 90-91-94 as of the 2022 Sixth South African National HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI). Nationally, challenges across the cascade remain, particularly around treatment continuation. In the 27 high-HIV burden districts currently supported by PEPFAR, the Second 95 remains a critical gap. District level 2022 Naomi estimates that only six of the twenty-seven PEPFAR priority districts have not reached the first 95, while none have achieved HIV treatment coverage of 95%.

In the Western Cape, HIV prevalence is estimated to be 8.3% as of the 2022 SABSSM VI. This suggests a declining prevalence since 2017 when prevalence was estimated at 10.2%. Complex barriers to quality health care, client psychosocial barriers, treatment hesitancy, and other challenges lead to failed treatment initiations and treatment interruptions.

This objective aims to close the gap to HIV epidemic control through simplified, client-centered HIV and TB prevention and treatment models, including high-quality, client-tailored differentiated services implemented in a comprehensive manner for all age and sex bands in both communities and health facilities.

Objective 2: Sustain health gains through strengthened and more resilient health systems.

As South Africa progresses toward HIV epidemic control and elimination of TB, the management of HIV as a chronic condition, and TB as a curable infectious disease, will require a health system that is impactful, responsive and adaptive to changing health needs health policy which is well-financed and efficiently managed. Access to health care must be equitable and affordable, with functioning, operational systems in place to ensure this accessibility. This objective supports building health systems that will maintain and sustain HIV and TB epidemic control over time, and will be resilient in the face of system-wide shocks, such as emergent infectious disease outbreaks. The objective will also address and support Western Cape’s near-term policy priorities and the national priority to shift to a national health insurance system. This objective will focus specifically on human resources for health, essential medicines and commodities, health information systems, data use for decision making, policy and guideline implementation, and effective governance and management systems at the provincial and district levels.

Objective 3: Leverage community, civil society, and private sector partnerships to improve service delivery and client outcomes.

USAID Southern Africa is committed to improving the underlying drivers and socio-economic determinants that currently limit service delivery and negatively affect health outcomes of our HIV and TB clients in Western Cape. To do so, this objective requires the strengthening of indigenously-led innovation, leadership, and implementation to improve the accessibility, quality and impact of sustained HIV and TB care. Enhancing partnerships with community groups, PLHIV-led organizations, civil society, and the private sector is key to ensure the sustained engagement and leadership of these key stakeholders in the province’s HIV and TB programming. Ending the HIV and TB epidemics, and sustaining those achievements, will require a whole-of-government and multi-sectoral approach with stakeholders particularly at provincial and district levels to ensure locally-relevant and co-owned innovations.

SPECIFIC QUESTIONS INTO WHICH USAID SEEKS INPUT:

The following are questions to solicit information to refine the design of the Activity, to obtain feedback on USAID/Southern Africa current assumptions and gain a better understanding of what is required to close the gap to achieving epidemic control while building a resilient and sustainable health system and leveraging community, civil society and private sector partnerships:

Achieving Epidemic Control

1. Describe the top three major impediments and/or development challenges within the health system at the provincial, district and sub-district levels to achieve epidemic control for all populations in Western Cape Province? Please define the problem statement for each impediment.

2. What innovative approaches are needed in Western Cape to close the gap in treatment, and improve treatment outcomes for men and youth? How might these innovative approaches overcome implementation challenges associated with safety, migration, the lack of economic opportunities, mental health, and limited access to adequate housing?

3. What are interventions that would be transformative in reaching epidemic control in Western Cape Province? Have any of these been piloted? If so, what were the results and how easily could they be scaled-up?

Partnership with the Government of South Africa

4. What different ways of collaboration and cooperation would be needed to ensure an effective partnership with Provincial and District Departments of Health in order to align with the Western Cape Provincial Implementation Plans on HIV, AIDS, and TB? What would be the measure(s) of success?

5. What would be the most effective approach to leverage Government of South Africa structures to complement and augment the Department of Health’s effort to promote a comprehensive HIV/TB response.

Community, Civil Society and Private Sector Involvement

6. What innovations and opportunities exist to leverage the community, civil society and private sector to improve service delivery and client outcomes, including those that address the social determinants of health that impact client retention in care? What would be the measure(s) of success?

7. What are the hurdles to including more community-based, indigenous partners in the program and the health information system for achieving epidemic control and a sustainable health system? What are ways to overcome those hurdles?

INSTRUCTIONS FOR RESPONDING TO THE RFI:

1) Part I - Narrative Statements:

Respondents are not required to respond to all eight questions listed under the Section entitled

“SPECIFIC QUESTIONS INTO WHICH USAID SEEKS INPUT”.

Respondents are requested to select and tailor which of the seven questions they respond to based on areas where they have the most useful insights and expertise to provide USAID/SA with information to achieve the purpose of the RFI. Response to Part I “Narrative Statements” shall be submitted electronically in the English language in writing specified by the due date and time indicated on the cover page not to exceed eight (8) pages using a 11-point font size, single spaced, 1-inch margin. Please indicate each question in your response using the correct number from the list.

2) Part II - Capabilities Statement:

Respondents are requested to send an additional one (1) page (11-point font size, single spaced, 1-inch margin) capabilities statement which describes their experience, specifically in the Western Cape Province, indicating their institutional capacity to implement a program or components of a program as conceptually described in this RFI.

Please note, this one-page statement should include all the following information:

● Technical capacity to successfully provide assistance in one or more component(s) of the RFI (respondents may respond to one or multiple components based on their expertise);

● Understanding the PEPFAR program and the unique context of the operational environment in South Africa in dealing with HIV/AIDS;

● Experience in implementing PEPFAR-supported programs;

● Corporate experience managing multi-million-dollar annual budgets;

● Organizational capacity to oversee human resources, finances, subcontracts, logistics and donor relations; and

● Existing or potential membership or participation in associations, consortiums, and partnerships (local, regional, or global) in the HIV/AIDS/TB health sector.

For more information about USAID/SA, please refer to: https://www.usaid.gov/south-africa.

https://www.usaid.gov/south-africa

Attachment 1: Illustrative Conceptual Results Framework of the USAID Provincial Care and Treatment Activity