SOL-611-14-000006_Eradicate_TB_Activity.pdf

SOL-611-14-000006

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

1 2

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

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J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

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SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

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16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

12. In compliance with the above, the undersigned agrees, if this offer is accepted within _______180_______ calendar days (60 calendar days unless a different period is inserted

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

REQ-611-14-00001811/06/2014

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ZAMBIA

USAID Zambia Mr Charlie Brown Supervisory Contracting Officer USAID/Zambia oaa-solicit-lusaka@usaid.gov

1200 LT 12/15/2014

Cecilia Kasoma 202 x7058 ckasoma@usaid.gov

216-6247

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PAGE(S)

Charlie Brown

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

Table of Contents:

Table of Contents:

Section B -Supplies or Services/Prices Section C- Description/Specifications Section D - Packaging and Marking Section E - Inspection and Acceptance Section F - Deliveries or Performance Section G - Contract Administration Data Section H - Special Contract Requirements Section I -Contract Clauses Section J - List of Documents, Exhibits and Other Attachments Section K- Representations, Certifications, and Other Statements of Bidders Section L- Instructions, Conditions, and Notices to Bidders Section M - Evaluation Factors for Award

Section B -Supplies or Services/Prices

B1. PURPOSE

The purpose of the National TB and Leprosy Control Program is to strengthen the implementation of key components of the Government of the Republic of Zambia’s (GRZ) response to control tuberculosis (TB) in Zambia at the national level.

The Contractor will work with the National TB and Leprosy Control Program (NTP) on outstanding policy-related activities such as strategies, guidelines, and protocols. The Contractor will implement TB control activities in six provinces (Northern, Luapula, Muchinga, Copperbelt, Central, and North-Western) building on USAID’s previous investments in TB. In addition to the Objectives listed below in Section C in this solicitation.

B.2 CONTRACT TYPE

The U.S. Government represented by United States Agency for International Development intends to award a Cost-Plus-Fixed-Fee Completion type of contract.

B.3. ESTIMATED COST, FIXED FEE, AND OBLIGATED AMOUNT

(a) The total estimated cost plus fixed fee for the performance of this award is between

$19,000,000 and $24,900,000. The final negotiated amounts will be entered in the table below at the time of award:

Estimated Cost: $ Fixed Fee: $ Total Estimated Cost:

(b) The total estimated cost for the performance of the work required hereunder, exclusive of fixed fee, is $TBD.

(c) Within the estimated cost plus fixed fee specified in paragraph (a) above, the amount currently obligated and available for reimbursement of allowable costs incurred by the Contractor for performance hereunder is $TBD.

(d) Funds obligated are anticipated to be sufficient through Date TBD.

B.4 LINE ITEMS

The Budget for the award is as follows:

Amount

Salaries and Wages Fringe Benefits

Travel, Transportation and Per Diem Other Direct Cost (ODC) Sub-Awards Indirect Cost Total Estimated Costs Fixed Fee

B.5 INDIRECT COSTS

Prime:

Description Rate Base Type Period

TBD TBD 1/ 1/ 1/

TBD TBD 2/ 2/ 2/

1/ Base of Application: TBD Type of Rate: TBD Period: TBD

2/ Base of Application: TBD Type of Rate: TBD Period: TBD

The Contractor is allowed to recover applicable indirect costs (i.e. overhead, G&A, etc.)

on other direct costs (ODCs), if it is part of the Contractor’s usual accounting procedures, consistent with FAR Part 31, and the Negotiated Indirect cost Rate Agreement (NICRA).

Indirect costs shall not be allowed for organizations that do not have a NICRA. All costs for organizations without a NICRA shall be budgeted and billed as direct costs.

B.5 CEILING ON INDIRECT COSTS

Reimbursements for allowable indirect costs shall be at final negotiated rates but not in excess of the following ceiling rates:

Contractor Overhead

Rate % Overhead Ceiling Rate

G&A Rate

G&A Ceiling Rate %

PRIME

MAJOR

SUBCONTRACTOR(S)

NOTE 1: Insert additional indirect rates as needed for prime and major subcontractors in the above table.

NOTE 2: If the Contractor does not have a NICRA, all costs must be budgeted and billed as direct costs, and this provision is applicable.

(1) The Government will not be obligated to pay any additional amount should the final indirect cost exceeds the negotiated ceiling rates. If the final indirect cost rates are less than the negotiated ceiling rates, the negotiated rates will be reduced to reflect the lower rates.

(2) This understanding shall not change any monetary ceiling, obligation, or specific cost allowance or disallowance. Any changes in classifying or allocating indirect costs require the prior written approval of the Contracting Officer.

B.6 COST REIMBURSEMENT

Allowable costs shall be limited to reasonable, allocable and necessary costs determined in accordance with FAR clause 52.216-7, Allowable Cost and Payment, FAR clause 52.216-8, Fixed Fee, and AIDAR clause 752.7003, Documentation for Payment.

B.7 PAYMENT OF FIXED FEE

Pursuant to FAR 52.216-8, Fixed Fee, payment of fixed fee shall be allocated based upon the execution of tasks outlined in Section C, the approval of required deliverables listed in Section F, and the proportion of allowable and allocable costs incurred to accomplish the tasks and deliverables.

[END OF SECTION B]

Section C- Description/Specifications

Acronyms

CSO - Civil society organizations

DOTS - Directly Observed Therapy Short-course

GRZ - Government of the Republic of Zambia

M&E - monitoring and evaluation plan

MDG - Millennium Development Goals

MDR - TB- Multi Drug Resistant TB

NTP - National TB and Leprosy Control Program

NAAT-Nucleic Acid Amplification Technics

OR - Operational Research

PLWHA/PLHIV- People Living With HIV/AIDS

PPP - Public Private Partnerships

TB - Tuberculosis

USAID - United States Agency for International Development

WHO - World Health Organization

ZDHS - Zambia Demographic and Health Survey (2007)

A. BACKGROUND

Zambia is a sub-Saharan African country with a land mass of 752,610 square kilometers, and a population of 13 million people. Zambia is classified as a low-middle income country with a Gross Domestic Product per capita of $1, 540 in 2013 (World Bank).

Tuberculosis (TB) is a major cause of morbidity and mortality in Zambia. Zambia notified 45,277 cases of TB in 2011(WHO, 2012). The high notification of TB is primarily attributed to the high prevalence of HIV, which is estimated to be 14.3 percent (ZDHS, 2007) in the adult population (age 15-49). The prevalence of HIV among TB patients is 61 percent (WHO, 2013).

The Government of the Republic of Zambia (GRZ) recognizes TB as a major public health problem and is committed to its control (National Health Strategic Plan 2011-16).

TB control is implemented by the National TB and Leprosy Control Program (NTP).

The main interventions for TB control in Zambia are based on the Daily Observed Treatment, Short-course (DOTS) and the Stop TB Strategies. Through these efforts, Zambia has made tremendous gains in TB control. For example, treatment success has increased from 77 percent in 2002 to 88 percent in the 2011 cohort (WHO Global TB Report 2013).

However, more work needs to be done to improve case detection, which stands at 68 percent for all forms of TB in 2012 (WHO Global TB Report 2013). The other critical gaps in TB control in Zambia are in the areas of multi-drug resistant TB (MDR-TB), TB/HIV co-infection, and awareness of rights and responsibilities of people and communities affected by TB. In addition, there is need for additional research to generate new evidence in TB programming.

USAID/Zambia has been providing support to TB control efforts in Zambia since 2005.

This support has been channeled through the NTP at the national level and in six Northern provinces, Luapula, Northern, North-western, Copperbelt, Muchinga, and Central provinces. At the national level, USAID/Zambia provides financial and technical support to strengthen supervision, develop guidelines, strengthen laboratories, strengthen the national surveillance system for incidence and prevalence level data, and strengthen national coordination with the HIV/AIDS program in TB/HIV collaborative activities. At the provincial level, USAID/Zambia supports laboratory strengthening, training of health care workers, infection control, procuring of supplies, infrastructure renovations, transportation of specimens, supervision of health care workers, and joint strategic planning.

B. SCOPE

Over the next five years, USAID will invest in supporting the GRZ’s vision of a “Nation of Healthy and Productive People” with the specific goal of reducing TB-related mortality by 50 percent in the intervention provinces by 2019.

The Contractor for this TB activity (the Activity) will work in partnership with the GRZ, NTP, private sector and others at the national, provincial and community levels to strengthen implementation of key components of the GRZ’s response to control TB in Zambia. At the national level, the Contractor will work with the NTP on outstanding policy-related activities such as strategies, guidelines, and protocols. At a minimum, the Contractor will implement its TB control activities in six provinces, building on USAID’s previous investments in TB. These provinces are: Northern, Luapula, Muchinga, Copperbelt, Central, and North-Western provinces. More specific geographic scope will be determined by USAID and the Contractor. The Activity’s target communities have a high burden of TB, including underserved communities, people in congregate settings such as prisons, children, and People Living with HIV (PLHIV). In addition to the Objectives listed below, infection control and intensified case finding will be priority interventions across activities.

C. OBJECTIVES

1. To increase the number of individuals screened for TB in the target provinces by 50 percent (Baseline: number of individuals screened for TB in the target provinces in 2013); thereby increasing the number of people diagnosed with TB;

and

2. To increase TB treatment success rate to 85 percent and beyond in the target provinces.

D. TASKS

The Tasks of the Activity will support the National TB Strategic Plan (2011-2016). The Activity has four main tasks which are aligned with the Global Stop TB Strategy1:

1. Pursue high-quality DOTS expansion and enhancement

2. Address TB-HIV, MDR-TB and the needs of poor and vulnerable populations in six target provinces

3. Engage all categories of care providers

4. Enable and promote research

1 WHO’s Stop TB Strategy is available at the following link: http://www.who.int/tb/strategy/en/.

Below are the required sub-tasks, expected results and mandatory indicators for each Activity task. The Contractor must collect the following indicators at a minimum but should suggest additional indicators as appropriate in the Activity Monitoring & Evaluation Plan.

Task 1: Pursue high-quality DOTS expansion and enhancement

Sub-task 1.1: Increase political commitment:

Political commitment in TB control involves engagement of a broad range of leaders at national, provincial, district, and community levels to raise awareness about the need to control TB and increase involvement in TB control at each level. Good political commitment not only results in promulgation of enabling legislature and policies but also stimulates allocation of resources to TB control efforts.

The Contractor must plan and implement activities to engage and organize stakeholders, including civil society organizations (CSO), traditional and religious opinion leaders, private sector, and international organizations implementing programs in-country to ensure a harmonized, evidence-based response to TB in Zambia. The Contractor must prioritize the following among TB stakeholders: promoting sufficient and appropriately directed funding for TB control activities; addressing human resources constraints in the NTP; strengthening the governance and accountability of NTP; and promoting awareness around the importance of controlling TB in a harmonized manner.

• The Contractor must provide technical assistance to NTP to increase financing for TB control efforts. This includes technical assistance for the preparation of proposals for funding from the GRZ, the private sector, and international funders, including the Global Fund, CIDA, and others.

• The Contractor must conduct an assessment of NTP’s governance structure to identify key human resource gaps at national and provincial levels and develop plans to fill them based on priorities and available resources. This must be done in close consultation with the host Government and other stakeholders/funders.

• The Contractor must plan and implement capacity building activities for organizations and community groups at the national and sub-national levels to advocate for TB control activities and to raise awareness among Zambians on TB detection and treatment (including the world TB day commemorations).

1.1 Expected Results

• Current and former TB patients and civil society organizations represented in national and subnational TB and HIV meetings increased

• Partnerships between the Activity and corporate entities aimed at increasing funding for TB control activities in Zambia formed

• In collaboration with the GRZ, human resources gaps at national and provincial levels of the NTP identified and filled based on priorities

• National/subnational activities aimed at raising awareness for TB implemented

• CSOs, current and former TB patients and other members of the community involved in organizing TB and TB/HIV awareness raising activities in communities where they are domiciled or active increased

• TB and TB/HIV promotional/awareness raising and stigma reduction activities and services organized by district, village, or neighborhood committees in collaboration with the local health service providers increased

1.1 Indicators

• Number of corporate entities funding TB control activities through partnerships with the program

• Percentage of staff positions at provincial and national levels filled

• Percentage of planned provincial TB and TB/HIV supervision visits conducted by the

GRZ to the districts

• Percentage of planned national TB supervisory visits conducted by the GRZ to the provincial level

• Percentage of national and sub-national TB meetings in which CSOs and community groups are involved

• Percentage of community-level planned activities to raise awareness for TB implemented

Sub-task 1.2: Increase TB case detection through quality-assured microscopy and other diagnostic methods (including the Gene Xpert mycobacterium tuberculosis/rifampicin (MTB/RIF) technology) in the six targeted provinces

While increasing TB case detection is a priority of the NTP, in 2010, Zambia detected only 73 percent (45,000) of the estimated incidence of TB (62,023).

• The Contractor must technically assist the NTP to systematically scale up quality assured TB diagnostic services, including the gene Xpert technology (See Deliverable

II).

• The Contractor must identify and renovate selected laboratories/diagnostic centers in each target province in accordance with the unique needs of the center/s (See Deliverable I).

• The Contractor must provide technical assistance to the NTP in the area of TB laboratory commodity forecasting and quantification

• The Contractor must provide technical assistance to the targeted provinces in the area of TB diagnosis quality assurance focused on province-to-district and district- to-health facilities activities.

• The Contractor must develop and implement an innovative mentoring program for laboratory staff in all the TB diagnostic centers located in the target provinces.

• The Contractor must provide material and technical assistance to the GRZ to strengthen the laboratory specimen courier system developed by the current USAID-supported TB control Program.

• The Contractor must procure lab equipment and supplies based on identified need by the host Government.

1.2 Expected Results

• TB case detection increased

• Commodity security for TB diagnostic supplies improved

• Equitable access by all the target provinces to quality assured TB diagnostic services including X-pert technology achieved

• TB diagnosis quality assurance in the target provinces improved

1.2 Indicators

• Percentage of the planned/targeted laboratories/diagnostic centers for renovation that are actually renovated and appropriately equipped

• Percentage of provinces reporting stock-out of key laboratory reagents (these key lab reagents will be determined by the Activity in collaboration with USAID and the

GRZ)

• Percentage of PEPFAR-supported TB diagnostic centers reporting 95 percent correct results (this will be determined during routine quarterly external quality assurance visits to centers supported by the program using panel testing and blinded rechecking methods)

• Number of staff mentored in TB diagnosis

• Number of individuals screened for TB

• Number of individuals diagnosed with TB

• Percentage increase in TB case notification from the previous year/s

• Percentage of districts using the national courier system for transportation of TB specimens

Sub-task 1.3: Standardize TB treatment, support, and care

A standard treatment regimen with adequate treatment support systems at institutional and community levels is critical for Zambia’s TB control program. Patient-centered TB treatment support systems will ensure that TB patients take TB treatment correctly and consistently. Treatment adherence support, which may include direct observation of therapy (DOT) and psycho-social support, helps patients take their drugs regularly and complete treatment, thus achieving cure and preventing the development of drug resistance.

• The Contractor must provide technical assistance to the GRZ through the NTP to update TB treatment guidelines based on current national and international evidence in the area of TB and combined TB/HIV treatment.

• The Contractor must print and disseminate TB treatment guidelines to front line health care workers and community health workers responsible for the care of TB and co-infected TB/HIV patients.

• The Contractor must train “community volunteers” to support patients receiving TB treatment in their communities.

• The Contractor must devise and implement a capacity building plan to equip health care workers with clinical and laboratory knowledge, skills, and abilities necessary to improve TB patient outcomes.

• The Contractor must create partnerships with the corporate world to support community volunteers as part of corporate social giving.

• The Contractor must support the national TB surveillance system by ensuring the GRZ has sufficient TB and TB/HIV reporting and recording tools printed and distributed, and the NTP provides ongoing mentoring on recording and reporting requirements.

1.3 Expected Results

• TB treatment success rates increased

• Health facilities reporting stock-outs of anti-TB medicines reduced

• NTP implementation of up-to-date TB treatment guidelines increased

• Community volunteers providing adherence counseling and TB drugs to TB patients at community level across target provinces increased

• Treatment outcomes (treatment success rate, mortality, and morbidity) and quality of care for patients suffering from TB (TB case management) and TB/HIV co-infection in all target districts improved

1.3 Indicators

• Percentage of targeted districts with active community TB treatment support groups, including CSOs

• Percentage of health facilities reporting stock-out of anti-TB medicines

• TB treatment success rates in the target provinces

• Percentage of targeted health care workers trained in patient-centered TB DOTS and TB/HIV care as well as direct observational therapy

• Percentage of targeted district health offices trained in patient-centered TB and

TB/HIV care

Sub-task 1.4: Support the existing NTP monitoring and evaluation (M&E) system

The NTP already has a Monitoring & Evaluation (M&E) system for monitoring TB control activities. The current USAID-supported TB program supports this M&E system emphasizing development of data collection and reporting tools and support for data review meetings. However, the NTP faces the following challenges: 1) MDR-TB data is not systematically collected and reported; 2) TB data is not consistently used at the points of generation; 3) NTP does not have adequate numbers of sufficiently trained staff in M&E; and 4) the provinces/districts do not have a systematic way of reporting data to the next/higher level.

• The Contractor must provide technical assistance to the GRZ to build the capacity of NTP staff in Monitoring & Evaluation.

• The Contractor must technically assist the GRZ to incorporate MDR-TB data in the M&E system.

• The Contractor must provide technical and administrative assistance to the GRZ to establish a standard system/format for reporting TB data by provinces

• The Contractor must technically and logistically assist the GRZ and other stakeholders to pilot an electronic TB register.

1.4 Expected Results

• A critical mass (to be defined by the NTP, Contractor, and USAID) of NTP M&E staff trained

• MDR-TB data routinely and systematically reported by NTP

• Provinces report TB data following a standard format

• New TB data collection and collating tools adapted and implemented

• TB data integrity in target provinces improved

• Use of TB data for decision making at the point of its generation in the target provinces improved

1.4 Indicators

• Number of NTP staff trained in M&E

• Percentage of planned provincial and district data review meetings that convened

• Number of provinces and districts submitting semi-annual and annual reports within the agreed reporting period

• Number of district quarterly reports that have been peer reviewed /audited during quarterly review meetings

Task 2: Address TB-HIV, MDR-TB and the needs of poor and vulnerable populations in target provinces

Sub-task 2.1: Reduce the burden of TB/HIV co-morbidity

Fifty-four percent of all TB patients in Zambia are also co-infected with HIV. The NTP needs to reduce the burden of the TB/HIV co-morbidity by screening all registered TB patients for HIV and screening all HIV-infected patients in HIV care for TB to reduce missed opportunities. The current USAID-supported TB program continues to support the NTP in implementing intensified TB case finding, TB infection control, and provider-initiated counseling and testing for HIV. Challenges in TB/HIV include: only 30% of HIV-infected patients are screened for TB, only 66% of TB/HIV infected patients are started on HIV treatment, and delayed implementation of the isoniazid preventive therapy (IPT) program.

• The Contractor must provide technical and administrative assistance to the NTP to coordinate integrated TB/HIV activities at the national, provincial, and district health offices.

• The Contractor must plan and implement activities aimed at increasing TB detection among HIV-infected individuals by targeting any combination of the following factors: increased use of effective technology, training, and/or location of TB and HIV service provision. The Contractor is not limited to addressing the list of factors outlined above.

• The Contactor must provide technical and financial assistance to the NTP to define a context-specific infection control package (a minimum number of infection control activities necessary to assure infection control at community and health facility levels) to be implemented in the target provinces.

• The Contractor must provide technical and financial assistance to the NTP to ensure continued screening of TB patients for HIV and provision of HIV-infected TB patients with HIV treatment.

2.1 Expected Results

• Joint planning for TB and HIV services/activities at provincial and district levels implemented

• Proportion of HIV-infected individuals screened for TB increased

• Proportion of patients with TB/HIV commenced on HIV treatment increased

• Infection control activities at TB/HIV sites and community levels strengthened

• Proportion of TB-infected patients tested for HIV increased

2.1 Indicators

• Percentage of TB/HIV patients initiated on HIV treatment

• Percentage of registered TB patients tested for HIV

• Number of districts implementing TB infection control plans

• Number of provinces with a joint annual TB/HIV implementation plan and which held at least three coordinating meetings in the past year

Sub-task 2.2: Strengthen systems to halt MDR-TB expansion

The incidence of new MDR-TB cases is still low in Zambia (between 500 and 800 cases per year), but there is a critical need to strengthen systems to ensure MDR-TB is controlled since other sub-Saharan African countries such as South Africa are experiencing increased rates of MDR-TB. Zambia continues to record new MDR-TB cases and the NTP is yet to operationalize the programmatic management of MDR-TB.

For example, the MDR-TB treatment guidelines have not yet been finalized and the country does not have a sufficient pool of health care workers trained to manage MDR- TB or special admission facilities for MDR-TB patients needing hospitalization.

• The Contractor must provide technical assistance to the NTP to finalize and implement the MDR-TB treatment guidelines.

• The Contractor must provide technical, financial, and logistical assistance to NTP to train health care workers in the diagnosis and management of MDR-TB.

• The Contractor must develop and implement a plan aimed at increasing TB and MDR-TB case detection among vulnerable groups, such as prisoners, children, and people living with HIV by involving key stakeholders like CSOs and community leaders and prison authorities.

• The Contractor must renovate two centers to serve all targeted provinces to manage MDR-TB patients.

• The Contractor must provide technical assistance and funding to the National TB reference laboratory to strengthen its capacity to process specimens from subordinate laboratories and to provide rapid turn-around time and complete reports to subordinate laboratories.

• The Contractor must materially and technically support the systematic scale-up of new diagnostic technology including the X-pert technology to enhance TB and MDR-TB case finding.

2.2 Expected Results

• Treatment success and cure rate among registered MDR-TB patients increased

• Intensified and active TB/MDR-TB case finding among high risk populations:

prisoners, children, PLWHA, pregnant women increased

• A pool of health care workers trained in managing MDR-TB patients developed

• Clinical and laboratory outcomes for MDR-TB patients/clients improved

• MDR-TB patients treated/managed in designated MDR-TB treatment facilities increased

• National TB reference laboratory’s capacity to process specimens referred from provinces and support an efficient feedback mechanism improved

• Equitable access to modern and quick TB testing equipment/technology such as the X-pert technology achieved

2.2 Indicators

• Number of health care workers trained to manage MDR-TB patients

• Average turn-around time of results for specimens referred to the national TB reference laboratory

• Number of patients diagnosed with drug resistant TB and MDR-TB

• Treatment success and cure rate among registered MDR-TB patients

Sub--task 2.3: TB detected and treated among children and other vulnerable populations

Diagnosing and treating children and other vulnerable populations is a particular unmet challenge in Zambia. In those cases in which children are identified by their families or communities as at-risk for TB, it is challenging to diagnose them because children are usually unable to produce the sputum specimen for examination. Compounding this difficulty is the fact that children with TB typically come from families that are poor, lack knowledge about the disease, and live in communities with limited access to health services.

• The Contractor must mentor health care workers in childhood TB.

• The Contractor must provide technical assistance to the NTP to integrate training on childhood TB into existing training for health workers on TB

• Integrate childhood TB into the mentorship activities listed in sub-tasks 1.2 and 1.3

• The Contractor must integrate specific information on childhood TB into community-level activities as mentioned in sub-task 1.1.

2.3 Results

• Number of children screened for and diagnosed with TB increased

• A pool of clinicians to manage childhood TB created

• Training and mentoring on childhood TB integrated into TB training

2.3 Indicators

• Number of health care workers trained to manage childhood TB

• Percentage of targeted districts with clinicians trained in the diagnosis of TB in children

• Number of children screened for TB

• Number of children diagnosed with TB

• Percentage of children successfully treated for TB of those cases identified

Sub--task 2.4: TB detected and treated among prisoners

TB prevalence in prisons is estimated to be significantly higher than prevalence in the general population in Zambia as in other countries given the often compact living conditions. While prisoners are frequently mobile, entering prisons with TB or leaving with it and infecting others in the general population, prisons are a static and high impact site for TB testing and treatment.

• The Contractor must provide technical assistance to ensure all new prisoners are screened for TB in selected prisons and that routine TB testing is done on an annual basis.

• The Contractor must provide technical and material assistance to ensure provider-initiated HIV counseling and testing is provided to prisoners with TB.

• The Contractor must provide technical and material assistance to ensure all prisoners exiting selected prisons are screened for TB and that those found positive are provided provider-initiated HIV counseling and testing.

2.4 Expected Results

• Proportion of prisoners screened and successfully treated for TB increased

• Proportion of children living in select prisons screened and successfully treated for TB increased

2.4 Indicators

• Percentage of prisoners screened for TB at the point of entry

• Percentage of prisoners screened for TB annually

• Percentage of targeted prisons that screen all new inmates entering prisons

• Proportion of children in prisons screened for TB

Task 3: Engage all categories of care providers (clinicians in public and private sectors, pharmacists, and community volunteers)

To accelerate achievement of TB control goals, Zambia must engage and coordinate all care providers in TB control in the public and private sectors (private medical practitioners and pharmacists) and communities, including traditional leaders.

The Contractor must develop and implement a strategy to increase organized involvement of private sector medical practitioners, pharmacists, and communities, including traditional healers in TB control activities.

3.1 Expected Results

• Private pharmacists collecting and referring sputum from TB suspects who visit their pharmacies increased

• Pharmacists providing TB drugs to confirmed TB patients increased

• Private medical practitioners diagnosing and treating TB patients increased

• Private-Public Partnerships in TB control created to increase financing for TB developed

• Community ‘volunteers’ collecting and referring sputum for examination increased

• Community ‘volunteers’ providing TB drugs and adherence counseling to TB patients increased

3.1 Indicators

• Number of private medical practitioners trained in TB

• Number of ‘community volunteers’ trained in TB

• Proportion of TB patients notified (diagnosed) by the private sector

• Number of traditional medical practitioners/healers trained with USAID support

• Number of referred presumptive TB patients and percentage of TB patients identified and diagnosed by the private sector (disaggregated by private clinic, and pharmacy)

• Number of referred presumptive TB patients and percentage of TB patients identified and diagnosed through referrals by ‘community volunteers’

• Number of ‘community volunteer’ groups receiving financial and material support from the private sector as a result of partnerships created with the program

• Number of ‘community volunteer’ groups implementing income generating activities with initial support from the corporate world

Task 4: Enable and promote operational research

Operational Research (OR) in TB has lagged behind the other components of the Stop TB Strategy in TB programming in Zambia. The main barriers limiting OR in TB programing in Zambia are: The NTP does not have sufficient staff adequately trained in TB OR; funding for TB OR has been limited; and Zambia has not defined key areas for

TB OR.

Program-based OR will be a core component of this TB Activity. To achieve TB OR objectives, the Contractor must:

• Strengthen the capacity of the NTP staff to conduct OR TB through training, mentorship, and strategic partnerships with research institutions and the academia

• Identify and prioritize areas requiring OR in order that resources are directed at TB OR areas with greatest potential of improving outcomes in TB control such as: childhood TB, new innovations in TB control, and community involvement in TB control.

• Create strategic partnerships with the corporate world to increase funding for TB

OR

4.1 Results

• Collaborative partnerships between the NTP, local research institutions, private sector partners and others in TB research developed

• NTP capacity to identify TB program operational problems and to develop, test, and scale-up context specific solutions together with contracted local and international research institutes strengthened

• NTP leveraging private sector funding for TB OR.

4.1 Indicators

• Percentage of health care workers targeted for training in research that are actually trained

• Number of organizations (public and private) supporting TB operational research

• Amount of funding allocated by NTP per year for operational research

• Number of targeted research activities conducted

KEY PERSONNEL

Key Personnel Minimum Qualifications

a. The Chief of Party will head the project team and make regular reports to the USAID Contracting Officer’s Representative (COR). The Chief of Party will be responsible for the overall management and implementation of the Activity. S/he will supervise project implementation and ensure that the Activity meets its planned results. The Chief of Party will represent and coordinate with all cooperating organizations and be the point of contact for all purposes of this project.

The Chief of Party must have an advanced degree (Masters) in Public Health or a relevant field from a reputable university. S/he must have at least 5 years of project management experience of public health projects. S/he should have demonstrated capacity to build and maintain productive working relationships with a wide network of partners and stakeholders; broad technical understanding of public health, particularly TB programing. S/he will have proven leadership and management skills to effectively achieve the Activity results described in the Request for Proposals (RFP). The Chief of Party must be Zambian, fluent in English and must possess excellent oral and written communication skills.

b. The Deputy Chief of Party is responsible for providing technical oversight to Activity operations. This includes providing overall technical guidance for planning, implementation and monitoring of the activities. This position will require a dynamic individual capable of translating public health data and evidence into practice and effective implementation of TB control activities.

The Deputy Chief of Party will preferably have a bachelor’s degree in health science or business or their equivalent and masters training in public health, management or their equivalent. The ideal candidate must have at least 5 years working in a senior technical position for a public health and/or international development project.

c. The Finance Director is a long term position responsible for overseeing the finance and administration functions of the project and ensuring compliance with project and USAID procedures. S/he will work closely with the Country Director and the Deputy Director and other staffs to ensure project resources are effectively and efficiently budgeted and managed.

The Financial Director should have a Bachelor’s Degree in business or accounting along;

ACCA or ZICA professional membership is preferred. A Master’s Degree in a related field is also preferred. S/he should have at least 5 years professional experience managing financial and contractual aspects of development projects.

d. The Strategic Information (SI) Advisor is responsible for overseeing monitoring and evaluation activities for the Activity. In addition, the SI Advisor will provide strategic and technical direction to improving data collection and the overall evidence-base for TB programing.

The SI Advisor should have a Bachelor’s Degree, and preferably a Master’s Degree in Public Health or a related field. S/he should have at least 5 years of professional experience in monitoring and evaluation.

[END OF SECTION C]

Section D - Packaging and Marking

D.1. AIDAR 752.7009 MARKING. (JAN 1993)

(a) It is USAID policy that USAID-financed commodities and shipping containers, and project construction sites and other project locations be suitably marked with the USAID emblem. Shipping containers are also to be marked with the last five digits of the USAID financing document number. As a general rule, marking is not required for raw materials shipped in bulk (such as coal, grain, etc.), or for semi-finished products which are not packaged.

(b) Specific guidance on marking requirements must be obtained prior to procurement of commodities to be shipped, and as early as possible for project construction sites and other project locations. This guidance will be provided through the Contracting Officer’s Representative (COR) indicated on this contract, or by the Mission Director in the Cooperating Country to which commodities are being shipped, or in which the project site is located.

(c) Authority to waive marking requirements is vested with the Regional Assistant

Administrators, and with Mission Directors.

(d) A copy of any specific marking instructions or waivers from marking requirements is to be sent to the Contracting Officer; the original must be retained by the Contractor.

D.2. BRANDING POLICY

The Offeror shall comply with the requirements of the policy directives and required procedures outlined in USAID Automated Directive System (ADS) 320.3.2 “Branding and Marking in USAID Direct Contracting” (version from January 8, 2007) at http://www.usaid.gov/policy/ads/300/320.pdf; and USAID "Graphic Standards Manual" available at www.usaid.gov/branding, or any successor branding policy.

As per 320.3.2 Branding and Marking is USAID Direct Contracts, USAID Policy is to require exclusive branding and marking in USAID direct acquisitions. “Exclusive Branding” means that the program is positioned as USAID’s, as showcased by the project name (e.g. “The USAID/Zambia Improving Prevention and Adherence to Care and Treatment”). “Exclusive Marking” means Contractors may only mark USAID-funded programs, projects, activities, public communications, commodities with the USAID Standard Graphic Identity and, where applicable, the host-country government or ministry symbol or another U.S. Government logo.

D.3 BRANDING STRATEGY

The USAID/Zambia’s Zambia Eradicate TB Activity is the project name assigned to this contract.

http://www.usaid.gov/policy/ads/300/320.pdf http://www.usaid.gov/branding

1. PROJECT MATERIALS AND COMMUNICATIONS:

Audiences The United States Agency for International Development’s Mission in Zambia has the following target audiences with whom it will promote and publicize USAID sponsorship:

Primary audience (clients): Government of the Republic of Zambia (GRZ) entities:

Ministry of Health (MOH), Ministry of Community Development, Mother and Child Health (MCDMCH), provincial medical offices, district medical offices and the National HIV/AIDS/STI/TB Council (NAC).

Secondary audience (supporters and influencers): USAID, other USG agencies, other donors working in health, private sector, local organizations working in TB and HIV, community groups, faith-based groups, PLHIV and TB and beneficiaries.

Messages The USAID/Zambia public sector support for TB control services through the Eradicate TB Activity operationalizes USAID/Zambia’s vision of equal access to quality, gender-sensitive, and sustainable TB services by the Zambian people, as close to the family as possible. The project aims at strengthening and expanding TB service delivery in six of Zambia’s ten provinces. This will be achieved through the following:

Providing material, financial, and technical assistance to the Government of the Republic of Zambia (GRZ) to implement evidence-based interventions to control TB in alignment with the National TB Strategic Plan 2011-16.

Maintaining the partnership and involvement of multiple stakeholders to sustain comprehensive TB services that emphasizes sustainability and greater GRZ allocation of resources, and supports the priorities of the MoH and NAC.

The program has a number of audiences, and messages will vary depending on the audience.

Marking Plan for Materials to be Produced

Materials: Training materials, posters, pamphlets, brochures, press releases, fact sheets, CDs, printed and electronic bulletins, organizational operational plans, studies, reports (progress and performance monitoring), work plans, promotional materials (bookmarks, leaflets, banners, etc.), public announcements, invitations, articles in the media, certificates, Power Point and other presentations, web sites and internet based materials will incorporate the message “From the American People” and the USAID identity. For all printed material, the project will use guidance set forth in the USAID Graphic Standards Manual http://www.usaid.gov/branding/USAID_Graphic_Standards_Manual.Pdf . This includes such issues as the USAID identities, color schemes, design and typeface for project http://www.usaid.gov/branding/USAID_Graphic_Standards_Manual.Pdf materials. Any other materials that will be produced under the contract will be subject to branding guidelines and COR or Mission approval, as appropriate. Please note that marking is not required on items used as part of the administration of the contract, such as stationery products, equipment, and offices. The goal is to mark programs and projects, not implementing partners. Thus, letterhead, name tags and business cards are not subject to branding.

Where appropriate, the materials and communications prepared under the contract will make clear that the product was produced with the support of the U.S. Agency for International Development. This acknowledgment may not be appropriate in some program materials, such as instances when the materials produced must appear to be coming directly from the host-country government or local organization.

Publication Disclaimer: All studies, reports, publications, web sites, and all informational and promotional products will contain the following provision:

This study/report/Web site [specify] is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents are the sole responsibility of the [name of organization] and do not necessarily reflect the views of USAID or the United States Government.

Events: At each public event USAID and the support from the American People will be verbally acknowledged in the following—or in an analogous—way: “This training/conference/seminar/fair/workshop is made possible by the support of the American people through the United States Agency for International Development (USAID). The content discussed is the sole responsibility of the Contractor and does not necessarily reflect the views of USAID or the US Government.”

Co-Branding The Contractor under the Eradicate TB Activity may collaborate with other organizations that contribute funds to publications, products, and events. In such cases, the guidelines for co- branding (outlined in ADS 320) will be followed, assuming the funding contributed is more than a token amount. Otherwise, USAID approval will be required for co-branding.

Level of Visibility: The desired level of visibility of the Eradicate TB Activity depends on the context of the given activity. Decisions on the level of visibility of the USG throughout the implementation of this Program will need to take into consideration the sensitive nature of the work requested under this RFP, and the need for the Zambian Government, civil society and the private sector to take ownership of processes and outcomes. In the majority of contexts, for example with government institutions where the Eradicate TB Activity is trying to promote client ownership and leadership, it may be beneficial to downplay the role of USG assistance. In other cases it may be beneficial to emphasize the role of USG assistance. Guidance on this issue will be provided by the

COR.

It is USAID’s policy that Contractors must not generate their own corporate publicity about a USAID-funded program without first obtaining permission from the Agency.

USAID should also be notified before Contractors make public the findings of USAID-funded studies or reports (e.g., at conferences, public meetings).

[END OF SECTION D]

Section E - Inspection and Acceptance

E.1. NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REF

The following contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAR "52.252-2 CLAUSES INCORPORATED BY REFERENCE" in Section I of this contract.

FEDERAL ACQUISITION REGULATION (48 CFR Chapter 1)

NUMBER TITLE DATE

52.246-5 INSPECTION OF SERVICES—

COST-REIMBURSEMENT APR 1984

E.2. INSPECTION AND ACCEPTANCE

USAID inspection and acceptance of services, reports and other required deliverables or outputs shall take place at USAID/ Zambia or at any other location where the services are performed and reports and deliverables or outputs are produced or submitted. The Contracting Officer’s Representative (COR) has been delegated authority to inspect and accept all services, reports and required deliverables or outputs.

[END OF SECTION E]

Section F - Deliveries or Performance

F.1. NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY

REFERENCE.

The following contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAR "52.252-2 CLAUSES INCORPORATED BY REFERENCE" in Section I of this contract.

FEDERAL ACQUISITION REGULATION (48 CFR CHAPTER 1)

NUMBER TITLE DATE

52.242-15 STOP-WORK ORDER AUG 1989

52.242-15 STOP-WORK ORDER ALTERNATE I APR 1984

F.2. PLACE OF PERFORMANCE

The place of performance for this award is Zambia at the National level and in Northern, Luapula, Muchinga, Copperbelt, Central, and North-Western provinces.

F.3. PERIOD OF PERFORMANCE

The period of performance for this…