RAFG_SOL-695-17-000002.pdf

U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT

ACQUISITION AND ASSISTANCE OFFICE

2657 AVENUE DE LA GENDARMERIE, KACYIRU

KIGALI, RWANDA

1. THIS CONTRACT IS A RATED ORDER RATING PAGE OF

PAGES

156 UNDER DPAS (15 CFR 700)

2. CONTRACT NUMBER 3. SOLICITATION NUMBER 4. TYPE OF SOLICITATION 5. DATE ISSUED

SEE COVER PAGE

6. REQUISITION/PURCHASE NUMBER

REQ-695-17-000005 SEALED BID (IFB)

NEGOTIATED (RFP)

7. ISSUED BY CODE 8. ADDRESS OFFER TO

U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT

ACQUISITION AND ASSISTANCE OFFICE

2675 AVENUE DE LA GENDARMERIE, KACYIRU

KIGALI, RWANDA

(If other than Item 7)

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

9. Sealed offers in original and _five_ 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 depository located in N/A until 4:00 p.m. (COB Burundi). Local Bujumbura) time June 12, 2017.

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.

A. NAME B. TELEPHONE (NO COLLECT CALLS) C. E-MAIL ADDRESS

zclarke@usaid.gov AREA CODE

250-252

NUMBER

596-400

EXT.

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

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

A SOLICITATION/CONTRACT FORM 1 I CONTRACT CLAUSES I-1

B SUPPLIES OR SERVICES AND PRICES/COSTS B-1 PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

C DESCRIPTION/SPECS./WORK STATEMENT C-1 J LIST OF ATTACHMENTS J-1

D PACKAGING AND MARKING D-1 PART IV - REPRESENTATIONS AND INSTRUCTIONS

E INSPECTION AND ACCEPTANCE E-1

F DELIVERIES OR PERFORMANCE F-1

G CONTRACT ADMINISTRATION DATA G-1 L INSTR., CONDS., AND NOTICES TO OFFERORS L-1

H SPECIAL CONTRACT REQUIREMENTS H-1 M EVALUATION FACTORS FOR AWARD M-1

K

REPRESENTATIONS, CERTIFICATIONS AND OTHER

STATEMENTS OF OFFERORS K-1

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

12. In compliance with the above, the undersigned agrees, if this offer is accepted within __________ calendar days (60 calendar days unless a different period is inserted 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 designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT 10 CALENDAR DAYS (%) 20 CALENDAR DAYS (%) 30 CALENDAR DAYS (%) CALENDAR DAYS (%)

(See Section I, Clause No. 52-232-8)

14. ACKNOWLEDGEMENT OF AMENDMENTS AMENDMENT NO. DATE AMENDMENT NO. DATE

(The offeror acknowledges receipt of amendments to the SOLICITATION for offerors and related documents numbered and dated:

CODE FACILITY

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

ADDRESS

OF OFFEROR

(Type or print)

15B. TELEPHONE NUMBER 17. SIGNATURE 18. OFFER DATE

AREA CODE NUMBER EXT.

15C. CHECK IF REMITTANCE ADDRESS IS DIFFERENT FROM

ABOVE - ENTER SUCH ADDRESS IN SCHEDULE

19. ACCEPTED AS TO ITEMS NUMBERED 20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION: 23. SUBMIT INVOICES TO ADDRESS SHOWN IN ITEM (4 copies unless otherwise specified)

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

24. ADMINISTERED BY (If other than Item 7) 25. PAYMENT WILL BE MADE BYCODE

USAID/RWANDA

FINANCIAL MANAGEMENT OFFICE

CODE

26. NAME OF CONTRACTING OFFICER (Type or print)

ZACHARY CLARKE

CONTRACTING OFFICER

27. UNITED STATES OF AMERICA 28. AWARD DATE

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

(Signature of Contracting Officer)

(REV. 9-97)

10. FOR INFORMATION CALL:

USAID/Rwanda Zachary Clarke, Contracting Officer

11. TABLE OF CONTENTS

STANDARD FORM 33

SOLICITATION, OFFER AND AWARD

SOLICITATION

OFFER (Must be fully completed by offeror)

AWARD (To be completed by Government)

N/A

SOL-695-17-000002

X

See Attached Table of Contents

X 1

SECTION A TABLE OF CONTENTS

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS................................................................... B-1

B.1 PURPOSE .............................................................................................................................................. B-1 B.2 CONTRACT TYPE ............................................................................................................................... B-1

B.3 ESTIMATED COST, FIXED FEE AND OBLIGATED AMOUNT…...…………………………….B-1

B.4 BUDGET ............................................................................................................................................... B-1 B.5 INDIRECT COSTS ............................................................................................................................... B-2

B.6 COST REIMBURSABLE……….…………………………… ……………………………………..B-2

B.7 MULTI‐YEAR CONTRACT ................................................................................................................ B-2 B.8 PAYMENT OF FEE .............................................................................................................................. B-3

SECTION C - STATEMENT OF WORK ....................................................................................................... C-1

C.1 OBJECTIVES……………… …………………………………………………………………………C-1

C.2 BACKGROUND ..................................................................................................................................... C-1 C.3 RESULTS AND GOALS........................................................................................................................ C-7

C.4 GENERAL ACTIVITY PARAMETERS……………………………………………………………...C-8

C.5 SERVICES/TASKS REQUIRED ......................................................................................................... C-15

SECTION D - PACKAGING AND MARKING ............................................................................................. D-1

D.1 AIDAR 752.7009 MARKING (JAN 1993) .......................................................................................... D-1 D.2 BRANDING AND MARKING ............................................................................................................ D-1

SECTION E - INSPECTION AND ACCEPTANCE ...................................................................................... E-1

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE ......................... E-1 E.2 INSPECTION AND ACCEPTANCE ................................................................................................... E-1

E.3 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)/MONITORING AND EVALUATION

PLAN ..................................................................................................................................................... E-1

SECTION F – DELIVERIES OR PERFORMANCE ...................................................................................... F-1

F.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE ............................. F-1

F.2 PERIOD OF PERFORMANCE…………………………………………………………………………..F-1

F.3 PLACE OF PERFORMANCE……………………………………………………………………………F-1

F.4 PERFORMANCE STANDARDS………………………………………………………………………...F-1

F.5 REPORTS AND DELIVERABLES .......................................................................................................... F-2

F.6 SUBMISSION OF DATA AND TECHNICAL MATERIALS…………………………………………F-10

F.7 KEY PERSONNEL……………………………………………………………………………………...F-11

F.8 AIDAR 752.7005 SUBMISSION REQUIREMENTS FOR DEVELOPMENT EXPERIENCE

DOCUMENTS (SEPTEMBRE 2013)…………………………………………………………………..F-15

SECTION G - CONTRACT ADMINISTRATION DATA ............................................................................. G-1

G.1 AIDAR 752.7003 DOCUMENTATION FOR PAYMENT (NOV 1998) ............................................ G-1

G.2 ADMINISTRATIVE CONTRACTING OFFICE ................................................................................. G-2 G.3 CONTRACTING OFFICER’S REPRESENTATIVE (COR) .............................................................. G-3 G.4 PAYING OFFICE .................................................................................................................................. G-3 G.5 INVOICING INSTRUCTIONS ............................................................................................................... G-3 G.6 ACCOUNTING AND APPROPRIATION DATA ............................................................................... G-3 G.7 TECHNICAL DIRECTIONS/RELATIONSHIP WITH USAID .......................................................... G-3 G.8 CONTRACTOR CONTACT INFORMATION.................................................................................... G-5

SECTION H - SPECIAL CONTRACT REQUIREMENTS ............................................................................ H-1

H.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE ......................... H-1 H.2 AIDAR 752.225-70 SOURCE AND NATIONALITY REQUIREMENTS (FEB 2012) ..................... H-1 H.3 AUTHORIZED GEOGRAPHIC CODE ............................................................................................... H-2 H.4 AIDAR 752.228-70 MEDICAL EVACUATION (MEDEVAC) SERVICES (JULY 2007) ............... H-2 H.5 INTERNATIONAL TRAVEL (AIDAR 752.7002 AND 752.7032) .................................................... H-2 H.6 PERSONNEL APPROVALS (AIDAR 752.7007 AND 752.7027) ...................................................... H-3 H.7 EXECUTIVE ORDER ON TERRORISM FINANCING (FEB 2002) ................................................. H-4 H.8 AIDAR 752.229-71 REPORTING OF FOREIGN TAXES (JULY 2007) ........................................... H-5

H.9 AIDAR 752.228-3 WORKER’S COMPENSATION INSURANCE (DEFENSE BASE ACT) (DEC

1991) ...................................................................................................................................................... H-6

H.10 INSURANCE AND SERVICES………………………...………………………………………….….H-6

H.11 SUBCONTRACTING PLAN, INDIVIDUAL SUBCONTRACT REPORT (ISR) AND THE

SUMMARY SUBCONTRACT REPORT .......................................................................................... H-67

H.12 CONSENT TO SUBCONTRACT ........................................................................................................ H-7

H.13 FOREIGN GOVERNMENT DELEGATIONS TO INTERNATIONAL CONFERENCES

(JAN 2002)…………………………………………………………………………………………….H-7

H.14 NONEXPENDABLE PROPERTY PURCHASES AND INFORMATION TECHNOLOGY

RESOURCES ........................................................................................................................................ H-7 H.15 LOGISTIC SUPPORT ........................................................................................................................... H-7 H.16 LANGUAGE REQUIREMENTS ......................................................................................................... H-8 H.17 GRANTS UNDER USAID CONTRACTS ........................................................................................... H-8 H.18 ENVIRONMENTAL COMPLIANCE .................................................................................................. H-8

H.19 DISCLOSURE OF INFORMATION……………………………………………………………… H-11

H.20 AIDAR 752.222-71 NONDISCRIMINATION (JUN 2012) ............................................................... H-12

H.21 AIDAR 752.222-70 USAID DISABILITY POLICY- ACQUISITION (DEC 2004)…………….....H-12

H.22 ADS 302.3.5.19 USAID-FINANCED THIRD-PARTY WEBSITES (AUG 2013)…………………H-12

H.23 AIDAR 752.231-72 CONFERENCE PLANNING AND REQUIRED APPROVALS

(AUG 2013)…………………………………………………………………………………….… ...H-14

H.24 ADS 302.3.5.22 SUBMISSION OF DATASETS TO THE DEVELOPMENT DATA

LIBARARY (OCT 2014).............................................................................................................…...H-15

H.25 COMPLIANCE WITH THE TRAFFICKING VICTIMS PROTECTION REAUTHORIZATION

ACT…………………………………………………………………………………………………..H-16

H.26 AUTHORIZED WORK WEEK...…………………………………………………...……………... H-16

H.27 FAR 52.203-18, PROHIBITION ON CONTRACTING WITH ENTITIES THAT REUIRE

CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS OR STATEMENTS-

REPRESENTATION (JAN 2017)…………………………………………………………………..H-16

H.28 AIDAR 752.7036 USAID IMPLEMENTING PARTNER NOTICES (IPN) PORTAL FOR

ACQUISITION (JULY 2014)……………………………………………………………………….H-17

H.29 LOGISTIC SUPPORT GOVERNMENT FURNISHED FACILITIES FOR PROPERTY…………H-18

H.30 COMPLIANCE WITH SECTION 508 OF THE REHABILITATION ACT OF 1973,

AS AMENDED………………………………………………………………………………………H-19

H.31 RIGHT TO PRODUCE FROM OTHER SOURCES (AUGUST 2016)………………………….....H-19

H.32 ELECTRONIC PAYMENTS SYSTEM……………………………………………………………..H-19

H.33 BUSINESS CLASS TRAVEL……………………………………………………………………….H-20

H.34 CLOUD COMPUTING (MAY 2016)…………...……………………………………………….….H-20

H.35 USAID/BURUNDI ADDITIONNAL REQUIREMENTS FOR PERSONNEL

COMPENSATION (APRIL 2017)…………………………………………..………………………H-26

H.36 ADS 302.3.5.16(a) (3) CONDOMS (ACQUISITION)…………………………………………. ….H.27 H.37 ADS 302.3.5.16(a) (4) PROHIBITION ON THE PROMOTION OR ADVOCACY OF THE

LEGALIZATION OR PRACTICE OF PROSTITUTION OR SEX TRAFFICKING (SEPT 201… H-27

H.38 ADS 302.3.5.16(a) (2) CONSCIENCE CLAUSE IMPLEMENTATION (FEB 2012)...……….…...H-29

H.39 AIDAR 752.7101 VOLUNTARY POPULATION PLANNING ACTIVITIES (JUNE 2008……….H-29

SECTION I - CONTRACT CLAUSES ........................................................................................................... I-1

I.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE .......................... I-1 I.2 FAR 52.203-13 CONTRACTOR CODE OF BUSINESS ETHICS AND CONDUCT (OCT 2015) .... I-4

I.3 FAR 52.217-2 CANCELLATION UNDER MULTI-YEAR CONTRACTS (OCT 1997)...………….I-7

I.4 FAR 52.222-50 COMBATING TRAFFICKING IN PERSONS (MAR 2015) ..................................... I-8 I.5 FAR 52.229-8 TAXES – FOREIGN COST-REIMBURSEMENT CONTRACT (MAR 1990) ......... I-15 I.6 FAR 52.243-7 NOTIFICATION OF CHANGES (JAN 2017) ............................................................ I-15 I.7 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) .................................. I-17

I.8 AIDAR 752.209-71 ORGANIZATIONAL CONFLICTS OF INTEREST DISCOVERED AFTER

AWARD (JUN 1993)………………………………………………………………………………….I-17

I.9 AIDAR 752.231-71 SALARY SUPPLEMENTS FOR Host Government (HG) EMPLOYEES (MAR 2015) ..................................................................................................................................................... I-18

I.10 AIDAR 752.7004 EMERGENCY LOCATOR INFORMATION (JULY 1997) ................................. I-18 I.11 AIDAR 752.7013 CONTRACTOR-MISSION RELATIONSHIPS (OCT 1989) ............................... I-18 I.12 AIDAR 752.7034 ACKNOWLEDGMENT AND DISCLAIMER (DEC 1991) ................................. I-19

SECTION J - LIST OF ATTACHMENTS ...................................................................................................... J-1

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS OF

OFFERORS…………………………………………………………………………………...K-1

K.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE ......................... K-1 K.2 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2017) ................. K-1

K.3 FAR 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATION

(OCT 2015)……………………………………………………………………………………………K-4

K.4 FAR 52.230-7 PROPOSAL DISCLOSURE--COST ACCOUNTING PRACTICE CHANGES (APR

2005) ...................................................................................................................................................... K-6

K.5 INSURANCE - IMMUNITY FROM TORT LIABILITY .................................................................... K-7

K.6 COMPLIANCE WITH VETERANS EMPLOYMENT REPORTING REQUIREMENTS

(FEB 2016) …………………………………………………………………………………………...K-7

K.7 AUTHORIZED NEGOTIATORS ......................................................................................................... K-7

K.8 52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS (JAN 2017)………....…………………………………………K-7

K.9 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013) ........... K-8

K.10 SIGNATURE…………………………………………………………………………………………..K-9

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS .................................. L-1

L.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE ............. L-1 L.2 FAR 52.216-1 TYPE OF CONTRACT (APR 1984) ............................................................................ L-1 L.3 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006) ........................................................................... L-1 L.4 GENERAL INSTRUCTIONS TO OFFERORS ................................................................................... L-2 L.5 DELIVERY INSTRUCTIONS .............................................................................................................. L-2

L.6 GENERAL INSTRUCTIONS FOR THE PREPARATION OF THE TECHNICAL PROPOSAL ..... L-4

L.7 TECHNICAL APPROACH AND IMPLEMENTATION PLAN (see Section M.3) ........................... L-5

L.8 MANAGEMENT APPROACH (See Section M.4)………………………………………… ……….L-6 L.9 PERSONNEL AND STAFFING PLAN (See Section M.5)….…..……… ………………………….L-7

L.10 ILLUSTRATIVE MONITORING, EVALUATION AND LEARNING PLAN (see Section M.6) ..... L-7 L.11 PAST PERFORMANCE (see Section M.7) .......................................................................................... L-8 L.12 INSTRUCTIONS FOR THE PREPARATION OF THE COST PROPOSAL ..................................... L-9 L. 13 INSTRUCTIONS FOR THE PREPARATION OF BRANDING AND MARKING PLANS: .......... L-18

SECTION M - EVALUATION FACTORS FOR AWARD ............................................................................ M-1

M.1 GENERAL INFORMATION ............................................................................................................... M-1 M.2 EVALUATION FACTORS................................................................................................................. M-1 M.3 TECHNICAL APPROACH AND IMPLEMENTATION PLAN ......................................................... M-1 M.4 MANAGEMENT APPROACH ............................................................................................................ M-2 M.5 PERSONNEL AND STAFFING PLAN ............................................................................................... M-3 M.6 ILLUSTRATIVE MONITORING, EVALUATION, AND LEARNING PLAN ................................ M-3 M.7 PAST PERFORMANCE ...................................................................................................................... M-4 M.8 COST EVALUATION ......................................................................................................................... M-5 M.9 DETERMINATION OF THE COMPETITIVE RANGE AND CONTRACT AWARD .................... M-6 M.10 CONTRACTING WITH SMALL BUSINESS CONCERNS .............................................................. M-7

ATTACHMENTS………………………………………………………………………………………...….ATT-1

RFP NO.: SOL-695-17-000002

RAFG ACTIVITY

B-1

PART I – THE SCHEDULE

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

B.1 PURPOSE

The purpose of this contract is to provide the services and deliverables as described in detail in Section C, Statement of Work, for the Reaching an AIDS-Free Generation (RAFG) Activity.

B.2 CONTRACT TYPE

This is a Cost-Plus-Fixed-Fee (CPFF) Completion Contract. For the consideration set forth below, the Contractor must achieve the performance objectives and deliverables or outputs described in Sections C, D and F, and otherwise comply with all contract requirements.

B.3 ESTIMATED COST, FIXED FEE AND OBLIGATED AMOUNT

(a) The estimated cost for the performance of the work required hereunder, exclusive of fee is $___________. The fixed fee is $__________. The estimated cost plus fixed fee is $________.

(b) Within the estimated cost plus fixed fee (if any) specified in paragraph (a) above, the amount currently obligated and available for reimbursement of allowable costs incurred by the Contractor (and payment of fee, if any) for performance hereunder is $4,025,000 {Estimate at time of solicitation; to be confirmed at time of award based upon available funding and total estimated cost of the contract}. The Contractor must not exceed the aforesaid obligated amount.

(c) Funds obligated hereunder are anticipated to be sufficient through December 2018 {To be confirmed based on the date of award and total estimated cost of contract}.

B.4 BUDGET

The total cost (exclusive of fixed fee) stated below for the budget categories specified below may not be adjusted without a modification to the contract signed by the Contracting Officer.

No amounts in excess of the amounts specified for each activity will be billed against the Contract.

Intermediate Result 1: Identify HIV-positive men, women and children through high quality, targeted HTS and link to ART services (see C.5.2.2) $_____ Intermediate Result 2: Increase ART coverage in men, women and children living with HIV (see C.5.2.2) $_____ Intermediate Result 3: Ensure HIV+ men, women and children on ART are virally suppressed (see C.5.2.2) $_____ Management and Administrative Services (see C.5.2.1) $_____

B-2

The Contractor must allocate costs to these budget categories based on the guidance in Section C below and consistent with the Contractor’s final proposal, which was accepted by USAID/Burundi through award of this contract.

B.5 INDIRECT COSTS

Pending the establishment of a revised provisional or final indirect cost rates, allowable indirect costs will be reimbursed on the basis of the following negotiated provisional or predetermined rates and the appropriate bases:

Description* Period** Rate Base***

* Description or type of rate indicated as a percentage, e.g., G&A ** Period, e.g., CY 2009 *** Base, e.g., Direct Labor for Labor Overhead

B.6 COST REIMBURSABLE

The U.S. dollar costs allowable will be limited to reasonable, allocable and necessary costs determined in accordance with FAR 52.216-7, Allowable Cost and Payment, FAR 52.216-8, Fixed Fee, if applicable, and AIDAR 752.7003, Documentation for Payment.

B.7 MULTI‐YEAR CONTRACT

The Contract is considered non‐severable, and is therefore a multi‐year contract as defined in FAR 17.103. Therefore, this contract is subject to the requirements of FAR 17.106.

Cancellation Dates:

Contract Year 2: Date________ Amount: $0______

Contract Year 3: Date________ Amount: $0______

Contract Year 4: Date________ Amount: $0______

Contract Year 5: Date________ Amount: $0______

Total Years 2-5: Amount: $0______

Cancellation Ceiling: This is a CPFF type contract where the Contractor is authorized to be reimbursed for all costs which are allowable in accordance with FAR 52.216‐7, “Allowable Costs and Payment.” Therefore, the Contractor will not incur any costs which would have been amortized over the life of the contract should the contract be cancelled in accordance with FAR 52.217‐2. The cancellation ceiling for each cancellation date is indicated above.

B-3

B.8 PAYMENT OF FEE

Payment of the fixed fee will be made as follows. The Contractor’s fixed fee is tied to the accomplishment of performance objectives and deliverables or outputs described in Sections C, D and F that are specified in Table 1 below. The Contractor will be paid the amount of fee specified for each denoted performance objective, deliverable or output set forth in the table below upon acceptance by the Contracting Officer’s Representative (COR). Because the clause entitled “Allowable Cost and Payment” (FAR 52.216‐7) is incorporated into this contract, the terms and conditions of this clause applies after total payments of fixed fee reach eighty‐five percent (85%) of the total fixed fee.

Table 1: Fixed Fee Payment Schedule

Identifier Performance Objective/Deliverable/Output

Reference Section

Means of Verification $ Amount

A Acceptance of Monitoring, Evaluation and Learning Plan with baselines for each performance indicator

F.5(3)

MEL Plan with baselines for each performance indicator approved by COR in signed memo

TBD

B Acceptance of the first Annual Work Plan

F.5(1) First Annual Work Plan as described in F.5(1) approved by COR in signed memo

TBD

C Pilot of Continuous Quality Improvement (CQI) plan for HIV/AIDS services

C.5.2.2 CQI completed reports TBD

D Completion of quality management system (QMS) plan for diagnostic laboratories

C.5.2.2 QMS completed reports TBD

E Completion of SMS Referral System

C.5.2.2. SMS system reports TBD

F __% of PLHIV know HIV status

C.5.2.2 DATIM data following DQA using Spectrum calculations for denominator

TBD

G

__% of suspected TB patients are tested using GeneXpert test

C.5.2.2 DATIM data following DQA using Spectrum estimations for denominator

TBD

H __% of children and adolescents living with HIV know their status

C.5.2.2 DATIM data following DQA using Spectrum estimations for denominator

TBD

I __% of infants born to HIV+ women have documented virological test results by 12 months of age

C.5.2.2 DATIM data following DQA using Spectrum estimations for denominator

B-4

Identifier Performance Objective/Deliverable/Output

Reference Section

Means of Verification $ Amount

J __% of newly identified HIV+ Adolescents initiated on ART

C.5.2.2 DATIM data following DQA using Spectrum estimations for denominator

TBD

K __% of newly identified PLHIV that are initiated on ART enrollment services within 1 week of diagnosis

C.5.2.2 SIDAINFO (or other agreed on software) following DQA

TBD

L __% of HIV+ individuals receiving ART that are retained in care for at least 12 months

C.5.2.2 DATIM data following DQA using Spectrum estimations for denominator

TBD

M __% of adolescents receiving ART that are retained in care for at least 12 months

C.5.2.2 DATIM data following DQA using Spectrum estimations for denominator

N

__% of PLHIV on ART that have a suppressed viral load documented in viral load register within 12 months of initiating ART

C.5.2.2 DATIM data following DQA using Spectrum calculations for denominator

TBD

O __% of children and adolescents living with HIV that have a suppressed viral load within 12 months of initiating ART

C.5.2.2 DATIM data following DQA using Spectrum estimations for denominator

TBD

P __% of laboratories that score __% in QMS assessments

C.5.2.2 QMS reports TBD

Q __% of facilities that score__% in CQI assessments

C.5.2.2 CQI reports TBD

R Turnaround time for __% EID samples is < 20 days from sample collection to delivery of results to facility staff

C.5.2.2 SIDAINFO (or other agreed on software) following DQA

Q-_ To be proposed by Offeror TBD TBD TBD

[END OF SECTION B]

C-1

SECTION C - STATEMENT OF WORK

C.1 OBJECTIVES

The objective of the Reaching an AIDS-Free Generation (RAFG) Activity is to scale up antiretroviral therapy (ART) services for people living with HIV (PLHIV) using an integrated, community-based approach in high-prevalence provinces to contribute towards the Government of Burundi’s goal to achieve epidemic control nationally. The RAFG Activity aims to increase coverage throughout the continuum of HIV/AIDS care and treatment to ensure that 90% of people living with HIV and HIV-exposed infants know their status, 90% of those who are HIV-positive are placed on lifelong ART, and that 90% of individuals on lifelong ART are virally suppressed.

C.2 BACKGROUND

The following section provides relevant background information regarding the: (A) country context and development challenge, (B) Government of Burundi’s response, (C) relationship with U.S. government priorities and other bilateral programs, and (D) relationship to other donors’ response.

A) Country Context and Development Challenges

Since the end of the thirteen year political-ethnic crisis and the return to democratic governance in 2005, Burundi has made gains in economic standing, health, and social welfare. The economy has grown steadily at about 4% per year through 2015, with the Gross National Income per capita increasing from $590 in 2005 to $730 in 2015. Despite these gains, Burundi remains one of the poorest countries in the world, ranked 184 out of 188 countries on the 2016 UNDP Human Development Index.1 With a population of approximately 11.5 million, more than 400 inhabitants per square kilometer, and a total fertility rate of 6.2 children per woman, Burundi has the second highest population density in sub-Saharan Africa, which impacts economic growth and health. Health challenges in Burundi are significant and the disease burden is predominant due to preventable causes, including malaria, malnutrition or infectious diseases such as

HIV/AIDS.

Burundi is considered to have a low-prevalence mixed HIV epidemic, which continues to be a growing public health threat. As of 2015, 1.3% of the population was living with HIV with approximately 3,000 annual deaths attributed to AIDS.2 According to data estimates compiled by the Joint United Nations Program on HIV/AIDS (UNAIDS) and the National AIDS Council (CNLS), approximately 68,000 adults and 9,100 children under 15 are living with HIV.

Although Burundi is not a high prevalence country, the 2013 PLACE study estimated that the prevalence of HIV among key populations is significantly higher, with a prevalence of 21.3%

1 UN 2016 Human Development Report: http://hdr.undp.org/en/composite/HDI 2 UNAIDS. "Burundi." Accessed August 26, 2016. http://www.unaids.org/en/regionscountries/countries/burundi.

C-2 among female sex workers and 4.8% among men having sex with men.3 Stigmatization and social/legal discrimination against key populations leads to unwillingness to self-identify, which makes it difficult to have them tracked by HIV/AIDS programs. No data is available on HIV prevalence in bisexual, transgender, or other marginalized populations including persons living with disabilities.

The HIV/AIDS epidemic in Burundi is becoming increasingly feminized, with 56% of new infections in women and girls, and a 1.7% prevalence rate in women compared with 1% in men.4 Pervasive gender-based violence (GBV) is likely one explanation for the higher prevalence in women,5 with a 2014 study estimating almost one quarter of Burundian women having experienced GBV.6 Other factors contributing to the higher prevalence rate in women include early sexual debut and transactional sex.3 In addition, it is estimated that 89,000 children are orphaned due to HIV/AIDS in Burundi, placing these children at risk.

Burundi has had success with scale-up of antiretroviral therapy (ART) for pregnant and breastfeeding women, at 89% coverage, whereas coverage is generally low for the general population: at 58.4% for adults and 26.5 % for children under 15. Once on ART, survival rates among people with HIV are among the best in Africa: 90.1% at 12 months, 87.4% at 24 months and 83.9% at 36 months of treatment.

Co-infection with HIV and tuberculosis (TB) is a potential major health challenge in Burundi.

Data is not available for TB rates in PLHIV, yet data for TB reveals poor linkages of TB and TB/HIV cases to care and treatment. Based on 2015 data from the World Health Organization’s Global TB Report,7 the estimated incidence rate of TB (including HIV-positive TB patients) is 122 per 100,000, with only 51% of those cases being notified to the National TB Program (6,892 new and relapse cases in total). Of the estimated 6,892 cases, 12% were among children under 15 years of age, and the incidence among males was almost double that of females. Multidrug resistant TB (MDR-TB) is a concern in Burundi. The estimated burden of MDR-TB is 3.2% among new TB cases, and 14% among retreatment cases, yet only 22% of the 190 clients notified for MDR-TB in 2015 started treatment. Among TB patients, HIV incidence is 17%.

There is no data available for the rate of diagnosis of HIV in TB patients, but once clients became aware of their HIV status, 94% were initiated on ART in 2015.

While several positive advances have been made in the health sector overall in Burundi, the healthcare system has been slow to recover in the decade since the end of the civil war. The second Poverty Reduction Strategy Paper (PRSP-II)8 highlights the underlying factors that contribute to the poorly performing health system: decentralization without sufficient healthcare staff; under-funding of the sector despite significant donor financing; weak epidemiological surveillance and health information systems; and poor access to drugs at affordable prices.

3 Priorities for Local AIDS Control Efforts (PLACE) Study, 2013 4 Burundi DHS, 2010 5 Burundi Sexual Violence Assessment, Engender Health, 2011 6 Sexual Violence in Burundi (Households in Conflict Network, 2014) 7 WHO Global TB Report 2016: http://apps.who.int/iris/bitstream/10665/250441/1/9789241565394-eng.pdf?ua=1 8 Poverty Reduction Strategy Paper-II IMF, 2012

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Health data collection capacity is limited, and this has hampered the Government of Burundi (GoB) understanding of, and response to health crises. In addition, most quality health services are concentrated in Bujumbura, and clean water and sanitation systems are lacking in most rural areas.

For HIV/AIDS care and treatment, healthcare infrastructures and the availability of human resources are major barriers to care access. The shortage of competent and motivated human resources for health care is significant, and different solutions, including task-shifting, are greatly needed to make progress in HIV goals.

Supportive infrastructure required for an effective HIV/AIDS response, including laboratory and supply chain, are generally weak in Burundi. The national supply chain, which procures all antiretroviral medications (ARVs) and most HIV-related commodities, is being improved in collaboration with external donors, including the U.S. Government (USG). All components of the national laboratory system currently need strengthening, including laboratory infrastructure/maintenance, human resources capacity, sample transport and timely results return.

Access to early infant diagnosis (EID) and viral load (VL) testing has been a major challenge, as only one polymerase chain reaction (PCR) machine served the entire country until mid-2016, when a second PCR machine was made operational at Ngozi Hospital. At the national level, the contested elections of 2015 have plunged Burundi into a political and social impasse. In light of decreased domestic revenue due to a steep decline in the economy, the GoB significantly cut its health budget in 2016. Coupled with proposed cuts by major donors including Belgium and the European Union, the gains made in the health sector remain fragile and are at risk.

The RAFG Activity must be grounded in Burundi’s overall development context, and explicitly address the components that drive the HIV/AIDS epidemic in Burundi. The Activity’s approach must be implemented through an integrated approach to address health systems, gender, capacity building, sustainability, and community involvement. This flagship HIV/AIDS activity integrates major areas of USAID and the President’s Emergency Plan for AIDS Relief (PEPFAR) programming, and builds on the major achievements and lessons learned from other USG health sector activities in Burundi.

B) Government of Burundi Response

The GoB is engaged in the health sector, and has introduced several significant reforms with donor support, including decentralization of the health system through the formation of health districts, introduction of Performance Based Financing (PBF), and the elimination of fees for pregnant women and children under the age of five. The national response to HIV/AIDS is led by the National AIDS Council (NAC), presided over by the Burundian President, and coordinated by the Ministry of Health and the Fight against HIV/AIDS (PNLS). In Burundi, HIV care and treatment services are integrated into the basic healthcare package delivered at public and private/faith-based health facilities. A large percentage of HIV prevention outreach and community-based care and support services are provided by local civil society organizations (CSOs) and faith-based organizations (FBOs), aligned with a strong national network of people living with HIV, Réseau Burundais des Personnes Vivant avec le VIH/SIDA (RBP+).

The GoB has enacted several policies to support the HIV/AIDS response, notably waiving all

C-4 taxes on HIV medications and commodities and declaring all HIV services free of charge to the patient. The PNLS has recently revised the national treatment guidelines to include the World Health Organization (WHO)-recommended “Test and Start” policy to extend antiretroviral therapy to all people living with HIV and to support decentralized care and treatment.9 This new policy supports ART initiation in all adults, adolescents, and children with HIV regardless of their CD4 count or stage of disease. Innovations in the new guidelines include new approaches to HIV testing (community-based, home testing, and self-testing), the adoption of lifelong treatment for all PLHIV, considerations for differentiated care models, implementation of viral load testing as the preferred monitoring tool, and new point of care viral load technologies.

The HIV response in Burundi is funded primarily by two sources in 2016-2017—the U.S.

President’s Emergency Plan for AIDS Relief (PEPFAR) under USAID and the Department of Defense (37%) and the Global Fund (56%). The national government’s contribution is estimated to be around 5%, while other donors contribute 3%. With support from PEPFAR and the Global Fund, the GoB has strategically scaled up HIV/AIDS interventions and has worked towards developing a more sustainable model of epidemic control, defined as the point at which new HIV infections have decreased and fall below the number of AIDS-related deaths. The effectiveness of the response to the epidemic has been evidenced by a decline in HIV prevalence from 2.9% in 2001 to 1.3% in 2014.

C) Relationship with USG priorities and other bilateral activities

i. Relationship with USG priorities

USAID/Burundi’s activities to address health challenges are guided by and directly support Embassy Bujumbura’s Integrated Country Strategy. In the HIV/AIDS sector, USAID/Burundi activities provide a package of activities designed to provide the GoB with support to strengthen and sustain HIV/AIDS prevention, care and treatment to achieve epidemic control. These activities emphasize local capacity building, as well as key policy and structural reforms needed for a sustainable national response. This paradigm aligns with PEPFAR 3.0 core principles, which place an emphasis on effective, efficient and country-led platforms for the sustainable delivery of essential services and public health programs.

Specifically, the USG supports the GoB in implementing the Burundi HIV/AIDS National Strategic Plan (NSP), National Health Development Plan, and Poverty Reduction Strategy by:

1. Improving access to high-quality HIV/AIDS prevention and care services;

2. Decentralizing HIV/AIDS services, especially prevention of mother-to-child transmission (PMTCT) services;

3. Building the capacity of CSOs to provide direct HIV/AIDS services;

4. Improving the performance of the national health system.

9 Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV (WHO, 2015)

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The USG and GoB, along with other international and local partners, have made significant strides in PMTCT efforts in targeted provinces. The USG is currently working with the implementing partner Family Health International (FHI 360) to conduct PMTCT interventions in three provinces through the PMTCT Acceleration Project: Bujumbura Rural, Bujumbura Mairie, and Ngozi. Activities include community sensitization of HIV testing services (HTS), PMTCT trainings, prevention messaging along with family planning (FP), testing and counseling services offered during antenatal care (ANC), and referral to care and treatment for HIV-positive mothers. These activities are reducing new HIV infections among women of childbearing age, increasing the number of pregnant women who know their HIV status, increasing the number of infants that are born HIV-negative regardless of their mother’s status, and increasing the number of mothers and infants who receive follow-up care and treatment.

These activities complement those of the USAID-funded Integrated Health Project in Burundi (IHPB), which seeks to integrate PMTCT and ART with maternal and child health (MCH) and family planning (FP) services in two additional provinces, Kayanza and Kirundo.

The RAFG Activity will serve as Burundi’s flagship HIV/AIDS activity and represents a shift from a PMTCT-focused activity to a general population model to support the recent expansion of ART availability to all PLHIV through Burundi’s national HIV/AIDS treatment guidelines. The RAFG Activity will build on the successes of previous HIV/AIDS activities, which have made significant progress in scaling-up PMTCT and ART availability in five targeted provinces:

Kayanza, Kirundo, Ngozi, Bujumbura Rural, and Bujumbura Mairie.

ii. Relationship with other USAID/Burundi bilateral activities

Services provided under the Contract must be delivered in a complex environment, alongside other USAID/Burundi activities as outlined below. The list below shows only ongoing activities with a close link with the RAFG Activity. The Contractor is also expected to work with other related USAID activities, including: quality improvement, HMIS and data collection strengthening, laboratory systems strengthening, and supply chain management. The Contractor must also learn about and leverage other related donor activities in Burundi.

The Contractor is expected to demonstrate how they will coordinate their activities with the ongoing activities below to avoid duplication, and demonstrate how proposed interventions are complementing what is being done by these activities.

a) Integrated Health Project in Burundi (IHPB)

The IHPB works with the MOH and other stakeholders to ensure a comprehensive and integrated approach to its assistance in the health sector in HIV/AIDS, malaria, family planning/reproductive health, and maternal, neonatal, and child health. The geographic focus is in four provinces, Kayanza, Muyinga, Kirundo, and Karuzi. HIV/AIDS services are provided in Kayanza and Kirundo following the PEPFAR COP15 geographic pivot. The IHPB is also expected to link into and establish beneficiary referrals to other services as appropriate. This activity ends in December 2018, and the RAFG Activity is expected to take over HIV service activities in Kayanza and Kirundo at that time.

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b) Linkages Across the Continuum of HIV Services for Key Populations

Affected by HIV (LINKAGES)

The LINKAGES activity supports the National Burundi HIV/AIDS program to provide high quality and stigma-free HIV/AIDS services to key populations (KPs) living with HIV or at high risk of infection to deliver, and increase demand for, accessible and evidence based HIV/AIDS services in higher risk provinces. LINKAGES provides and facilitates both community and facility based services to key populations in Burundi – primarily for sex workers (SW), men who have sex with men (MSM), and transgender (TG) populations. LINKAGES also provides targeted support to the GoB and other HIV stakeholders (e.g. Global Fund) in the development of a national key population strategy, incorporation of evidence-based interventions to address gaps in current HIV programs, and the use of data for strategy and program improvement.

c) Enhanced Outcomes for Adolescent Girls and Young Women in Burundi (Mwigeme Kerebuka Urabishoboye)

The objective of the Mwigeme Kerebuka Urabishoboye activity is to mitigate the risk of vulnerable adolescent girls (aged 10-18) from acquiring HIV, which is closely associated with the incidence of unintended pregnancies, transactional sex, and gender-based violence in Kayanza Province. Consistent with the evidence and strategies associated with the PEPFAR Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe Women (DREAMS) initiative, enhanced educational, economic, psychosocial, and sexual and reproductive health outcomes (appropriate for age and situation) will contribute to achieving this overarching objective.

d) Burundians Responding Against Violence and Inequality (BRAVI)

The purpose of the BRAVI activity is to improve sexual and gender-based violence (SGBV) prevention and response efforts in Ngozi province. BRAVI is designed to complement the GoB’s efforts on SGBV prevention interventions, and works at the national level with the Ministry of Human Rights, Social Affairs, and Gender. At the provincial and community levels, BRAVI works with centers of family and community development to improve SGBV services, improve community advocacy for SGBV prevention, and to promote positive attitudes and behaviors.

Key results include strengthening the health sector response, promoting awareness and use of SGBV services and strengthening referral networks, and promoting gender equitable norms in the community to prevent SGBV and to support survivors.

e) EQUIP

The focus of the EQUIP activity in Burundi is to provide technical assistance for the implementation and scaling up of new national “Test and Start,” guidelines for provision of ART, including cost analyses and differentiated service delivery models, through working with USAID implementing partners. EQUIP will work at the facility level to provide training, mentoring and supportive supervision to health care workers on the implementation of “Test and Start.” In addition, EQUIP will support planning and implementation for viral load (VL) and EID scale-up, including cost analysis for scale-up, and training to healthcare workers on interpretation

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D) Relationship to other donors’ response

The Country Coordinating Mechanism (CCM) submitted a concept note on January 30, 2015, based on the UNAIDS costed and prioritized National Strategic Plan (NSP) to access funds under the Global Fund New Funding Model (NFM) allocation for the period of 2015-2017. The Concept Note was approved in June 2015 and grant making started in August 2015. The disbursements related to the Concept Note began in March 2015 and includes the purchase of all ARVs for adult and pediatric treatment, tuberculosis diagnostics and treatment, and health systems strengthening. These activities will be accomplished in close coordination with the GoB and other key stakeholders.

Activities in the Global Fund Concept Note are expected to complement the RAFG activities in both geography and programmatic goals. The Global Fund will be critical to early success of the Activity, particularly in ensuring availability for ART for all PLHIV under the new “Test and Start” policy. Through the implementation of the Concept Note, the Global Fund is currently implementing numerous key activities, notably prevention services for the general population and at-risk populations, improving diagnosis of sexually transmitted infections (STIs) and the provision of ARVs to health facilities through district hospitals. The Contractor, therefore, must work in close collaboration with the Global Fund principal recipients to harmonize service delivery, address service gaps, and ensure the integration and the continuum of care.

C. 3 RESULTS AND GOALS

The Contractor must provide targeted services and technical assistance to people living with and at risk of acquiring HIV/AIDS, and increasing the country ownership of the HIV/AIDS response.

Through this Contract, USAID/Burundi expects to ensure that __% {to be proposed by offerors and determined at the time of award} of PLHIV know their HIV status; that __% {to be proposed by offerors and determined at the time of award} of those HIV-positive individuals are enrolled on lifelong ART; and that __% {to be proposed by offerors and determined at the time of award} of those HIV-positive individuals on ART have suppressed viral loads in targeted provinces.

The following Results Framework outlines the Strategic Objective, Intermediate Results (IR), Sub-Intermediate Results (Sub-IR), and the required PEPFAR MER 2.0 performance indicators, which are subject to change over the course of this Activity.10 Expected Results are further described in Section C.5.2.

10 PEPFAR MER 2.0, Oct 12 2016: http://www.pepfar.gov/documents/organization/263233.pdf Note: PEPFAR MERs are subject to change annually.

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Table: Reaching an AIDS-free Generation Activity Results Framework

Strategic Objective: Contribute towards HIV/AIDS epidemic control in PEPFAR target provinces.

Intermediate Results IR 1 Identify HIV-positive men, women and children through high quality, targeted HTS and link to ART services

IR 2 Increase ART coverage in men, women and children living with HIV.

IR 3 Ensure HIV+ men, women and children on ART are virally suppressed

Sub-Intermediate Results Sub IR 1.1 Increase targeting of high quality HTS.

Sub IR 1.2 Ensure active linkage to ART of PLHIV identified through HTS.

Sub IR 1.3 Provide high quality DNA-PCR testing and HIV-exposed infant services.

Sub IR 1.4 Improve TB/HIV case-finding and linkage to care.

Sub IR 2.1 Increase ART enrollment in men, women and children living with HIV.

Sub IR 2.2 Improve ART adherence and retention in care by strengthening and sustaining linkages between site and community.

Sub IR 3.1 Ensure PLHIV on ART receive quality viral load monitoring and counseling.

Sub IR 3.2 Strengthen laboratory capacity and sample transport networks.

Required PEPFAR MER 2.0 Performance Indicators

HTS_TST

PMTCT_STAT

PMTCT_EID

PMTCT_FO

TB_STAT

TX_NEW

TX_CURR

TX_RET

PMTCT_ART

TB_ART

TX_TB

LAB_PTCQI

TX_PLVS

HRH_PRE

C. 4 GENERAL ACTIVITY PARAMETERS

The following guidance is provided with respect to: (A) geographic focus and target beneficiaries, (B) sustainability, (C) cross-cutting approaches, and (d) partnership and management.

C.4.1 Geographic Focus and Target Beneficiaries

The Contractor must implement the RAFG Activity in three provinces in the first year, Bujumbura Rural, Bujumbura Mairie, and…