Sol_SOL-OAA-17-000043.pdf

SOL-OAA-17-000043

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

1 144

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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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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A

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

CODE FACILITY

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 ______________ 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-GH-17-000081

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M/GH/HSR

M/OAA/GH/HIDN

1300 Pennsylvania Avenue, NW Room 568-E SA-44 Washington DC 20523-1000

Patricia Bradley, Contracting Officer, USAID M/OAA/GH, SA-44, Room No.: 568-E 1300 Pennsylvania Ave., NW Washington, D.C. 20523-6601

Christie Cooper APMSD@usaid.gov

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PAGE(S)

Patricia Bradley

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

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

See Section L.5

Solicitation No.: SOL-OAA-17-000043

TABLE OF CONTENTS

LIST OF ACRONYMS ________________________________________________________ 6

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS ________________________ 7

B.1 PURPOSE ___________________________________________________________ 7

B.2 CONTRACT TYPE AND SERVICES _____________________________________ 7

B.3 ESTIMATED COST, FIXED FEE AND OBLIGATED AMOUNT ______________ 7

B.4 BUDGET ____________________________________________________________ 7

B.5 INDIRECT COST _____________________________________________________ 8

B.6 ADVANCE UNDERSTANDING ON CEILING INDIRECT COST RATES AND

FINAL REIMBURSEMENT FOR INDIRECT COSTS _____________________________ 8

B.7 COST REIMBURSABLE _______________________________________________ 9

B.8 PAYMENT OF FIXED FEE _____________________________________________ 9

B.9 MULTI-YEAR CONTRACT ____________________________________________ 9

SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK ___________ 11

C.1 PURPOSE __________________________________________________________ 11

C.2 BACKGROUND _____________________________________________________ 11

C.3 OVERVIEW OF INTERVENTIONS: POLICIES, PROGRESS, AND CHALLENGES

___________________________________________________________________ 13

C.4 CONTRACT OBJECTIVES ____________________________________________ 17

C.5 RELATIONSHIP/COORDINATION TO/WITH PARTNERS AND PROGRAMS _ 18

C.6 GEOGRAPHIC FOCUS _______________________________________________ 18

C.7 STATEMENT OF WORK ______________________________________________ 19

C.8 MONITORING AND EVALUATION ____________________________________ 22

C.9 EXPECTED OUTCOMES _____________________________________________ 22

C.10 GENDER CONSIDERATIONS _______________________________________ 23

SECTION D - PACKAGING AND MARKING ____________________________________ 24

D.1 AIDAR 752.7009 MARKING (JAN 1993) _________________________________ 24

D.2 BRANDING _________________________________________________________ 24

D.3 BRANDING IMPLEMENTATION AND MARKING PLAN __________________ 26

SECTION E - INSPECTION AND ACCEPTANCE _________________________________ 27

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE 27

E.2 INSPECTION AND ACCEPTANCE _____________________________________ 27

SECTION F - DELIVERIES OR PERFORMANCE _________________________________ 28

F.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE 28

F.2 PERIOD OF PERFORMANCE __________________________________________ 28

F.3 PLACE OF PERFORMANCE___________________________________________ 28

F.4 AUTHORIZED WORK DAY/WEEK ____________________________________ 28

F.5 PERFORMANCE STANDARDS ________________________________________ 28

F.6 KEY PERSONNEL ___________________________________________________ 29

F.7 REPORTS AND DELIVERABLES OR OUTPUTS _________________________ 30

SECTION G - CONTRACT ADMINISTRATION DATA ____________________________ 36

G.1 AIDAR 752.7003 DOCUMENTATION FOR PAYMENT (NOV 1998) __________ 36

G.2 CONTRACTING OFFICER’S AUTHORITY ______________________________ 37

G.3 ADMINISTRATIVE CONTRACTING OFFICE ____________________________ 37

G.4 CONTRACTING OFFICER’S REPRESENTIVE (COR) _____________________ 37

G.5 TECHNICAL DIRECTION/RELATIONSHIP WITH USAID _________________ 38

G.6 INVOICES __________________________________________________________ 39

G.7 ACCOUNTING AND APPROPRIATION DATA ___________________________ 39

SECTION H - SPECIAL CONTRACT REQUIREMENTS ___________________________ 40

H.1 AUTHORIZED GEOGRAPHIC CODE ___________________________________ 40

H.2 LANGUAGE REQUIREMENTS ________________________________________ 40

H.3 ADS 302.3.5.5 REPORTING OF FOREIGN TAXES (JULY 2007) _____________ 40

H.4 AIDAR 752.225-70 SOURCE AND NATIONALITY REQUIREMENTS

(FEB 2012 ____________________________________________________________ 41

H.5 NONDISCRIMINATION (JUN 2012) ____________________________________ 42

H.6 USAID DISABILITY POLICY – ACQUISITION (DEC 2004) ________________ 42

H.7 ADS 302.3.5.19 USAID-FINANCED THIRD-PARTY WEB SITES (AUGUST 2013)

___________________________________________________________________ 42

H.8 CONFERENCE PLANNING AND REQUIRED APPROVALS (AUGUST 2013) _ 44

H.9 USAID IMPLEMENTING PARTNER NOTICES (IPN) PORTAL FOR

ACQUISITION (JULY 2014) ___________________________________________ 45

H.10 SUBMISSION OF DATASETS TO THE DEVELOPMENT DATA LIBRARY

(DDL) (OCTOBER 2014) _____________________________________________ 46

H.11 DEFENSE BASE ACT (DBA) INSURANCE ____________________________ 48

H.12 LOGISTIC SUPPORT _______________________________________________ 48

H.13 EXECUTIVE ORDER ON TERRORISM FINANCING (FEB 2002) __________ 48

H.14 FOREIGN GOVERNMENT DELEGATIONS TO INTERNATIONAL

CONFERENCES (JAN 2002) ___________________________________________ 49

H.15 PROHIBITION OF ASSISTANCE TO DRUG TRAFFICKERS ______________ 49

H.16 TITLE TO AND CARE OF PROPERTY ________________________________ 49

H.17 ENVIRONMENTAL COMPLIANCE ____________________________________ 49

H.18 GOVERNMENT FURNISHED FACILITIES OR PROPERTY ________________ 50

H.19 COMPLIANCE WITH SECTION 508 OF THE REHABILITATION ACT OF 1973,

AS AMENDED ____________________________________________________ 51

H.20 CLOUD COMPUTING (MAY 2016) ___________________________________ 51

H.21 AIDAR 752.7031 LEAVE AND HOLIDAYS (OCTOBER 1989) ______________ 56

H.22 CONSENT TO SUBCONTRACT ________________________________________ 59

SECTION I - CONTRACT CLAUSES ___________________________________________ 60

I.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE __ 60

I.2 52.203-99, Prohibition on Contracting with Entities that Require Certain Internal

Confidentiality Agreements (DEVIATION 2015-02) _________________________ 63

I.3 52.204-21 Basic Safeguarding of Covered Contractor Information Systems. (JUN 2016) ___________________________________________________________________ 63

I.4 52.215-19 Notification of Ownership Changes. (OCT 1997) ___________________ 65

I.5 52.216-7 Allowable Cost and Payment. (JUN 2013) __________________________ 66

I.6 52.217-2 Cancellation Under Multi-Year Contracts (OCT 1997) ________________ 72

I.7 52.217-8 Option to Extend Services. (NOV 1999) ___________________________ 74

I.8 52.229-8 Taxes - Foreign Cost-Reimbursement Contracts. (MAR 1990) __________ 74

I.9 52.252-2 Clauses Incorporated by Reference. (FEB 1998) _____________________ 75

I.10 752.7032 International Travel Approval and Notification Requirements (APR 2014) 75

SECTION J - LIST OF ATTACHMENTS ________________________________________ 76

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS

OF THE OFFEROR ______________________________________________ 77

K.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE 77

K.2 52.203-98, Prohibition on Contracting with Entities that Require Certain Internal

Confidentiality Agreements-Representation (DEVIATION 2015-02) ____________ 77

K.3 52.204-8 Annual Representations and Certifications. (JAN 2017) _______________ 78

K.4 52.209-5 Certification Regarding Responsibility Matters. (OCT 2015) ___________ 83

K.5 52.209-7 Information Regarding Responsibility Matters. (JUL 2013) ____________ 85

K.6 52.222-25 Affirmative Action Compliance. (APR 1984) ______________________ 87

K.7 52.225-20 Prohibition on Conducting Restricted Business Operations in Sudan-- Certification. (AUG 2009) _______________________________________________ 87

K.8 52.230-1 Cost Accounting Standards Notices and Certification. (OCT 2015) ______ 88

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS _______ 91

L.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE (FEB 1998) ______________________________________________ 91

SECTION M - EVALUATION FACTORS FOR AWARD __________________________ 109

M.1 GENERAL INFORMATION __________________________________________ 109

ATTACHMENT 1 –ENVIRONMENTAL COMPLIANCE INFORMATION ___________ 114

ATTACHMENT 2 – PAST PERFORMANCE MATRIX ____________________________ 140

ATTACHMENT 3 - CONTRACTOR BIOGRAPHICAL DATA SHEET _______________ 141

ATTACHMENT 4 – SMALL BUSINESS SUBCONTRACTING PLAN TEMPLATE ____ 142

ATTACHMENT 5 - BASELINE DATA FOR OUTCOME INDICATORS _____________ 143

LIST OF ACRONYMS

ACT artemisinin-based combination therapy ADS Automated Directives System (USAID’s operational policies) AIDAR USAID Acquisition Regulation ANC antenatal care CFR Code of Federal Regulations COR Contracting Officer’s Representative CPARs Contractor Performance Assessment Reporting System EMMP environmental mitigation and monitoring plan FAR Federal Acquisition Regulation HCG host-country government iCCM integrated community case management IEE initial environmental examination IPTi intermittent prevention treatment for infants IPTp intermittent preventive treatment for pregnant women ISTp intermittent screen and treat in pregnancy M&E monitoring and evaluation MDA mass drug administration MIP malaria in pregnancy MOP malaria operational plan NICRA Negotiated Indirect Cost Rate Agreement NMCP national malaria control program PMI President’s Malaria Initiative RBM Roll Back Malaria RCD reactive case detection RDT rapid diagnostic test RFP request for proposal RMNCH reproductive, maternal, newborn, and child health SBCC social and behavior change communication SMC seasonal malaria chemoprevention SM&E surveillance, monitoring, and evaluation SP sulfadoxine-pyrimethamine SSTp single screen and treatment in pregnancy UNICEF United Nations Children’s Fund USG U.S. Government WHO World Health Organization

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

B.1 PURPOSE

The purpose of this contract is to provide the services as described in the Statement of Work (SOW) specified in Section C to implement the Advancing Progress in Malaria Service Delivery activity.

B.2 CONTRACT TYPE AND SERVICES

This is a Cost-Plus-Fixed-Fee (CPFF) completion form contract. For the consideration set forth in the contract, the Contractor must provide the deliverables and outputs as described in Section C and Section F.

B.3 ESTIMATED COST, FIXED FEE AND OBLIGATED AMOUNT

[To be completed at time of award]

(a) The estimated cost for the performance of the work required hereunder, exclusive of fixed fee is [TBD]. The fixed fee, if any, is [TBD]. The total estimated cost-plus-fixed-fee is [TBD].

(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 [TBD]. The Contractor must not exceed the aforesaid obligated amount nor will the U.S. Government (USG) be responsible for costs incurred should the Contractor do so.

B.4 BUDGET

[To be completed at time of award]

Description Year 1 Year 2 Year 3 Year 4 Year 5 Total All

Years

1. Personnel $TBD $TBD $TBD $TBD $TBD $TBD

2. Fringe Benefits $TBD $TBD $TBD $TBD $TBD $TBD

3. Allowances $TBD $TBD $TBD $TBD $TBD $TBD

4. Travel and Transportation

$TBD $TBD $TBD $TBD $TBD $TBD

5. Equipment $TBD $TBD $TBD $TBD $TBD $TBD

6. Supplies $TBD $TBD $TBD $TBD $TBD $TBD

7. Contractual $TBD $TBD $TBD $TBD $TBD $TBD

8. Other Direct Costs $TBD $TBD $TBD $TBD $TBD $TBD *8b. Other Direct Costs-Activity costs

$15,150,000 $15,150,000 $15,150,000 $15,150,000 $15,150,000 $75,750,000

9. Indirect Costs $TBD $TBD $TBD $TBD $TBD $TBD

10. Fixed Fee $TBD $TBD $TBD $TBD $TBD $TBD

Total Cost Plus Fixed Fee

$TBD $TBD $TBD $TBD $TBD $TBD

*The total for Activity Cost was estimated based on the following assumptions:

● On an annual basis, five countries would utilize this contract to support “large programs”, i.e., intensive support for comprehensive service delivery activities nationally or with a large geographic scope and/or multiple activities.

● On an annual basis, six countries would utilize this contract to support “medium programs”, i.e., support for a subset of activities or activities targeted at sub-national level.

● On an annual basis, six countries would utilize this contract to support “small programs”, i.e., minimal support with a few activities or technical assistance for a one-time activity.

Other Direct Costs/Activity Costs includes all field level training costs (rental space, visual aids, office training supplies, etc.), material costs for studies/evaluations (including operational research), printing and materials dissemination, supervision costs, materials such as slides for training and quality assurance, and any other direct implementation costs (excluding salaries and travel which is included in 1. Personnel and 4. Travel and Transportation).

B.5 INDIRECT COST

The contract clause entitled “Allowable Cost and Payment (JUN 2013)”, FAR Subpart 52.216-7, specifies that the indirect cost rates shall be established for each of the Contractor’s accounting periods which apply to this contract. Pending establishment of revised provisional or final indirect cost rates, allowable indirect costs shall be reimbursed on the basis of the following negotiated provisional or predetermined rates and the appropriate bases.

Description Rate Base Type Period

[TBD] [TBD] 1/ 1/ 1/

[TBD] [TBD] 2/ 2/ 2/

[TBD] [TBD] 3/ 3/ 3/

1/ Base of Application:

Type of Rate:

Period:

2/ Base of Application:

3/ Base of Application:

B.6 ADVANCE UNDERSTANDING ON CEILING INDIRECT COST RATES AND

FINAL REIMBURSEMENT FOR INDIRECT COSTS

(a) For each of the contractor's accounting periods during the term of this contract, the parties agree as follows:

(1) The distribution base for establishment of final overhead rates is [TBD]. The distribution base for establishment of final G&A rates is [TBD].

(2) The contractor will make no change in its established method of classifying or allocating indirect costs without the prior written approval of the contracting officer.

(3) Reimbursement for indirect costs shall be at final negotiated rates, but not in excess of the following ceiling rates:

Description Rate Base Type Period

1/ 1/ 1/ 2/ 2/ 2/ 1/Base of Application:

Type of Rate:

Period:

2/Base of Application:

Type of Rate:

Period:

(4) USAID is not obligated to pay any additional amount on account of indirect costs above the ceiling rates established in the contract. This advance understanding shall not change any monetary ceiling, cost limitation, or obligation established in the contract.

B.7 COST REIMBURSABLE

Allowable costs shall 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.8 PAYMENT OF FIXED FEE

Payment of fixed fee will be made upon receipt of a proper invoice and shall directly correspond to the percentage of allowable costs being paid. In accordance with FAR 52-216-8, Fixed Fee, the CO will withhold 15% of the total fee or $100,000, whichever is less until the required awards conditions under the reference clause have been met.

B.9 MULTI-YEAR CONTRACT

In the event that the Government cancels requirements for services in subsequent program years under this contract, the following conditions will apply: [Amount and dates to be filled in at time of award]

Cancellation Dates:

Contract Year 2: DATE TBD, [Award year + 1 year] Cancellation Ceiling: TBD Contract Year 3: DATE TBD, [Award year + 2 years] Cancellation Ceiling: TBD Contract Year 4: DATE TBD, [Award year + 3 years] Cancellation Ceiling: TBD Contract Year 5: DATE TBD, [Award year + 4 years] Cancellation Ceiling: TBD

The cancellation dates and ceiling amounts will be established at the time of award. The amounts will be based on the nonrecurring costs to be incurred by the awardee, which would be applicable to, and which normally would be amortized over the life of the contract, and the items or services to be furnished under the multi-year requirement. This is a CPFF type contract, pursuant to which all costs for which the contractor seeks reimbursement must be allowable in accordance with FAR 52.216-7, “Allowable Costs and Payment.”

[END OF SECTION B]

SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

Advancing Progress in Malaria Service Delivery

C.1 PURPOSE

The purpose of this contract is to provide implementation support services and technical assistance to countries to accelerate progress in comprehensive malaria facility and community service delivery including malaria case management, prevention of malaria in pregnancy, and other malaria drug-based interventions.

C.2 BACKGROUND

The past decade has seen extraordinary progress in malaria control efforts, especially in the sub- Saharan Africa region. The scale-up of proven, cost-effective malaria interventions – such as effective case management and prevention of malaria in pregnancy – has contributed to substantial progress in malaria control and prevention. The risk of malaria is declining as a result of cumulative efforts and funding by the United States Government (USG) through the President’s Malaria Initiative (PMI), the USG and other governments through the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), national governments, the World Bank, the Bill and Melinda Gates Foundation, and many other donors and foundations. The World Health Organization’s (WHO) 2015 World Malaria Report1 estimates that more than 6.2 million malaria deaths were averted worldwide between 2000 and 2015. During that same time period, new malaria cases fell by 37 percent, and malaria mortality declined by an estimated 48 percent worldwide. Even greater reductions in malaria mortality were recorded in sub-Saharan Africa, where deaths among children under the age of five years declined by 71 percent. Based on these results, WHO and UNICEF reported that the Millennium Development Goal for malaria (halting and reversing malaria incidence by 2015) was achieved.

However, despite historic gains, WHO reported that there were still an estimated 214 million new cases of malaria and approximately 438,000 malaria-attributed deaths worldwide in 2015 alone2. The overwhelming majority of these cases and deaths occurred among young children in sub-Saharan Africa. An estimated 838 children still die from malaria every day. Malaria infection during pregnancy contributes to maternal and newborn morbidity and mortality (with an estimated 10,000 maternal deaths and up to 200,000 newborn deaths each year).3

Gaps in intervention quality and coverage contribute to continued malaria related mortality and morbidity. Millions of people still do not receive the malaria prevention and treatment services that they need. In sub-Saharan Africa in 2014, between 68 and 80 million of the 92 million

1WHO World Malaria Report, accessed: http://www.who.int/malaria/publications/world-malaria-report- 2015/report/en/ 2 WHO World Malaria Report, 2015 3 WHO World Malaria Report, 2015 children with malaria did not receive an artemisinin-based combination therapy (ACT), and an estimated 15 million of the 28 million pregnant women at risk did not receive a dose of sulfadoxine-pyrimethamine (SP, a medicine administered to prevent malaria).4

President’s Malaria Initiative The U.S. President’s Malaria Initiative, led by USAID and implemented together with the U.S.

Centers for Disease Control and Prevention, is the U.S. Government’s primary vehicle for assisting malaria affected countries to scale up proven malaria control and elimination interventions. When it was launched in 2005, the goal of PMI was to reduce malaria-related mortality by 50 percent across 15 high-burden countries in sub-Saharan Africa through a rapid scale-up of four proven and highly effective malaria prevention and treatment measures:

insecticide-treated mosquito nets; indoor residual spraying; accurate diagnosis and prompt treatment with ACTs; and intermittent preventive treatment of pregnant women (IPTp). PMI developed a U.S. Government Malaria Strategy for 2009–2014, which articulated a long-term vision for malaria control in which sustained high coverage with malaria prevention and treatment interventions would progressively lead to malaria-free zones in Africa, with the ultimate goal of worldwide malaria eradication by 2040-2050. The contributions of PMI, together with those of other partners, led to dramatic improvements in the coverage of malaria control interventions in PMI-supported countries, and all 15 original countries have documented substantial declines in all-cause mortality rates among children less than five years of age.

The PMI Strategy for 2015-20205 accounts for the progress over the past decade and new and emerging challenges. Malaria prevention and control remains a major U.S. foreign assistance objective and PMI’s strategy fully aligns with the U.S. Government’s vision of ending preventable child and maternal deaths and protecting communities from infectious diseases.

Under the PMI Strategy 2015-2020, the USG’s goal is to work with PMI-supported countries and partners to further reduce malaria deaths and substantially decrease malaria morbidity, towards the long-term goal of elimination. To do so, PMI will work with National Malaria Control Programs (NMCPs) and partners to accomplish the following objectives by 2020:

1. Reduce malaria mortality by one-third from 2015 levels in PMI-supported countries, achieving a greater than 80 percent reduction from PMI’s original 2000 baseline levels.

2. Reduce malaria morbidity in PMI-supported countries by 40 percent from 2015 levels.

3. Assist at least five PMI-supported countries to meet the WHO criteria for national or sub-national pre-elimination.6

These objectives will be accomplished by emphasizing five core areas of strategic focus:

1. Achieving and sustaining scale of proven interventions

2. Adapting to changing epidemiology and incorporating new tools

3. Improving countries’ capacity to collect and use information

4 World Malaria Report, 2015 5 Available at https://www.pmi.gov/docs/default-source/default-document-library/pmi-reports/pmi_strategy_2015- 2020.pdf 6 PMI has not yet decided on the five countries

4. Mitigating risk against the current malaria control gains

5. Building capacity and health systems towards full country ownership

PMI’s approach to programming resources and defining support at the country level is to work within the framework of the national malaria control program’s existing strategic plan. PMI prioritizes investments to support high priority malaria program needs and gaps, taking into account investments by partner countries and other donors and partners active in malaria control.

Each year, PMI undertakes a planning process, working closely with partner country counterparts and key stakeholders, to develop a country Malaria Operational Plan (MOP). These plans summarize the current policies and status of malaria prevention and control intervention scale-up; describe the surveillance, monitoring, and evaluation strategies to be supported;

identify challenges and programmatic and resource gaps; and provide a description of planned USG investments by activity, budget amount, and implementing partner. Annual MOPs thus serve as the guide for implementing partners on PMI’s expectations across technical area and for each specific activity, informing the basis for partner annual work plan development. PMI MOPs undergo rigorous interagency technical review and are ultimately approved by the U.S.

Global Malaria Coordinator and made publicly available at www.pmi.gov in advance of the availability of fiscal year new funding.

C.3 OVERVIEW OF INTERVENTIONS: POLICIES, PROGRESS, AND

CHALLENGES

The work to be carried out under this contract builds on more than a decade of PMI and USAID investments at the country level in strengthening malaria diagnosis and case management, malaria in pregnancy, and related service delivery efforts, and takes into account learning across countries and the current evidence base for these interventions and approaches. During the first five years of the initiative, PMI invested in the Improving Malaria Diagnostics project, which was designed to expand, improve, and build capacity for laboratory-based diagnosis of malaria in PMI partner countries. This project was followed by the MalariaCare project, which was designed with an expanded scope to support the scale-up of and build country capacity for malaria case management, which included strengthening of prompt malaria diagnosis and appropriate treatment.

The overall purpose of this contract is to strengthen malaria services delivered in health facilities and community settings. Specifically, the scope includes technical assistance and implementation support for malaria case management (the primary focus), malaria in pregnancy services (i.e., IPTp and case management of pregnant women), and other malaria drug-based interventions appropriate for the given epidemiological setting and as agreed to with partner countries and PMI. To complement these activities, the scope also includes technical and implementation support for strengthening facility- and community-level case reporting, addressing provider behaviors, conducting operational research, and provision of technical leadership at the global level. For the purposes of this contract, malaria drug-based interventions encompass WHO-recommended and/or proven prevention and treatment approaches using antimalarials, such as seasonal malaria chemoprevention (SMC) and mass drug administration (MDA). However, newer drug-based approaches, which may be endorsed by WHO during the timeframe of the contract, may also be included for operational research, pilots, and/or scale-up, as directed by

PMI.

Key information for each intervention area is summarized below. PMI annually updates technical guidance which provides the technical parameters and direction for the use of PMI resources (see: https://www.pmi.gov/docs/default-source/default-document-library/tools-curricula/pmi-technical-guidance-(march-2016).pdf?sfvrsn=8). The PMI technical guidance contains links to relevant WHO guidelines and policies.

Malaria Case Management Prompt, effective case management is a crucial component of reducing malaria morbidity and mortality and a cornerstone of malaria control. In 2010, WHO revised its treatment guidelines, calling for all patients with suspected malaria to undergo quality-assured diagnostic testing with either microscopy or rapid diagnostic tests (RDTs), and for treatment decisions to be based on test results. Consistent with these guidelines, PMI supports partner countries to implement universal diagnostic testing, and when a test is positive, provide immediate treatment with appropriate antimalarial drugs at public health facility and community levels, and the private sector when/if relevant. The goal is for all patients with suspected malaria to seek care, all patients with suspected malaria to be quickly identified and tested, and all patients with confirmed malaria receive effective treatment without delay. Over the last decade, PMI has invested significant resources to support the scale-up of malaria case management at health facility and community levels. PMI has worked closely with ministries of health to invest in efforts aimed at building capacity for effective implementation of malaria case management, providing support for all elements of a comprehensive quality program to diagnose and treat patients appropriately.

PMI has worked alongside partner countries to promote and expand quality assurance of case management by providing support for strengthening expert diagnostic capacity at reference laboratories and through support for training and supervision activities at health facilities, including on-site training, mentoring, and troubleshooting with routine supervision that assesses and documents health worker performance through direct observation, facility and record review, and re-checking of blood slides.

In collaboration with partner countries, PMI has also supported the implementation of integrated community case management (iCCM) for malaria, pneumonia, and diarrhea. To date, all 19 PMI focus countries in sub-Saharan Africa have received PMI financial and technical support for iCCM efforts. Because of these efforts, RDTs and ACTs are now widely available and thousands of facility and community health workers have been trained in their use. The proportion of suspected malaria cases confirmed with a diagnostic test and treated with a recommended antimalarial has increased from baseline measures in nearly every PMI focus country, and most countries are scaling up quality assurance systems for case management.

However, despite these advances, progress in case management (which varies significantly across PMI focus countries) continues to lag behind expectations for several reasons. Country-level barriers include poor provider practices (e.g., continued presumptive treatment or treatment despite a negative diagnostic test) and insufficient ability of individuals (including caregivers) to recognize symptoms of malaria and seek prompt diagnosis and appropriate care. Broader service delivery challenges include stock outs of essential drugs and commodities (including laboratory supplies, ACTs, RDTs, and SP); lack of access to public sector facilities and to laboratory services; poor health provider knowledge and practices in diagnosing and/or treating patients;

and lack of or poor quality supervision. There also continues to be critical policy barriers to effective malaria case management such as outdated country-level policies and guidelines related to treatment of severe malaria (including treatment of severe malaria for pregnant women) and regulations preventing private sector or community health workers from performing diagnostic tests.

Malaria in Pregnancy Services Malaria infection during pregnancy contributes to maternal and newborn morbidity and mortality. Approximately 125 million women living in malaria-endemic countries throughout the world become pregnant every year, more than 30 million of whom live in tropical areas of Africa where there is intense transmission of Plasmodium falciparum7. In these areas, malaria infection directly contributes to adverse outcomes in maternal and newborn health. Pregnant women, particularly those in their first or second pregnancies, are particularly vulnerable to malaria as pregnancy reduces a woman’s immunity to malaria, making her more susceptible to malaria infection and increasing the risk of illness, severe anemia, and death. For the unborn child, maternal malaria increases the risk of miscarriage, stillbirth, premature delivery, and low birth weight - a leading cause of child mortality. Preventive interventions, including IPTp, promotion of long lasting insecticide treated net usage, and promoting prompt health care seeking for fever during pregnancy have been shown to significantly reduce the risk of maternal anemia, low birth weight, and perinatal deaths.

In line with WHO guidelines, PMI works with partner countries to support a three-pronged approach to reducing malaria in pregnancy in areas with moderate to high levels of malaria transmission: (1) provision and promotion of insecticide-treated mosquito nets to pregnant women; (2) administration of IPTp with SP, where indicated; and (3) prompt diagnosis and effective treatment of malaria and anemia among pregnant women. WHO guidelines can be seen here: http://www.who.int/malaria/areas/high_risk_groups/pregnancy/en/. PMI may work with more than one PMI implementing partner at country level to support this three-pronged approach.

PMI supports the delivery of these activities through the antenatal care (ANC) platforms in partner countries and promotes collaboration between NMCPs and reproductive, maternal, newborn and child health (RMNCH) programs at the country level. Coordination and planning between NMCP and RMNCH units are essential to increasing coverage of malaria in pregnancy interventions including successful uptake of IPTp delivered through ANC services.

Coordination with other infectious disease programs (including HIV) is also important for the successful delivery of MIP services provided to pregnant women. With support from PMI, coverage of pregnant women with at least two doses of IPTp in PMI focus countries has increased from a baseline of 14 percent to 38 percent8.

7 Dellicour S, Tatem AJ, Guerra CA, Snow RW, ter Kuile FO. Quantifying the Number of Pregnancies at Risk of Malaria in 2007: a Demographic Study. PLOS Med. 2010;7:1, e1000221.

8 PMI Tenth Annual Report to Congress, April 2016: https://www.pmi.gov/about/pmi-annual-report-2016

While progress on IPTp uptake has been slower than expected, PMI recognizes the need for continued efforts and creative approaches to scaling-up IPTp through addressing remaining barriers hindering uptake. In addition to the service delivery challenges listed above, some of the key challenges and barriers to progress in uptake of malaria in pregnancy interventions at the country level include inadequate provider adherence to national malaria in pregnancy IPTp and diagnosis and treatment guidelines; slow country roll-out and implementation of the updated 2012 WHO IPTp policy recommendations; lack of effective communication between and inconsistency across NMCP and RMNCH program policies and guidelines; delays in pregnant women initiating their first ANC visit and failure to return regularly; and consumer perceptions of ANC services. Global partners, including PMI, are working with countries to develop and evaluate new strategies and approaches for prevention and control of MIP in service delivery settings – including the implementation of intermittent screen and treat in pregnancy (ISTp) and single screen and treatment in pregnancy (SSTp), etc., with potential applicability for low transmission and pre-elimination areas, alternative drugs for IPTp, and possible implementation of community delivery of IPTp to improve uptake. PMI may choose to support countries in the evaluation of new approaches in the context of operational research but does not support new approaches in a routine matter prior to WHO policy recommendations. Furthermore, the new 2016 WHO ANC Guidelines (http://apps.who.int/iris/bitstream/10665/250800/1/WHO-RHR- 16.12-eng.pdf?ua=1) which call for a minimum of 8 contacts with a health provider will have implications for MIP programming.

Other Drug-Based Service Delivery Interventions/New Tools Over the past several years, WHO has recommended new drug-based interventions for prevention and reduction of malaria that are targeted at areas of high transmission for specific high risk groups (e.g., Intermittent Preventive Treatment for infants (IPTi) and SMC). Although IPTi has not been taken up by most countries, SMC - the administration of a curative dose of antimalarial drugs in areas of highly seasonal transmission at monthly intervals to children aged 3–59 months without malaria symptoms – is being rolled out in countries that meet the WHO criteria for SMC implementation. Details on the WHO criteria can be found at:

http://www.who.int/malaria/areas/preventive_therapies/children/en/.

PMI currently supports Mali and Senegal’s NMCPs to implement SMC, and plans are underway to support SMC implementation in additional PMI partner countries where the intervention is recommended, and where PMI, together with the NMCP, has prioritized this support. However, reaching sustained high uptake of SMC in targeted geographic areas will be challenging for two main reasons. First, implementation often requires building on an existing community-based platform that is designed for routine public health service delivery, rather than mass, campaign-like services. Second, high coverage and adherence to the full treatment course at each round of delivery requires strong community sensitization and buy-in.

In areas approaching interruption of P. falciparum transmission, there has been a renewed interest in the use of MDA as a tool to reduce the parasite reservoir and malaria transmission from a population. Although PMI has not yet invested in MDA implementation, there are several pilot and research activities testing various MDA approaches with support from a variety of research and development partners, including PMI, in different transmission settings across

Africa and Asia. In November 2015, WHO reviewed the available evidence and recommended that MDA could be considered in certain situations, including geographic areas approaching elimination. The specific guidance can be found at:

http://www.who.int/malaria/publications/atoz/role-of-mda-for-malaria.pdf?ua=1. However, questions remain about its effectiveness and feasibility in specific country contexts. As further evidence is developed on the appropriate indications for MDA, PMI may support additional operational research or piloting of MDA to assess feasibility and effectiveness of this strategy.

Decisions regarding when and where MDA would be deployed will be made by PMI country teams, in consultation with NMCP and PMI technical leadership.

Finally, as countries move toward pre-elimination at national or sub-national levels, identifying and treating all malaria patients and individuals carrying parasites is critical. As in any other setting, in the pre-elimination setting, all malaria cases should be confirmed with a diagnostic test and treated with effective antimalarials. Community health workers often become the foundation for malaria case management as the need for rapid diagnosis, treatment, and response necessitates quick and easy access to care. In addition, single, low-dose primaquine for Plasmodium falciparum could be considered.

Surveillance in the pre-elimination setting must be reinforced. Timely, complete, and accurate reporting of passively detected and confirmed malaria cases diagnosed in both the public and private sectors is required. Surveillance system components may require active/reactive case detection (RCD), treatment, follow up, and reporting. PMI is currently working with NMCPs to support implementation and/or evaluation of RCD activities in areas of Cambodia, Ethiopia, Madagascar, Rwanda, Senegal, and Zanzibar that are targeted for elimination, and may consider support for scaling up these efforts based on the results and implementing and/or evaluating RCD in additional countries, as appropriate.

C.4 CONTRACT OBJECTIVES

The purpose of this contract, as stated in Section C.2, reflects the intent of PMI and USAID missions to continue investments in ongoing and new areas of emphasis related to malaria case management, control of malaria in pregnancy, and other malaria drug-based service delivery interventions (both existing and those that may be identified and proven effective in the future).

The three objectives to be addressed through this contract are:

Objective 1: Improve quality of and access to malaria case management and malaria in pregnancy interventions.

Objective 2: Improve quality of and access to other malaria drug-based approaches and provide support to pilot/scale-up newer malaria drug-based approaches.

Objective 3: In support of Objectives 1 and 2, provide global technical leadership, support operational research, and advance program learning.

In achieving these objectives, the contract will contribute to PMI’s three overall objectives

(reducing malaria mortality, reducing malaria morbidity, and moving countries towards pre-elimination) and will work across all five of PMI’s core areas of strategic focus.

C.5 RELATIONSHIP/COORDINATION TO/WITH PARTNERS AND PROGRAMS

In achieving these objectives, the contractor shall support Ministries of Health, particularly National Malaria Control Programs, in coordination with key malaria stakeholders active in malaria service delivery including other in-country PMI and USAID implementing partners, Global Fund supported grant recipients, and donors and research/academic groups involved in malaria control. Particularly crucial will be establishing country-level linkages with PMI and USAID implementing partners supporting activities in the areas of supply chain, social and behavior change communication (SBCC), and surveillance, monitoring, and evaluation (SM&E).

C.6 GEOGRAPHIC FOCUS

Countries that may request implementation services and/or technical support under this contract include, but are not limited to, Angola, Benin, Burkina Faso, Burma, Burundi, Cambodia, Cameroon, Cote D’Ivoire, Democratic Republic of Congo, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Tanzania, Uganda, Zambia, Zimbabwe – as well as focus countries in the Greater Mekong Sub-region including Burma, Cambodia, and Thailand.

PMI anticipates that the contractor will work with most countries over the course of the five years but at various times (e.g., some countries may request services for one or two years only and others for the full contract period) and various size of programming. As stated in Section B, for purposes of this contract, countries have been divided into three size categories: large, medium, and small. Based on current and projected demand from the field, PMI estimates that 17 countries will buy into the contract during any given year: five large programs, six medium programs, and six small programs. This includes the projected need due to the possible addition of four new PMI focus countries pending Congressional approval (Burkina Faso, Sierra Leone, Cote D’Ivoire, and Cameroon).

Large programs are defined as those that would need intensive support for comprehensive service delivery activities nationally (or with a large geographic scope) for implementation and/or scale-up of multiple activities (updating national policies, diagnostic and clinical trainings, supervision support, setting up quality assurance programs, updating registries for data capture, therapeutic efficacy studies, etc.). Likely countries with large programs estimated for the first year of the contract are Burkina Faso, Sierra Leone, Cote D’Ivoire, Cameroon, and Ghana.

Medium programs are defined as needing support for implementing and/or scaling-up a subset of activities or activities targeted at sub-national level (i.e. setting up quality assurance system, implementing clinical or laboratory trainings, etc.). Likely countries with medium programs estimated for the first year of the contract are Burundi, DRC, Kenya, Malawi, Mali, and Tanzania.

Small programs are defined as needing minimal support with a few activities or programs that request technical assistance for a one-time activity, such as setting up a therapeutic efficacy study or help with operational research. Likely countries with small programs estimated for the first year of the contract are Burma, Liberia, Madagascar, Mozambique, Senegal, and Zambia.

Due to changing needs in countries, it is assumed that over the life of the contract, the number of countries in each category may fluctuate, as well as the needs in each country. Thus, a country may start off as a ‘small’ size program but may grow over time to become a medium or large program or vice-versa. The number of countries per year covered by the project may also fluctuate.

C.7 STATEMENT OF WORK

The objectives below are listed in ascending order in terms of both anticipated funding levels as well as in total level of effort that will be requested to achieve each objective (e.g., work requested under Objective 1 will require more time and resources to achieve than Objective 2 requires). While implementing requested services and technical support, the contractor will build capacity and skills of ministry of health and other in-country staff at all levels of the health system (i.e., provincial, district, health facility, community level and private sector where appropriate) without creating parallel structures. Technical and material assistance is to be delivered in support of the national malaria control and related health policies and strategies. The intent is to build the capacity of the government and other key stakeholders to lead planning and implementation of all malaria control service delivery strengthening program activities.

Objective 1: Improve quality of and access to malaria case management and malaria in pregnancy interventions.

The contractor will provide technical assistance and/or implementation support for malaria case management and malaria in pregnancy interventions at public health facilities, community level through iCCM or other community-based platforms, and the private sector, as appropriate.

Activities must be informed by routine data, supervision data, and other information collected through monitoring and evaluation efforts to strategically identify needs and target interventions/activities. In addition, activities must be carried out in coordination with PMI and USAID central and bilateral partners working in the areas of supply chain, SBCC, and SM&E, and other partners (as appropriate) working in RMNCH , HIV/AIDS, and infectious diseases.

Prioritization of country-level activities will be guided by the approved country malaria operational plan.

Illustrative tasks include, but are not limited to:

● Provide technical assistance to ministries of health in assessing, developing, and updating country malaria policies and guidelines, training and supervision materials, and diagnostic quality assurance frameworks, and operational support to disseminate these materials to all levels of the health care system.

● Participate in and/or provide material assistance to functional in-country technical working groups and stakeholder workshops, or advocate for the formation or revitalization of such groups.

● Provide technical and material assistance for training and supervision of health care providers, at all levels, in the diagnosis and treatment of uncomplicated malaria, treatment and/or referral of severe malaria, and malaria in pregnancy.

● Provide technical assistance to support implementation of quality assurance/quality control systems on diagnostic testing for malaria.

● Provide technical and implementation support for strengthening facility and community level case reporting.

● Provide technical assistance to support the introduction and/or expansion of diagnostic and clinical malaria services at the community level and in the private sector, where appropriate.

● Identify and…