Sustaining HIV and TB epidemic control in Lesotho through health system strengthening and technical assistance under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA JG 25 0078

Opportunity Information: Apply for CDC RFA JG 25 0078

The Centers for Disease Control and Prevention (CDC), through PEPFAR, is soliciting applications for a cooperative agreement focused on sustaining HIV epidemic control and reducing tuberculosis (TB) incidence in Lesotho by strengthening the health system and providing targeted technical assistance. The opportunity is titled "Sustaining HIV and TB epidemic control in Lesotho through health system strengthening and technical assistance under the President's Emergency Plan for AIDS Relief (PEPFAR)" (Funding Opportunity Number: CDC RFA JG 25 0078; CFDA: 93.067). It is a discretionary health-focused award mechanism structured as a cooperative agreement, which typically means substantial CDC involvement in planning, implementation support, and performance monitoring. The original application closing date is February 20, 2025, and CDC expects to make one award.

The program is geographically concentrated in four districts of Lesotho: Leribe, Berea, Quthing, and Qacha's Nek. The central objective is to accelerate and then sustain HIV epidemic control while also driving down TB incidence by addressing unmet needs across the HIV clinical cascade. The work is explicitly tied to achieving and maintaining the UNAIDS 95-95-95 targets, meaning a focus on improving HIV diagnosis coverage, ensuring people diagnosed with HIV are on sustained antiretroviral therapy, and maximizing viral suppression among those on treatment. The notice also frames the work within the broader PEPFAR 2030 direction, emphasizing not only HIV/TB outcomes but also durable public health system strengthening so gains are maintained over time.

A key expectation is close collaboration with the Lesotho Ministry of Health (MOH) to implement evidence-based interventions and innovative strategies that build long-term capacity at multiple levels of the system. The intended capacity building targets district health management teams (DHMTs), individual health facilities, and communities, with an emphasis on sustainability and person-centered service delivery. In practice, this points to a combination of management strengthening, service delivery optimization, and community-linked approaches so that improvements in quality and coverage continue even beyond the period of intensive external support.

The scope of work includes health systems strengthening, continuous quality improvement (CQI), and technical assistance (TA) across several program areas. Priority service areas include improved identification of HIV and TB cases, stronger HIV care and treatment services (including management of advanced HIV disease), and expanded cervical cancer screening as part of integrated care for people affected by HIV. Prevention priorities include biomedical interventions such as elimination of mother-to-child transmission of HIV (EMTCT) and pre-exposure prophylaxis (PrEP), signaling an expectation that applicants can support both routine prevention services and targeted approaches for populations at higher risk.

TB is treated as a core, integrated priority alongside HIV, with activities spanning TB prevention, diagnosis, and treatment. The notice also highlights integration of non-communicable disease (NCD) management into HIV service delivery, specifically calling out conditions like hypertension and mental health challenges. This suggests the program is meant to support more holistic chronic care models, using HIV platforms to detect and manage common comorbidities that can affect treatment adherence, retention in care, and overall health outcomes.

Laboratory systems support and surveillance/data use are also central components. The program includes interfacing with laboratory networks to strengthen timely and accurate testing services that underpin HIV viral load monitoring, TB diagnostics, and other priority tests. On the surveillance side, the opportunity mentions recency testing and improved use of data for program improvement, which generally implies strengthening data quality, triangulating multiple data sources to identify gaps, and using findings to drive CQI cycles and more precise targeting of interventions in facilities and communities.

In terms of funding, the notice states that the award ceiling for Year 1 is listed as 0 (none), while also indicating CDC anticipates approximately $15,000,000 in total fiscal year funding for Year 1, contingent on availability of funds. This can be confusing on its face, but it typically reflects how the funding opportunity is configured in the announcement system rather than signaling no funds are available; the practical takeaway is that CDC intends to support a single recipient at a scale around $15 million in the first year, subject to appropriations and final allocations.

Eligibility is broad, encompassing various levels of government, public and private institutions of higher education, tribal governments and organizations, nonprofits with or without 501(c)(3) status, public housing authorities/Indian housing authorities, for-profit organizations (including entities other than small businesses), small businesses, and other unrestricted applicants. Overall, the opportunity is designed for an organization capable of partnering closely with MOH structures in Lesotho, delivering high-quality technical assistance and systems strengthening across HIV/TB programming, and using data-driven CQI to help districts reach and sustain epidemic control benchmarks.

• The Centers for Disease Control-GHC in the health sector is offering a public funding opportunity titled "Sustaining HIV and TB epidemic control in Lesotho through health system strengthening and technical assistance under the President's Emergency Plan for AIDS Relief (PEPFAR)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.067.
• This funding opportunity was created on 2024-12-04.
• Applicants must submit their applications by 2025-02-20. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• The number of recipients for this funding is limited to 1 candidate(s).
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Unrestricted.

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