Implementing Comprehensive HIV Prevention Services for Injection Drug Users and Other Most At-Risk Populations in the United Republic of Tanzania under the President's Emergency Plan for AIDS Relief

I. Funding Opportunity Description

Authority: This program is authorized under Public Law 108-25 (United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003) [22 U.S.C. 7601].

President Bush's Emergency Plan for AIDS Relief has called for immediate, comprehensive and evidence-based action to turn the tide of global HIV/AIDS. The initiative aims to treat more than two million HIV-infected people with effective combination anti-retroviral therapy (ART) by 2008; care for ten million HIV-infected and affected persons, including those orphaned by HIV/AIDS, by 2008; and prevent seven million infections by 2010, with a focus on 15 priority countries, including 12 in sub-Saharan Africa. The Five-Year Strategy for the Emergency Plan is available at the following Internet address: http://www.state.gov/s/gac/plan/c11652.htm.

Over the same time period, as part of a collective national response, the Emergency Plan goals specific to Tanzania are to treat at least 150,000 HIV-infected individuals; and to care for 750,000 HIV-affected individuals, including orphans.

Under the leadership of the U.S. Global AIDS Coordinator, as part of the President's Emergency Plan, the U.S. Department of Health and Human Services (HHS) works with host countries and other key partners to assess the needs of each country and design a customized program of assistance that fits within the host nation's strategic plan.

HHS focuses on two or three major program areas in each country. Goals and priorities include the following:

The purpose of this announcement is to support the development and implementation of comprehensive, multi-level interventions in Dar es Salaam and Zanzibar to reduce high-risk sexual and drug related practices among injection drug users (IDUs) and sub-groups within this population (e.g., commercial sex workers or CSWs and men who have sex with men or MSM).

Injection drug use, specifically the sharing of contaminated injection equipment, as well as associated risk factors, has been a known causal factor for HIV transmission since the beginning of the HIV epidemic, and has been recognized as contributing to the epidemics in Asia, the Americas, and Europe. In Tanzania, as in other sub-Saharan African countries, injecting is a relatively new means of transmitting HIV. Current data indicates that injection drug use, specifically heroin, is rapidly increasing in urban Tanzania and on the island of Zanzibar. Further, injection practices and unsafe sexual behaviors associated with selling sex to buy drugs, are contributing to HIV transmission. A convergence of factors has increased the risk for syringe mediated HIV transmission, including the recent availability of “white” heroin for injection, which has replaced smoked brown heroin. In addition, the growing lack of employment opportunities and impoverishment have created an environment where urban residents of Tanzania are increasingly engaging in injection drug use, sharing syringes, and trading sex for money.

Recent study data collected by university researchers within the past 18 months in Dar es Salaam found the common practice of unsafe behaviors such as needle sharing and a high prevalence of HIV. Risks for female IDUs are heightened in many instances by a reliance on commercial sex, both formal and informal, to acquire the financial resources to purchase drugs.

As demonstrated by recent IDU behavioral data in Tanzania, the changing epidemiology of HIV/AIDS risks associated with injection drug use will require innovative HIV prevention approaches that are able to address multiple and changing levels of risks and contexts (e.g., social network, dyadic, family, community and structural). The activities funded through this program will respond to the evolving epidemiology and assist drug using populations to reduce their risk for HIV/AIDS, other sexually transmitted infections (STDs), and hepatitis B and C by: (1) conducting community-based outreach and engaging IDUs and other most at-risk populations in HIV prevention, including condom distribution; (2) communicating appropriate prevention and risk reduction messages which will help IDUs address their HIV risk behaviors (i.e., reduce drug use and increase use of sterile needles, and increase utilization of evidence-based, integrated care for injection drug abuse when available); (3) providing mobile HIV counseling and testing and, if feasible, STD services; (4) linking IDUs and members of other most at-risk groups with follow-up care at STD clinics and facilities providing HIV care and treatment for those found to be HIV-positive; and (5) facilitating access to drug abuse treatment when available and appropriate. An additional intent of this announcement is to foster greater understanding and awareness of injection drug use in Tanzania and provide forums for discussing opportunities, gaps, challenges and strategies for HIV prevention efforts with these most at risk populations.

Measurable outcomes of the program will be in alignment with the following performance goal(s) for the Emergency Plan:

Number of individuals trained to provide HIV prevention interventions for persons engaged in high risk behaviors

Number of clients, tracked by age and sex, will be reached with HIV prevention education and outreach services.

Number of clients, tracked by age and sex, provided with HIV counseling and testing.

Number of clients tracked, by age and sex, referred to HIV care and treatment services.

Number of clients, tracked by age and sex, referred for treatment and management of STDs and other infectious diseases.

This announcement is primarily intended for non-research activities supported by the Centers for Disease Control and Prevention (CDC) within HHS. If an applicant proposes research activities, HHS will not review the application. For the definition of “research,” please see the HHS/CDC Web site at the following Internet address: http://www.cdc.gov/od/science/regs/hrpp/researchdefinition.htm.

The recipient of these funds is responsible for activities in multiple program areas designed to target underserved populations in Tanzania. Either the awardee will implement activities directly or will implement them through its subgrantees and/or subcontractors; the awardee will retain overall financial and programmatic management under the oversight of HHS/CDC and the strategic direction of the Office of the U.S. Global AIDS Coordinator. The awardee must show a measurable progressive reinforcement of the capacity of indigenous organizations and local communities to respond to the national HIV epidemic, as well as progress towards the sustainability of activities.

Applicants should describe activities in detail that reflect the policies and goals outlined in the Five-Year Strategy for the President’s Emergency Plan.

The grantee will produce an annual operational plan, which the U.S. Government Emergency Plan team on the ground in Tanzania will review as part of the annual Emergency Plan for AIDS Relief Country Operational Plan review-and-approval process, managed by the Office of the U.S. Global AIDS Coordinator. The grantee may work on some of the activities listed below in the first year and in subsequent years, and then progressively add others from the list to achieve all of the Emergency Plan performance goals, as cited in the previous section. HHS/CDC, under the guidance of the U.S. Global AIDS Coordinator, will approve funds for activities on an annual basis, based on documented performance toward achieving Emergency Plan goals, as part of the annual Emergency Plan for AIDS Relief Country Operational Plan review-and-approval process.

1. Work with CDC-Tanzania, USG (Tanzania) and technical experts from CDC-Atlanta to facilitate comprehensive trainings (both initially and on an ongoing basis) for conducting outreach with IDUs and other most-at-risk populations. Trainings should include, but are not limited to, the following: engagement of IDUs and other at-risk populations, communicating behavior change skills to clients, HIV/AIDS information, STI and other infectious disease training, drugs and substance abuse, orientation to resources and services accessible to clients in the surrounding communities, correct condom use and condom promotion with high-risk groups, and syringe cleaning and safer syringe practices for IDUs.

2. Participate in routine lessons learned and experience exchanges with agencies implementing similar activities in other locations (e.g. Mombassa, Kenya).

3. Use existing data and resources to map and identify locations for community-based outreach and mobile services for most at-risk populations. Work with local researchers and CDC-Tanzania and USG (Tanzania) to continually monitor behavioral data to identify emerging trends, practices, access points and sub-groups.

4. Develop appropriate staffing plan and outreach protocol, including a strategy for engaging former members of at-risk groups as peer outreach workers and counselors. Management and supportive supervision issues should also be included as part of this plan.

5. Implement, scale-up and sustain a comprehensive, multi-component intervention for most at-risk populations. The community-based intervention should include: education and information on HIV and drug abuse prevention, risk reduction counseling, condom distribution, mobile HIV counseling and testing, STD screening and management (if feasible), referrals for drug abuse treatment (when available), and linkages to existing USG-supported HIV care and treatment for those found to be HIV-infected.

6. Tailor intervention activities, as needed, to address gender, sexual orientation, and/or risk behaviors and the social context in which the individual behaviors occur. It is anticipated that multiple intervention strategies will be needed to take into account the behavioral heterogeneity among subpopulations most at risk for HIV. For example, outreach workers engaging female CSWs may be required to offer “women only” services or target emergent female-only injection houses where these women feel safe from violence.

7. Develop and disseminate appropriate IEC/BCC and social marketing materials to reduce high-risk sexual and drug related practices.

8. Establish a system for efficient procurement of supplies (e.g., condoms and test kits) or develop linkages with other organizations to acquire needed supplies.

9. Coordinate, with assistance and guidance from CDC-Tanzania and USG (Tanzania) educational forums to foster greater understanding and awareness of injection drug use in Tanzania.

10. Collect and report standardized data on all services through routine program monitoring and evaluation to assess effectiveness and impact.

Administration

The awardee of this funding competition must comply with all HHS/CDC management requirements for meeting participation and progress and financial reporting for this cooperative agreement (See HHS/CDC activities and reporting sections below for details), and comply with all policy directives established by the Office of the U.S. Global AIDS Coordinator.

In a cooperative agreement, HHS/CDC staff is substantially involved in the program activities, above and beyond routine grant-monitoring.

1. Organize an orientation meeting with the grantee to brief it on applicable U.S. Government, HHS, and Emergency Plan expectations, regulations and key management requirements, as well as report formats and contents. The orientation could include meetings with staff from HHS agencies and the Office of the U.S. Global AIDS Coordinator.

2. Review and approve the process used by the grantee to select key personnel and/or post-award subcontractors and/or subgrantees to be involved in the activities performed under this agreement, as part of the Emergency Plan for AIDS Relief Country Operational Plan review and approval process, managed by the Office of the U.S. Global AIDS Coordinator.

3. Review and approve the grantee’s annual work plan and detailed budget, as part of the Emergency Plan for AIDS Relief Country Operational Plan review-and-approval process, managed by the Office of the U.S. Global AIDS Coordinator.

4. Review and approve the grantee’s monitoring and evaluation plan, including for compliance with the strategic information guidance established by the Office of the U.S. Global AIDS Coordinator.

5. Meet on a monthly basis with the grantee to assess monthly expenditures in relation to approved work plan and modify plans, as necessary.

6. Meet on a quarterly basis with the grantee to assess quarterly technical and financial progress reports and modify plans as necessary.

7. Meet on an annual basis with the grantee to review annual progress report for each U.S. Government Fiscal Year, and to review annual work plans and budgets for subsequent year, as part of the Emergency Plan for AIDS Relief review and approval process for Country Operational Plans, managed by the Office of the U.S. Global AIDS Coordinator.

8. Provide technical assistance, as mutually agreed upon, and revise annually during validation of the first and subsequent annual work plans. This could include expert technical assistance and targeted training activities in specialized areas, such as strategic information, project management, confidential counseling and testing, palliative care, treatment literacy, and adult-learning techniques.

9. Provide in-country administrative support to help grantee meet U.S. Government financial and reporting requirements approved by the Office of Management and Budget (OMB) under 0920-0428 (Public Health Service Form 5161).

10. Collaborate with the awardee on designing and implementing the activities listed above, including, but not limited to the provision of technical assistance to develop program activities, data management and analysis, quality assurance, the presentation and possibly publication of program results and findings, and the management and tracking of finances.

11. Provide consultation and scientific and technical assistance based on appropriate, HHS/CDC and Office of the U.S. Global AIDS Coordinator documents to promote the use of best practices known at the time.

12. Assist the recipient in developing and implementing quality assurance criteria and procedures.

13. Facilitate in-country planning and review meetings for technical assistance activities.

Please note: Either HHS staff or staff from organizations that have successfully competed for funding under a separate HHS contract, cooperative agreement or grant will provide technical assistance and training.

II. Award Information

Award Mechanism: U2G – Global HIV/AIDS Non-Research Cooperative Agreements

In cooperation with other countries, international organizations, and other partners to conduct HIV/AIDS prevention, care and treatment non-research activities in international countries most heavily affected by the HIV/AIDS epidemic.

Approximate Total Project Period Funding: $2,000,000 (This amount is an estimate, and is subject to availability of funds.)

Approximate Average Award: $400,000 (This amount is for the first 12-month budget period, and includes direct costs.)

Ceiling of Individual Award Range: $400,000 (This ceiling is for the first 12-month budget period.)

Throughout the project period, HHS/CDC’s commitment to continuation of awards will be conditioned on the availability of funds, evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the Federal Government, through the Emergency Plan for AIDS Relief review and approval process for Country Operational Plans, managed by the Office of the U.S. Global AIDS Coordinator.

III. Eligibility Information

Applications may be submitted by Tanzania-based entities that meet the following criteria:

1. Have proven experience working with and providing services to IDUs, CSWs and/or MSM in the United Republic of Tanzania.

2. Have the organizational capacity to provide a comprehensive range of services for most at-risk populations either individually or in partnership with other agencies (letters of support are required).

3. Are able to coordinate appropriate care and treatment linkages for HIV-infected individuals either in communities where at-risk populations are engaged or an appropriate nearby site.

Applications may be submitted by individual organizations or by consortia consisting of one or more organizations.

Competition for this cooperative agreement is limited to the types of Tanzania-based organizations listed above because of the uniqueness of the specific activities for this project and the location of where the work will be performed. The types of Tanzania-based organizations listed above are those that have direct experience with performing this type of activity.

The goal of PEPFAR’s New Partners Initiative, announced in December 2006, are to “develop indigenous capacity to address HIV/AIDS to promote the sustainability of host nations’ efforts.” An indigenous organization is one that originated and is located in the geographic area it services, serves the population located in the geographic area, and has a majority of organizational staff (senior, mid-level, and support) comprised of persons native to that area. Building, strengthening and sustaining institutional capacity of Tanzania-based organizations is a key strategy for achieving the prevention, care and treatment goals of the Emergency Plan and to ensuring the long-term sustainability of Emergency Plan Programs. Organizations indigenous to Tanzania are more familiar with the target population and culture. Services provided by these organizations are more acceptable to the target population because services are more culturally and linguisticaly appropriate. Activities are more effective in addressing the needs of the target population and services are more cost effective. Engaging local partners is a critical step towards achieving this strategy.

Matching funds are not required for this program. If applicants receive funding from other sources to underwrite the same or similar activities, or anticipate receiving such funding in the next 12 months, they must detail how the disparate streams of financing complement each other.

If an applicant requests a funding amount greater than the ceiling of the award range, HHS/CDC will review the budgets greater than the ceiling of the award range.

If the application is incomplete or non-responsive to the special requirements listed in this section, it will not enter into the review process. HHS/CDC will notify the applicant the application did not meet submission requirements.

IV. Application and Submission Information

Each applicant agency or organization must have a Dun and Bradstreet Data Universal Numbering System (DUNS) number to apply for a grant or cooperative agreement from the Federal Government. The DUNS number is a nine-digit identification number, which uniquely identifies business entities. Obtaining a DUNS number is easy and there is no charge. To obtain a DUNS number, please go to the following Internet address: http://fedgov.dnb.com/webform/displayHomePage.do;jsessionid=D12B99D19654F9B26C193B1EFDE3430B. From the home page, 1) click on "Begin DUNS Search/Request Process", 2) select country and submit your organization information. A DUNS number should be created within one day. Please direct any questions to govt@dnb.com.

If the application form does not have a DUNS number field, please write the DUNS number at the top of the first page of the application, and/or include the DUNS number in the cover letter that accompanies the application.

HHS/CDC strongly encourages the applicant to submit the application electronically by using the forms and instructions posted for this announcement on www.Grants.gov, the official Federal agency-wide E-grant Web site. Only applicants who apply on-line may forego submitting paper copies of all application forms.

Registering an organization through www.Grants.gov is the first step in submitting applications online. Registration information is located in the “Get Registered” screen of www.Grants.gov. For Foreign Organizations, the next step would be to obtain an NATO Commercial and Governmental Entity (NCAGE) Code http://www.cdc.gov/od/pgo/funding/grantmain.htm. While application submission through www.Grants.gov is optional, applicants are strongly encouraged to use this online tool.

If technical difficulties are encountered in Grants.gov, customer service may be obtained by e-mail at support@grants.gov, or by phone 1-800-518-4726 (1-800-518-GRANTS). The Customer Support Center is open from 7:00 a.m. to 9:00 p.m. Eastern Standard Time, Monday through Friday.

Application forms and instructions are available on the HHS/CDC Web site, at the following Internet address: http://www.cdc.gov/od/pgo/forms.shtm

If access to the Internet is not available, or if difficulty is encountered in accessing the forms on-line, contact the HHS/CDC Procurement and Grants Office Technical Information Management Section (PGO-TIM) staff at 770-488-2700, who can mail the application forms.

A Project Abstract must be submitted with the application forms. The abstract must be submitted in the following format:

The Project Abstract must contain a summary of the proposed activity suitable for dissemination to the public. It should be a self-contained description of the project and should contain a statement of objectives and methods to be employed. It should be informative to other persons working in the same or related fields and insofar as possible understandable to a technically literate lay reader. This Abstract must not include any proprietary/confidential information.

Applicants must submit a project narrative with the application forms, in the following format:

· Maximum number of pages: 25 (If your narrative exceeds the page limit, HHS/CDC will only review the first pages that are within the page limit.);

The narrative should address activities the applicant will conduct over the entire project period, and must include the following items, in the order listed:

Applicants may include additional information in appendices. The appendices and budget information will not count toward the narrative page limit. This additional information includes the following:

line-item budget and a narrative with justification for all requested costs. Be sure to include, if any, in-kind support or other contributions provided by the national Government and its donors as part of the total project, but for which funding is not being requested.

Budgets must be consistent with the purpose, objectives of the Emergency Plan and the program activities listed in this announcement and must include the following:

o Line-item breakdown and justification for all personnel, i.e., name, position title, annual salary, percentage of time and effort, and amount requested.

For each contract, list the following: (1) name of proposed contractor; (2) breakdown and justification for estimated costs; (3) description and scope of activities the contractor will perform; (4) period of performance; (5) method of contractor selection (e.g., competitive solicitation); and (6) methods of accountability. Applicants should, to the greatest extent possible, employ transparent and open competitive processes to choose contractors;

Additional requirements that could require submission of additional documentation with the application appear in Section “VI.2. Administrative and National Policy Requirements.”

IV.3. Submission Dates and Times

Explanation of Deadlines: The HHS/CDC Procurement and Grants Office must receive applications by 5:00 p.m. Eastern Time on the deadline date.

HHS/CDC will consider applications completed on-line through Grants.gov as formally submitted when the applicant organization’s Authorizing Official electronically submits the application to www.grants.gov. The application will be electronically time/date stamped, which will serve as receipt of submission. Applicants will receive an e-mail notice of receipt when HHS/CDC receives the application.

HHS/CDC will consider electronic applications as having met the deadline if the applicant organization’s Authorizing Official has submitted the application electronically to Grants.gov on or before the deadline date and time.

If an applicant submits an application by the United States Postal Service or commercial delivery service, the applicant must ensure the carrier will be able to guarantee delivery by the closing date and time. If HHS/CDC receives the submission after the closing date because of (1) carrier error, when the carrier accepted the package with a guarantee for delivery by the closing date and time; or (2) significant weather delays or natural disasters, the applicant will have the opportunity to submit documentation of the carrier’s guarantee. If the documentation verifies a carrier problem, HHS/CDC will consider the submission as having been received by the deadline.

If an applicant submits a hard-copy application, HHS/CDC will not notify the applicant upon receipt of the submission. If questions arise on the receipt of the application, the applicant should first contact the carrier. If the applicant still has questions, it should contact the HHS/CDC staff at (770) 488-2700. The applicant should wait two to three days after the submission deadline before calling. This will allow time for HHS/CDC to process and log submissions.

This announcement is the definitive guide on application content, submission address, and deadline. It supersedes information provided in the application instructions. If the application submission does not meet the deadline above, it will not be eligible for review, and HHS/CDC will discard it. HHS/CDC will notify the applicant the application did not meet the submission requirements.

Restrictions, which applicants must take into account while writing the budget, are as follows:

· Needle Exchange - No funds appropriated under this Act shall be used to carry out any program of distributing sterile needles or syringes for the hypodermic injection of any illegal drug.

· Recipients may spend funds for reasonable program purposes, including personnel, training, travel, supplies and services. Recipients may purchase equipment and complete renovations if deemed necessary to accomplish program objectives, and if authorized by, and in accordance with applicable federal law and HHS/CDC policy and the funding stream used for this activity. This procurement of equipment should occur through a transparent and competitive process and, if authorized by, and in accordance with, applicable federal law and HHS/CDC policy and the funding stream used for this activity.

· Applicants shall state all requests for funds contained in the budget in U.S. dollars. Once HHS/CDC makes an award, foreign grantees will not be compensated for currency-exchange fluctuations through the issuance of supplemental awards.

· The costs generally allowable in grants to domestic organizations are allowable to foreign institutions and international organizations, with the following exception: With the exception of the American University, Beirut, and the World Health Organization, HHS/CDC will not pay indirect costs (either directly

or through sub-award) to organizations located outside the territorial limits of the United States or to international organizations, regardless of their location.

· Recipients may contract with other organizations under this program; however, recipients must perform a substantial portion of the activities (including program management and operations, and delivery of prevention services for which funds are required) relating to the management of sub-grants to local organizations and improving their capacity, and must award any subcontracts through a competitive and transparent process.

· Recipients must obtain an annual audit[1] of these HHS/CDC funds (program-specific audit) by a U.S.-based audit firm with international branches and current licensure/authority in-country, and in accordance with International Accounting Standards or equivalent standard(s) approved in writing by HHS/CDC.

· A fiscal Recipient Capability Assessment may be required, prior to or post award, to review the applicant’s business management and fiscal

The U.S. Government is opposed to prostitution and related activities, which are inherently harmful and dehumanizing, and contribute to the phenomenon of trafficking in persons.

Any entity that receives, directly or indirectly, U.S. Government funds in connection with this document (“recipient”) cannot use such U.S. Government funds to promote or advocate the legalization or practice of prostitution or sex trafficking. Nothing in the preceding sentence shall be construed to preclude the provision to individuals of palliative care, treatment, or post-exposure pharmaceutical prophylaxis, and necessary pharmaceuticals and commodities, including test kits, condoms, and, when proven effective, microbicides.

A recipient that is otherwise eligible to receive funds in connection with this document to prevent, treat, or monitor HIV/AIDS shall not be required to endorse or utilize a multisectoral approach to combating HIV/AIDS, or to endorse, utilize, or participate in a prevention method or treatment program to which the recipient has a religious or moral objection. Any information provided by recipients about the use of condoms as part of projects or activities that are funded in connection with this document shall be medically accurate and shall include the public health benefits and failure rates of such use.

In addition, any recipient must have a policy explicitly opposing prostitution and sex trafficking. The preceding sentence shall not apply to any “exempt organizations” (defined as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Health Organization and its six Regional Offices, the International AIDS Vaccine Initiative or any United Nations agency).

· Sex trafficking means the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act. 22 U.S.C. § 7102(9).

All recipients must insert provisions implementing the applicable parts of this section, “Prostitution and Related Activities,” in all subagreements under this award. These provisions must be express terms and conditions of the subagreement, must acknowledge that compliance with this section, “Prostitution and Related Activities,” is a prerequisite to receipt and expenditure of U.S. Government funds in connection with this document, and must acknowledge that any violation of the provisions shall be grounds for unilateral termination of the agreement prior to the end of its term. Recipients must agree that HHS may, at any reasonable time, inspect the documents and materials maintained or prepared by the recipient in the usual course of its operations that relate to the organization’s compliance with this section, “Prostitution and Related Activities.”

All prime recipients that receive U.S. Government funds (“prime recipients”) in connection with this document must certify compliance prior to actual receipt of such funds in a written statement that makes reference to this document (e.g., “[Prime recipient's name] certifies compliance with the section, “Prostitution and Related Activities.”) addressed to the agency’s grants officer. Such certifications by prime recipients are prerequisites to the payment of any U.S. Government funds in connection with this document.

Recipients' compliance with this section, “Prostitution and Related Activities,” is an express term and condition of receiving U.S. Government funds in connection with this document, and any violation of it shall be grounds for unilateral termination by HHS of the agreement with HHS in connection with this document prior to the end of its term. The recipient shall refund to HHS the entire amount furnished in connection with this document in the event HHS determines the recipient has not complied with this section, “Prostitution and Related Activities.”

Guidance for completing the budget appears on the HHS/CDC Web site, at the following Internet address:

HHS/CDC strongly encourages applicants to submit applications electronically at www.Grants.gov. The application package is available at www.Grants.gov. Applicants are able to complete it off-line, and then upload and submit the application via the Grants.gov Web site. HHS/CDC will not accept e-mail submissions. If the applicant has technical difficulties in Grants.gov, it can reach customer service by e-mail at support@grants.gov, or by phone at 1-800-518-4726 (1-800-518-GRANTS). The Customer Support Center is open from 7:00 a.m. to 9:00 p.m., Eastern Time, Monday through Friday.

HHS/CDC recommends applicants submit their applications to Grants.gov early enough to resolve any unanticipated difficulties prior to the deadline. Applicants may also

submit a back-up paper submission of the application. HHS/CDC must receive any such paper submission in accordance with the requirements for timely submission detailed in Section IV.3. of the grant announcement. The applicant must clearly mark the paper submission: “BACK-UP FOR ELECTRONIC SUBMISSION.” The paper submission must conform to all requirements for non-electronic submissions. If HHS/CDC receives both electronic and back-up paper submissions by the deadline, the electronic version will be considered as the official submission.

The applicant must submit all application attachments using a PDF file format when submitting via Grants.gov. Directions for creating PDF files are available on the Grants.gov Web site. Use of file formats other than PDF could make the file unreadable for our staff.

Applicants should submit the original and two hard copies of the application by mail or express delivery service to:

V. Application Review Information

Applicants are required to provide specific measures of effectiveness that will demonstrate the accomplishment of the various identified objectives of the cooperative agreement. Measures of effectiveness must relate to the performance goals stated in the “Purpose” section of this announcement. Measures must be objective and quantitative, and must measure the intended outcome. Applicants must submit the measures of effectiveness with the application, and they will be an element of evaluation.

Does the applicant demonstrate the local experience in Tanzania and institutional capacity (both management and technical) to achieve the goals of the project with documented good-governance practices? Does the applicant have the ability to coordinate and collaborate with existing Emergency Plan partners and other donors, including the Global Fund and other U.S. Government Departments and agencies involved in implementing the Emergency Plan, including the U.S. Agency for International Development? Is there evidence of leadership support and evidence of current or past efforts to enhance HIV prevention? Does the applicant have the capacity to reach rural and other underserved populations in Tanzania? Does the organization have the ability to target audiences that frequently fall outside the reach of the traditional media, and in local languages? To what extent does the applicant provide letters of support?

Does the application include an overall design strategy, including measurable time lines, clear monitoring-and-evaluation procedures, and specific activities for meeting the proposed objectives? Does the applicant display knowledge of the strategy, principles and goals of the President's Emergency Plan for AIDS Relief, and are the proposed activities consistent with and pertinent to that strategy and those principles and goals? Does the applicant describe activities that are evidence-based, realistic, achievable, measurable and culturally appropriate to achieve the goals of the Emergency Plan? Does the application propose to build on and complement the current national response in Tanzania with evidence-based strategies designed to reach underserved populations and meet the goals of the Emergency Plan? Does the application include reasonable estimates of outcome targets? (For example, the numbers of sites to be supported, number of clients the program will reach.) To what extent does the applicant propose to work with other organizations? The reviewers will assess the feasibility of the applicant's plan to meet the target goals, whether the proposed use of funds is efficient, and the extent to which the specific methods described are sensitive to the local culture.

Does the applicant have a proven track-record of building the capacity of indigenous organizations and individuals? Does the applicant have relevant experience in using participatory methods and approaches, in project planning and implementation? Does the applicant describe an adequate and measurable plan to progressively build the capacity of local organizations and of target beneficiaries to respond to the epidemic? If not a local indigenous organization, does the applicant articulate a clear exit strategy, which will maximize the legacy of this project in the intervention communities? Does the capacity-building plan clearly describe how it will contribute to a) improved quality and geographic coverage of service delivery to achieve the "2,7,10" targets of the Emergency Plan, and b) (if not a local indigenous organization) an evolving role of the prime beneficiary with transfer of critical technical and management competence to local organizations/sites in support of a decentralized response?

Does the applicant demonstrate the local experience and capability to implement rigorous monitoring and evaluation of the project? Does the applicant describe a system for reviewing and adjusting program activities based on monitoring information obtained by using innovative, participatory methods and standard approaches? Does the plan include indicators developed for each program milestone, and incorporated into the financial and programmatic reports? Are the indicators consistent with the Emergency Plan Indicator Guide? Is the system able to generate financial and program reports to show disbursement of funds, and progress towards achieving the numerical objectives of the President's Emergency Plan? Is the plan to measure outcomes of the intervention, and the manner in which they will be provided, adequate? Is the monitoring-and-evaluation plan consistent with the principles of the "Three Ones?" Applicants must define specific output and outcome indicators must be defined in the proposal, and must have realistic targets in line with the targets addressed in the Activities section of this announcement.

Does the applicant demonstrate a clear and concise understanding of the current national HIV/AIDS response and the cultural and political context relevant to the programmatic areas targeted? Does the applicant display an understanding of the Five-Year Strategy and goals of the President's Emergency Plan? To what extent does the applicant justify the need for this program within the target community?

Does the organization employ staff fluent in local languages who will work on this project? Are the staff roles clearly defined? As described, will the staff be sufficient to meet the goals of the proposed project? If not an indigenous organization, does the staff plan adequately involve local individuals and organizations? Are staff involved in this project qualified to perform the tasks described? Curricula vitae provided should include information that they are qualified in the following: management of HIV/AIDS prevention activities, especially confidential, voluntary counseling and testing; and the development of capacity-building among and collaboration between Governmental and non-governmental partners.

Does the applicant provide a clear plan for the administration and management of the proposed activities, and to manage the resources of the program, prepare reports, monitor and evaluate activities, audit expenditures and produce collect and analyze performance data? Is the management structure for the project sufficient to ensure speedy implementation of the project? If appropriate, does the applicant have a proven track record in managing large laboratory budgets; running transparent and competitive procurement processes; supervising consultants and contractors; using subgrants or other systems of sharing resources with community-based organizations, faith-based organizations or smaller non-governmental organizations; and providing technical assistance in laboratory or pharmacy management? The grantee must demonstrate an ability to submit quarterly reports in a timely manner to the HHS/CDC office.

Is the itemized budget for conducting the project, along with justification, reasonable and consistent with stated objectives and planned program activities? Is the budget itemized, well-justified and consistent with the Five-Year Strategy (2003-2008) and goals of the President's Emergency Plan and Emergency Plan activities? If applicable, are there reasonable costs per client reached for both year one and later years of the project?

The HHS/CDC Procurement and Grants Office (PGO) staff will review applications for completeness, and the HHS Global AIDS Program will review them for responsiveness. Incomplete applications and applications that are non-responsive to the eligibility criteria will not advance through the review process. Applicants will receive notification that their application did not meet submission requirements.

An objective review panel will evaluate complete and responsive applications according to the criteria listed in the “V.1. Criteria” section above. All persons who serve on the panel will be external to the U.S. Government Country Program Office in Tanzania. The panel may include both Federal and non-Federal participants.

All other things being equal, advantage will be given to indigenous organizations (with local ownership) or collaborations with indigenous organizations.

The anticipated award date is September 28, 2007.

VI. Award Administration Information

Successful applicants will receive a Notice of Award (NoA) from the HHS/CDC Procurement and Grants Office. The NoA shall be the only binding, authorizing document between the recipient and HHS/CDC. An authorized Grants Management

Officer will sign the NoA, and mail it to the recipient fiscal officer identified in the application.

Unsuccessful applicants will receive notification of the results of the application review by mail.

Successful applicants must comply with the administrative requirements outlined in 45 CFR Part 74 and Part 92, as appropriate. The following additional requirements apply to this project:

The applicant must provide HHS/CDC with an original, plus two hard copies, of the following reports :

1. Interim progress report, due no less than 90 days before the end of the budget period. The progress report will serve as the non-competing continuation application, and must contain the following elements:

e. Measures of Effectiveness, including progress against the numerical goals of the President's Emergency Plan for AIDS Relief for Tanzania; and

2. Annual progress report, due 90 days after the end of the budget period. Reports should include progress against the numerical goals of the President's Emergency Plan for AIDS Relief for Tanzania;

3. Financial status report, due no more than 90 days after the end of the budget period; and

4. Final financial performance reports, due no more than 90 days after the end of the project period.

Recipients must mail the reports to the Grants Management listed in the "VII. Agency Contacts" section of this announcement.

VII. Agency Contacts

CDC Telecommunications for the hearing impaired or disabled is available at: TTY 770-488-2783.

and on the web site of the HHS Office of Global Health Affairs, Internet address: www.globalhealth.gov.

[1] AUDIT REQUIREMENT: Foreign recipients are subject to audit requirements specified in 45 CFR 74.26(d). A non-Federal audit is required, if during the recipients fiscal year, the recipient expended a total of $500,000 or more under one or more HHS awards (as a direct recipient and/or as a sub-recipient). The recipient either may have (1) A financial related audit (as defined in the Government Auditing Standards, GPO stock #020-000-00-265-4) of a particular award in accordance with Government Auditing Standards, in those cases where the recipient received awards under only one HHS program; or, if awards are received under multiple HHS programs, a financial related audit of all HHS awards in accordance with Government Auditing Standards; or (2) An audit that meets the requirements contained in OMB Circular A-133.