Opportunity Information: Apply for CDC RFA GH19 1922

The grant opportunity titled "Combination Prevention Solutions to Reach Epidemic Control among High Risk, Priority Populations in High Burden Areas in the Republic of South Africa under PEPFAR" (Funding Opportunity Number: CDC RFA GH19-1922) is a U.S. Centers for Disease Control and Prevention (CDC) cooperative agreement focused on accelerating progress toward HIV epidemic control in South Africa. It is framed around the reality that, even with relatively high coverage of HIV services, South Africa continues to face HIV/AIDS as a leading cause of death and has not yet met the threshold indicators associated with epidemic control. A central concern highlighted in the opportunity is the disproportionate burden among adolescent girls and young women (AGYW), particularly those ages 15-19, who experience HIV prevalence rates far higher than their male peers, with prevalence increasing sharply into the 20-24 age range. The opportunity is designed to respond to those disparities while also improving overall prevention, care, and treatment outcomes in geographic areas with the highest burden.

The program is explicitly aligned with and intended to support the Republic of South Africa's national "She Conquers" campaign for AGYW. In practice, this means applicants are expected to implement comprehensive, expanded, integrated, and sustainable HIV and TB/HIV prevention, care, and treatment programming across 27 priority high-burden districts. The NOFO emphasizes that these efforts should not be stand-alone activities; they should be integrated across the prevention-to-treatment continuum and built in a way that strengthens local systems and can be sustained. In addition to scaling interventions, the opportunity places major weight on intensive health systems strengthening (HSS) to improve prevention performance and raise service quality, recognizing that reaching epidemic control depends on reliable service delivery systems, data quality, workforce capacity, and consistent clinical and community standards.

A key feature of the opportunity is support for combination HIV prevention implemented through evidence-based interventions in 19 high-burden communities. Combination prevention generally refers to layering multiple complementary approaches so that biomedical, behavioral, and structural strategies work together, particularly for populations and places where incidence remains high. Within the scope described, recipients are expected not only to deliver interventions but also to use implementation experience to identify and refine best practices that can reduce HIV incidence at the population level in defined geographic areas. The intent is to move beyond incremental gains toward measurable changes in community-level transmission, using targeted, data-driven approaches that reflect the local epidemic and the needs of priority and key populations.

The NOFO also situates performance expectations within global epidemic-control benchmarks, specifically the UNAIDS 95-95-95 goals. This signals that funded work should contribute to increasing the proportion of people living with HIV who know their status, improving linkage and retention so that more people receive sustained antiretroviral therapy, and ensuring viral suppression at scale, because viral suppression is a cornerstone of reduced onward transmission. The opportunity further highlights the need for improved efficiency and effectiveness across both technical assistance (TA) and direct service delivery (DSD). In other words, recipients are expected to combine hands-on service expansion with targeted support to strengthen national and district capacity, so that improvements are not dependent on external implementers alone.

From an administrative standpoint, this is a discretionary funding opportunity offered by the U.S. Department of Health and Human Services, CDC (Center for Global Health), using a cooperative agreement mechanism. Cooperative agreements typically involve substantial CDC engagement, meaning recipients should anticipate close coordination with CDC and alignment with PEPFAR priorities, reporting expectations, and programmatic guidance. The CFDA number listed is 93.067. Eligibility is described as unrestricted (open to any type of entity, subject to any additional eligibility language in the full notice). The opportunity was created on September 14, 2018, with an original closing date of November 14, 2018 (applications due by 11:59 p.m. Eastern Time). The award ceiling is $20,000,000, and CDC anticipated making three awards, indicating a small number of relatively large awards intended to support substantial district and community-level impact.

Overall, the grant is aimed at accelerating epidemic control in South Africa by concentrating resources in high-burden districts and communities, prioritizing AGYW and other priority and key populations, strengthening the health system to improve quality and sustainability, and deploying evidence-based combination prevention alongside effective treatment scale-up. The expected end state is a measurable reduction in HIV incidence in targeted geographies, stronger prevention and treatment systems, and demonstrable progress toward 95-95-95 outcomes through a coordinated approach that blends direct services, technical assistance, and continuous improvement based on what works best in real-world implementation.

  • The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Combination Prevention Solutions to Reach Epidemic Control among High Risk, Priority Populations in High Burden Areas in the Republic of South Africa 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 Sep 14, 2018.
  • Applicants must submit their applications by Nov 14, 2018 Electronically submitted applications must be submitted no later than 1159 p.m., ET, on the listed application due date.. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
  • Each selected applicant is eligible to receive up to $20,000,000.00 in funding.
  • The number of recipients for this funding is limited to 3 candidate(s).
  • Eligible applicants include: Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled Additional Information on Eligibility.
Apply for CDC RFA GH19 1922

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Frequently Asked Questions (FAQs)

What is the official title of this grant opportunity?

The opportunity is titled "Combination Prevention Solutions to Reach Epidemic Control among High Risk, Priority Populations in High Burden Areas in the Republic of South Africa under PEPFAR."

What is the Funding Opportunity Number (NOFO/RFA identifier)?

The Funding Opportunity Number is CDC RFA GH19-1922.

Which U.S. agency is offering this funding?

This is a discretionary funding opportunity offered by the U.S. Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), Center for Global Health.

What funding mechanism is used?

The mechanism is a cooperative agreement. This typically means substantial CDC involvement, including close coordination, alignment with PEPFAR priorities, and adherence to CDC reporting and programmatic guidance.

What is the CFDA number for this opportunity?

The CFDA number listed is 93.067.

What is the overall purpose of the program?

The program is designed to accelerate progress toward HIV epidemic control in South Africa by focusing on high-burden geographic areas and populations, strengthening health systems, and implementing evidence-based combination prevention alongside improvements in HIV care and treatment outcomes.

Why is this opportunity focused on South Africa even though service coverage is described as relatively high?

The notice highlights that, despite relatively high coverage of HIV services, HIV/AIDS remains a leading cause of death in South Africa and the country has not yet met threshold indicators associated with epidemic control. The program is intended to address remaining gaps and accelerate measurable progress.

Which populations are prioritized in this opportunity?

A central priority is adolescent girls and young women (AGYW), especially ages 15-19, due to disproportionate HIV burden compared with male peers, with prevalence increasing sharply into the 20-24 age range. The opportunity also references high risk, priority, and key populations more broadly in high-burden areas.

How is this opportunity aligned with South Africa's national priorities?

The program is explicitly aligned with and intended to support the Republic of South Africa's national "She Conquers" campaign focused on AGYW.

Where will funded activities be implemented?

Applicants are expected to implement programming across 27 priority high-burden districts. In addition, the opportunity emphasizes combination HIV prevention implemented through evidence-based interventions in 19 high-burden communities.

What does the opportunity mean by "combination prevention"?

Within the description provided, combination prevention refers to layering multiple complementary approaches so biomedical, behavioral, and structural strategies work together, particularly in populations and places where HIV incidence remains high.

Is the program limited to prevention, or does it include treatment as well?

It includes prevention, care, and treatment. The NOFO calls for comprehensive, expanded, integrated, and sustainable HIV and TB/HIV prevention, care, and treatment programming, integrated across the prevention-to-treatment continuum.

What is meant by integrating activities across the "prevention-to-treatment continuum"?

The notice emphasizes that activities should not be stand-alone. Instead, prevention, diagnosis, linkage to care, treatment, retention, and viral suppression-related efforts should be connected and coordinated to improve overall outcomes and reduce transmission.

How important is health systems strengthening (HSS) in this program?

Health systems strengthening is a major emphasis. The opportunity places major weight on intensive HSS to improve prevention performance and raise service quality, recognizing that epidemic control depends on reliable service delivery systems, data quality, workforce capacity, and consistent clinical and community standards.

What types of results is the grant aiming to achieve at the community level?

The NOFO emphasizes moving beyond incremental gains toward measurable reductions in HIV incidence at the population level in defined geographic areas. Recipients are also expected to use implementation experience to identify and refine best practices that can reduce HIV incidence.

How does the opportunity connect to the UNAIDS 95-95-95 goals?

The notice explicitly situates performance expectations within the UNAIDS 95-95-95 goals. Funded work is expected to contribute to more people living with HIV knowing their status, more people receiving sustained antiretroviral therapy through improved linkage and retention, and viral suppression at scale, which helps reduce onward transmission.

What balance of activities is expected between direct service delivery and technical assistance?

The opportunity highlights the need for improved efficiency and effectiveness across both technical assistance (TA) and direct service delivery (DSD). Recipients are expected to combine hands-on service expansion with targeted support that strengthens national and district capacity so improvements are not dependent on external implementers alone.

Is TB/HIV included within the scope?

Yes. The description calls for integrated and sustainable HIV and TB/HIV prevention, care, and treatment programming.

What is the award ceiling (maximum funding amount) for this opportunity?

The award ceiling is $20,000,000.

How many awards did CDC anticipate making?

CDC anticipated making three awards.

Who is eligible to apply?

Eligibility is described as unrestricted (open to any type of entity), subject to any additional eligibility language that may be included in the full notice.

When was the opportunity created?

The opportunity was created on September 14, 2018.

What was the original application closing date and time?

The original closing date was November 14, 2018, with applications due by 11:59 p.m. Eastern Time.

What does it mean that this is a PEPFAR-related opportunity?

The description frames the work under PEPFAR and notes that recipients should anticipate alignment with PEPFAR priorities, reporting expectations, and programmatic guidance, alongside close coordination with CDC under the cooperative agreement structure.

What does "high-burden areas" refer to in this notice?

In the information provided, high-burden areas refer to the 27 priority high-burden districts and 19 high-burden communities where programming and evidence-based combination prevention interventions are expected to be implemented.

What is the intended long-term end state of the funded work?

The grant is aimed at achieving measurable reductions in HIV incidence in targeted geographies, strengthening prevention and treatment systems, improving quality and sustainability of services, and demonstrating progress toward 95-95-95 outcomes through coordinated direct services, technical assistance, and continuous improvement based on real-world implementation lessons.

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