Full-Access Home-Based Confidential Counseling and Testing Using Outreach Teams in One District in the Republic of Uganda, 43872-43879 [05-15003]

Agencies

• Centers for Disease Control and Prevention
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 70, Number 145 (Friday, July 29, 2005)]
[Notices]
[Pages 43872-43879]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-15003]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Full-Access Home-Based Confidential Counseling and Testing Using 
Outreach Teams in One District in the Republic of Uganda

    Announcement Type: New.
    Funding Opportunity Number: AA009.
    Catalog of Federal Domestic Assistance Number: 93.067.
    Key Dates: Application Deadline: August 22, 2005.

I. Funding Opportunity Description

    Authority: This program is authorized under Sections 307 and 
317(k)(2) of the Public Health Service Act, [42 U.S.C. 242l(a) and 
247b(k)(2)], as amended, and under Public Law 108-25 (United States 
Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003) 
[22 U.S.C. 7601].

    Background: 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 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: 
https://www.state.gov/s/gac/rl/or/c11652.htm.

Purpose

    The Centers for Disease Control and Prevention (CDC) within the 
U.S. Department of Health and Human Services (HHS) announces the 
availability of fiscal year (FY) 2005 funds for a cooperative agreement 
program for Full-Access Home-Based Confidential Counseling and Testing 
(HB--CT) by using outreach teams in one district in the Republic of 
Uganda.
    The purpose of this funding announcement is to progressively build 
an indigenous, sustainable response to the national HIV epidemic in 
Uganda through the rapid expansion of innovative, culturally 
appropriate, high-quality HIV/AIDS prevention and care interventions.
    Specifically, the winner of this announcement will develop a 
replicable model of rapid HB-CT to provide access for the entire 
population of a district to confidential HIV counseling and testing 
(CT) services within their residences. These services would include 
referral of those testing positive to sources of ongoing psycho-social 
support and basic preventative and palliative care. The provision of 
anti-retroviral therapy(ART) is not part of this program, although 
patients who qualify for ART under medical criteria may receive 
referrals to treatment sites as they become available.
    The United States Government seeks to reduce the impact of HIV/AIDS 
in specific countries in sub-Saharan Africa, Asia and the Americas by 
working with governments 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. The President's Emergency Plan 
for AIDS Relief encompasses HIV/AIDS activities in more than 100 
countries, and focuses on 15 countries, including Uganda, to develop 
comprehensive and integrated prevention, care and treatment programs.
    Under the leadership of the U.S. Global AIDS Coordinator, as part 
of the

[[Page 43873]]

Emergency Plan, the HHS Global AIDS Program (GAP) strengthens capacity 
and expands local activities in the areas of: (1) Culturally 
appropriate HIV primary prevention: (2) HIV care, support and 
treatment; and (3) capacity and infrastructure development, including 
surveillance. Goals and priorities include the following:
     Achieving primary prevention of HIV infection through 
activities such as expanding confidential counseling and testing 
programs, building programs to reduce mother-to-child transmission, and 
strengthening programs to reduce transmission via blood transfusion and 
medical injections.
     Improving the care and treatment of HIV/AIDS, sexually 
transmitted diseases (STDs) and related opportunistic infections by 
improving STD management; enhancing care and treatment of opportunistic 
infections, including tuberculosis (TB); and initiating programs to 
provide anti-retroviral therapy (ART).
     Strengthening the capacity of countries to collect and use 
surveillance data and manage national HIV/AIDS programs by expanding 
HIV/STD/TB surveillance programs and strengthening laboratory support 
for surveillance, diagnosis, treatment, disease-monitoring and HIV 
screening for blood safety.
    Targeted countries represent those with the most severe epidemics 
and the highest number of new infections. They also represent countries 
where the potential impact is greatest and where United States 
Government agencies are already active; Uganda is one of those 
countries.
    The mission of the Emergency Plan in Uganda is to work with Ugandan 
and international partners to develop, evaluate, and support effective 
implementation of interventions to prevent HIV and related illnesses 
and improve care and support of persons with HIV/AIDS. In Uganda, 
Emergency Plan goals include treating at least 60,000 HIV-infected 
individuals; and providing care for 300,000 HIV-affected individuals, 
including orphans over the five years of Emergency Plan implementation. 
According to the 2002 Uganda Health Facilities Survey, confidential 
counseling and testing services are only available at five percent of 
public and private health facilities. In addition, the most recent 
Demographic and Health Survey in Uganda indicates that 70 percent of 
people would like to receive HIV testing, but only ten percent report 
they have been tested. Also, evidence from studies in several districts 
suggests that when offered confidential CT in their homes, between 50 
and 90 percent accept the service. Cost-effective procedures of 
offering full-access HB-CT to the whole population over a relatively 
short period would provide an important strategy for averting 
infections and providing timely care to persons-living-with-HIV/AIDS 
(PLWHAs), especially in rural areas.
    This announcement seeks to provide confidential HIV-CT services, 
and appropriate referrals to care and treatment, to all adults (and 
potentially all children) who reside in one district over a period of 
24 months, to evaluate the experience, and to develop guidelines for 
cost-effective indigenous replication. This first phase of the program, 
including preparation and evaluation, will last 18 months. The grantee 
may complete follow-up activities and documentation of lessons learned 
in the form of guidelines during the last six months of this program. 
This program will include referrals to local care providers that offer 
basic preventative care, opportunistic disease management, palliative 
care, and, if available, ART, to persons with HIV/AIDS in the district, 
without taking on the long term responsibility or financial support for 
care provision.
    Measurable outcomes of the program will be in alignment with the 
performance goals of the President's Emergency Plan and with one (or 
more) of the following performance goal(s) for the CDC National Center 
for HIV, STD and TB Prevention(NCHSTP) within HHS: By 2010, work with 
other countries, international organizations, the U.S. Department of 
State, U.S. Agency for International Development (USAID), and other 
partners to achieve the United Nations General Assembly Special Session 
on HIV/AIDS goal of reducing prevalence among young persons 15 to 24 
years of age and to reduce HIV transmission and improve care of persons 
living with HIV. Specific measurable outcomes of this program include, 
but are not be limited to, the number, age and sex of clients 
(individual and couples) provided with confidential HIV HB-CT, the 
percentage coverage of the population by confidential HIV HB-CT, 
unrecognized HIV infections discovered, the cost per client service and 
per unrecognized infection, and the number of persons with HIV 
successfully referred to an effective care or treatment provider.
    This announcement is only for non-research activities supported by 
HHS, including the Centers for Disease Control and Prevention (CDC). 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: https://www.cdc.gov/od/ads/
opspoll1.htm.

Activities

    Based on its competitive advantage and proven field experience, the 
winning applicant will undertake a broad range of activities to meet 
the numerical Emergency Plan targets outlined above. For each of these 
activities, the grantee will give priority to evidence-based, yet 
culturally adapted, innovative approaches.
    The recipient of these funds is responsible for activities in 
multiple program areas designed to target underserved populations in 
Uganda. 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 as part of a two-
year action plan (U.S. Government Fiscal Years 2005-2008 inclusive) 
that reflects the policies and goals outlined in the five-year strategy 
for the President's Emergency Plan.
    The grantee will produce an annual operational plan in the context 
of this two-year plan, which the U.S. Government Emergency Plan team on 
the ground in Uganda 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.
    Awardee activities for this program are as follows:
    1. Identify project staffing needs; hire and train staff.

[[Page 43874]]

    2. Identify the procurement needs of the project and implementing 
partners for vehicles, furnishings, fittings, equipment, computers and 
other fixed assets procurement, and acquire from normal sources through 
competitive processes.
    3. Establish suitable administrative and financial management 
structures, including a project office, if required.
    4. Work within the chosen district to implement confidential HIV 
HB-CT in such a manner that the coverage of the district's population 
is progressive, predictable and comprehensive by reaching communities 
systematically to ensure maximum and efficient coverage for the 
district.
    5. Work with district public and private sector stakeholders to 
develop an effective referral system to care and treatment providers 
for those testing positive.
    6. Ensure that all persons testing positive receive information 
about a basic preventive care package and referral to an effective care 
provider, or treatment provider, if available.
    7. Support the development of a simple data-collection system, 
integrated within the general Ugandan government Health Management 
Information System (HMIS) that reflects useful information specifically 
related to confidential CT activities and Emergency Plan reporting 
requirements, consistent with the strategic information guidance 
provided by the Office of the U.S. Global AIDS Coordinator.
    8. Ensure the installation and operation of a commodities supply 
and management system for test kits and other necessary items.
    9. Implement a simple quality-assurance system for confidential HIV 
CT in a home-based setting.
    10. Evaluate the activity and disseminate conclusions.
    11. Participate in working groups to produce guidelines and 
training manuals in collaboration with the Ugandan Ministry of Health 
(MOH) and other public and private stakeholders relating to full-access 
confidential HB-CT.
    12. Undertake the above activities in a manner consistent with the 
Ugandan national HIV/AIDS strategy and the five-year strategy and 
performance goals of the President's Emergency Plan for AIDS Relief.
    13. Provide information on HIV prevention methods (or strategies) 
including abstinence, faithfulness and, for populations engaged in 
high-risk behaviors, correct and consistent condom use.
    Awardee activities for covering all program areas are as follows:
    1. Work to link activities described here with related HIV care and 
other social services in the area, and promote coordination at all 
levels, including through bodies such as village, district, regional 
and national HIV coordination committees and networks of faith-based 
organizations.
    2. Participate in relevant national technical coordination 
committees and in national process(es) to define, implement and monitor 
simplified small grants program(s) for faith- and community-based 
organizations, to ensure local stakeholders receive adequate 
information and assistance to engage and access effectively funding 
opportunities supported by the President's Emergency Plan and other 
donors.
    3. Progressively reinforce the capacity of faith- and community-
based organizations and village and district AIDS committees to promote 
quality, local ownership, accountability and sustainability of 
activities.
    4. Develop and implement a project-specific participatory 
monitoring and evaluation plan by drawing on national and U.S. 
Government requirements and tools, including the strategic information 
guidance provided by the Office of the U.S. Global AIDS Coordinator.

Administration

    Comply with all HHS management requirements for meeting 
participation and progress and financial reporting for this cooperative 
agreement. (See HHS Activities and Reporting sections below for 
details.) Comply with all policy directives established by the Office 
of the U.S. Global AIDS Coordinator.
    In a cooperative agreement, HHS staff is substantially involved in 
the program activities, above and beyond routine grant monitoring.
    HHS Activities for this program are as follows:
    1. Organize an orientation meeting with the grantee to brief them 
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 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. Meet on a monthly basis with grantee to assess monthly 
expenditures in relation to approved work plan and modify plans as 
necessary.
    5. Meet on a quarterly basis with grantee to assess quarterly 
technical and financial progress reports and modify plans as necessary.
    6. Meet on an annual basis with 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.
    7. Provide technical assistance in the development of training 
curricula, materials, and diagnostic therapeutic guidelines.
    8. Collaborate with the recipient in the development of an 
appropriate information technology system for medical record-keeping 
and an effective monitoring and evaluation and data-collection system 
for semi-annual and annual Emergency Plan reporting requirements, 
consistent with the strategic information guidance established by the 
Office of the U.S. Global AIDS Coordinator.
    9. Review and approve awardee's monitoring and evaluation plan and 
the development of further appropriate initiatives, including for 
compliance with the strategic information guidance established by the 
Office of the U.S. Global AIDS Coordinator.
    10. Assist in appropriate analysis and interpretation of data 
collected during training sessions.
    11. Provide input into the overall program strategy.
    12. Collaborate with the recipient in the selection of key 
personnel to be involved in the activities to be performed under this 
agreement including approval of the overall manager of the program.
    13. Provide in-country administrative support to help grantee meet 
U.S. Government financial and reporting requirements.


    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.


[[Page 43875]]


    Measurable outcomes of the program will be in alignment with the 
following performance goals for the Emergency Plan:

A. Prevention

    Number of individuals trained to provide HIV prevention 
interventions, including abstinence, faithfulness and, for populations 
engaged in high-risk behaviors,\1\ correct and consistent condom use.
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    \1\ Behaviors that increase risk for HIV transmission including 
engaging in casual sexual encounters, engaging in sex in exchange 
for money or favors, having sex with an HIV-positive partner or one 
who status is unknown, using drugs or abusing alcohol in the context 
of sexual interactions, and using intravenous drugs. Women, even if 
faithful themselves, can still be at risk of becoming infected by 
their spouse, regular male partner, or someone using force against 
them. Other high-risk persons or groups include men who have sex 
with men and workers who are employed away from home.
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    1. Abstinence (A) and Be Faithful (B)
     Number of community outreach and/or mass media (radio) 
programs that are A/B focused
     Number of individuals reached through community outreach 
and/or mass media (radio) programs that are A/B focused.

B. Care and Support

    1. Confidential counseling and testing
     Number of patients who accept confidential counseling and 
testing in a health-care setting.
     Number of clients served, direct.
     Number of people trained in confidential counseling and 
testing, direct, including health-care workers.
    2. Orphans and Vulnerable Children (OVC)
    Number of service outlets/programs, direct and/or indirect.
     Number of clients (OVC) served, direct and/or indirect.
     Number of persons trained to serve OVC, direct.
    3. Palliative Care: Basic Health Care and Support
     Number of service outlets/programs that provide palliative 
care, direct and/or indirect.
     Number of service outlets/programs that link HIV care with 
malaria and tuberculosis care and/or referral, direct and/or indirect.
     Number of clients served with palliative care, direct and/
or indirect.
     Number of persons trained in providing palliative care, 
direct.

C. HIV Treatment With ART

     Number of clients enrolled in ART, direct and indirect.
     Number of persons trained in providing ART, direct.

D. Strategic Information

     Number of persons trained in strategic information, 
direct.

E. Expanded Indigenous Sustainable Response

     Project-specific quantifiable milestones to measure:
    a. Indigenous capacity-building.
    b. Progress toward sustainability.

II. Award Information

    Type of Award: Cooperative Agreement.
    HHS involvement in this program is listed in the Activities Section 
above.
    Fiscal Year Funds: 2005.
    Approximate Total Funding: $1,290,000 (This amount is an estimate, 
and is subject to availability of funds.).
    Approximate Number of Awards: One.
    Approximate Average Award: $645,000 (This amount is for the first 
12-month budget period, and includes direct costs.).
    Floor of Award Range: None.
    Ceiling of Award Range: $645,000.
    Anticipated Award Date: August 31, 2005.
    Budget Period Length: 12 months.
    Project Period Length: Two years.
    Throughout the project period, HHS' 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

III.1. Eligible Applicants

    The applicants for this program are limited to the following:
    1. Ugandan MOH District Directorates of Health Services (DDHS) that 
are able to demonstrate existing partnerships with faith-based and 
community-based organizations.
    2. Ugandan MOH District hospitals or Regional hospitals that 
partner with DDHS and have existing community-level networks/programs.
    3. Private, not-for-profit hospitals in Uganda (including those 
managed or operated by faith-based institutions) with delegated 
responsibility of district hospital that partner with DDHS and CBOS.
    Justification for limited competition:
     DDHS in Uganda are responsible for planning, management, 
and coordination of all health activities in each district. They also 
have a role in supporting supervision in health sub-districts and, 
through them, to lower-level health units. In this role, they are fully 
capable of planning the implementation of a full-access confidential 
HIV HB-CT program by working through the district health system and 
faith-based and community-based groups.
     All public health units are engaged in the delivery of the 
Uganda National Minimum Health Care Package \2\ and collaborate with 
the community through integrated outreach services and community 
volunteers for health known as ``Community-Owned Resource Persons 
(CORPS).'' This is an excellent structure under which to pilot a full-
access confidential HB-CT Program.
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    \2\ This refers to Essential Health Care Package of 
interventions and services which is recommended for different levels 
of health units in Uganda including control of communicable diseases 
like STD/HIV/AIDS, Malaria, TB, IMCI, Reproductive health, 
Immunization, Environmental Health, Health education, School Health, 
Epidemics & Disaster preparedness, Nutrition, Mental Health and 
essential Clinical care.
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     Linking confidential HIV HB-CT to hospitals and other 
health facilities will provide clients who test positive for HIV with 
direct referrals to basic care and palliative care services, as well as 
to ART, where available.
     The involvement of DDHS will strengthen collaboration, 
advocacy and networking for all district HIV/AIDS programs.
     The Ugandan MOH is responsible for the development of 
policies and provision of technical assistance in the implementation of 
confidential HIV-HB-CT. The involvement of the MOH will facilitate the 
development of appropriate policies and guidelines for the replication 
of such programs in other districts, with advice and technical 
assistance from U.S. Government agencies that implement the President's 
Emergency Plan.
     Currently, VCT sites and services in Uganda are located in 
higher-level facilities only, the majority of which are located more 
than five kilometers away from where over 60 percent of the Ugandan 
population lives. Therefore, allowing districts to take a lead in the 
implementation of a confidential HIV CT program will bring confidential 
HIV CT nearer to the people in rural settings. Additionally, community-
based and faith-based organizations are already providing most of the 
health care and basic social services at the community level, which 
makes them ideal partners to the DDHS and hospitals for successful 
implementation of this program.

[[Page 43876]]

     Using this approach in a district will complement the 
first full-access confidential HB-CT project currently implemented 
through a local non-governmental organization (PA 04228, cooperative 
agreement U62/CCU024535). The project undertaken under this 
announcement will not duplicate or replace the project just mentioned.

III.2. Cost Sharing or Matching

    Matching funds are not required for this program. Although matching 
funds are not required, preference will go to organizations that can 
leverage additional funds to contribute to program goals.

III.3. Other

    If applicants request a funding amount greater than the ceiling of 
the award range, HHS/CDC will consider the application non-responsive, 
and it will not enter into the review process. We will notify you that 
your application did not meet the submission requirements.
Special Requirements
    If your application is incomplete or non-responsive to the special 
requirements listed in this section, it will not be entered into the 
review process. We will notify you that your application did not meet 
submission requirements.
     HHS/CDC will consider late applications to be considered 
non-responsive. See section ``IV.3. Submission Dates and Times'' for 
more information on deadlines.

IV. Application and Submission Information

IV.1. Address to Request Application Package

    To apply for this funding opportunity use application form PHS 
5161-1.
    HHS strongly encourages the applicant to submit your application 
electronically by using the forms and instructions posted for this 
announcement at https://www.grants.gov.
    Application forms and instructions are available on the HHS/CDC Web 
site, at the following Internet address: https://www.cdc.gov/od/pgo/
forminfo.htm.
    If you do not have access to the Internet, or if you have 
difficulty accessing the forms on-line, you may contact the HHS/CDC 
Procurement and Grants Office Technical Information Management Section 
(PGO-TIM) staff at: 770-488-2700. We can mail application forms to you.

IV.2. Content and Form of Submission

    Application: You must submit a project narrative with your 
application forms. You must submit the narrative in the following 
format:
     Maximum number of pages: 25. If your narrative exceeds the 
page limit, we will only review the first pages within the page limit.
     Font size: 12 point unreduced
     Double spaced
     Page margin size: One inch
     Printed only on one side of page
     Held together only by rubber bands or metal clips; not 
bound in any other way.
     Pages should be numbered and a complete index to the 
application and any appendices must be included.
     Your application MUST be submitted in English.
    Your narrative should address activities to be conducted over the 
entire project period, and must include the following items in the 
order listed:
     Project Context and Background (Understanding and Need)
     Project Strategy--Description and Methodologies
     Project Goals
     Project Outputs
     Project Contribution to the Goals and Objectives of the 
Emergency Plan for AIDS Relief
     Work Plan and Description of Project Components and 
Activities
     Performance Measures
     Timeline (e.g., GANNT Chart)
     Management of Project Funds and Reporting.
    You may include additional information in the application 
appendices. The appendices will not count toward the narrative page 
limit. This additional information includes the following:
     Project Budget and Justification
     Curriculum vitae of current staff who will work on the 
activity
     Job descriptions of proposed key positions to be created 
for the activity
     Quality-Assurance, Monitoring-and-Evaluation, and 
Strategic-Information Forms
     Applicant's Corporate Capability Statement
     Letters of Support
     Evidence of Legal Organizational Structure
    The budget justification will not count in the narrative page 
limit.
    Although the narrative addresses activities for the entire project, 
the applicant should provide a detailed budget only for the first year 
of activities, while addressing budgetary plans for subsequent years.
    You 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, access 
https://www.dunandbradstreet.com or call 1-866-705-5711.
    For more information, see the HHS/CDC Web site at: https://
www.cdc.gov/od/pgo/funding/pubcommt.htm. If your application form does 
not have a DUNS number field, please write your DUNS number at the top 
of the first page of your application, and/or include your DUNS number 
in your application cover letter.
    Additional requirements that could require you to submit additional 
documentation with your application are listed in section 
``Administrative and National Policy Requirements.''

IV.3. Submission Dates and Times

    Application Deadline Date: August 22, 2005.
    Explanation of Deadlines: Applications must be received in the CDC 
Procurement and Grants Office by 4 p.m. eastern time on the deadline 
date.
    You may submit your application electronically at https://
www.grants.gov. We consider applications completed on-line through 
Grants.gov as formally submitted when the applicant organization's 
Authorizing Official electronically submits the application to https://
www.grants.gov. We will consider electronic applications as having met 
the deadline if the application organization's Authorizing Official has 
submitted the application electronically to Grants.gov on or before the 
deadline date and time.
    If you submit your application electronically through Grants.gov 
(https://www.grants.gov), your application will be electronically time/
date stamped, which will serve as receipt of submission. You will 
receive an e-mail notice of receipt when HHS/CDC receives the 
application.
    If you submit your application by the United States Postal Service 
or commercial delivery service, you must ensure the carrier will be 
able to guarantee delivery by the closing date and time. If HHS/CDC 
receives your submission after closing because: (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, you will have the opportunity to submit documentation of the 
carriers guarantee. If the documentation verifies

[[Page 43877]]

a carrier problem, HHS/CDC will consider the submission as received by 
the deadline.
    If you submit a hard copy application, HHS/CDC will not notify you 
upon receipt of your submission. If you have a question about the 
receipt of your application, first contact your courier. If you still 
have a question, contact the PGO-TIM staff at: 770-488-2700. Before 
calling, please wait two to three days after the submission deadline. 
This will allow time for us 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 your submission does not meet the deadline above, it will not be 
eligible for review, and we will discard it. We will notify you that 
you did not meet the submission requirements.

IV.4. Intergovernmental Review of Applications

    Executive Order 12372 does not apply to this program.

IV.5. Funding Restrictions

    Awardee may use funds for the following:
     Confidential HIV CT within the program District, including 
required training, purchase of test kits, simple laboratory 
refurbishment, vehicles and logistical support to testing teams, 
staffing and other related commodities and expenses. Awardee must 
perform all procurement in a competitive and transparent manner.
     Evaluation and management of the project activities.
    Restrictions, which you must take into account while writing your 
budget, are as follows:
     Funds may not be used for research.
     Awards will not allow reimbursement of pre-award costs.
     You may not use funds for any new construction.
     Anti-retroviral drugs (ARVs)--purchase of ARVs, reagents, 
and laboratory equipment for antiretroviral treatment projects require 
pre-approval from HHS/CDC officials.
     Needle exchange--No funds appropriated under this 
solicitation shall be used to carry out any program of distributing 
sterile needles or syringes for the hypodermic injection of any illegal 
drug.
     Funds may be spent for reasonable program purposes, 
including personnel, travel, supplies, and services. Equipment may be 
purchased if deemed necessary to accomplish program objectives; 
however, you must request prior approval by HHS/CDC officials in 
writing, and you must perform all procurement in a competitive and 
transparent manner.
     All requests for funds contained in the budget in U.S. 
dollars. Once an award is made, HHS/CDC will not compensate foreign 
grantees for currency exchange fluctuations through the issuance of 
supplemental awards.
     The costs that are 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, Indirect Costs will not be paid (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.
     The applicant may contract with other organizations under 
this program; however the applicant must perform a substantial portion 
of the activities (including program management and operations, and 
delivery of prevention services for which funds are requested).
     You must obtain an annual audit 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 Standard(s) 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 capabilities regarding the handling of U.S. Federal funds.
     Prostitution and Related Activities
    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 
to any United Nations agency).
    The following definition applies for purposes of this clause:
     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.

[[Page 43878]]

    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.''
    You may find guidance for completing your budget on the HHS/CDC Web 
site, at the following Internet address: https://www.cdc.gov/od/pgo/
funding/budgetguide.htm.

IV.6. Other Submission Requirements

    Application Submission Address:
    HHS/CDC strongly encourages you to submit electronically at: http:/
/www.grants.gov. You will be able to download a copy of the application 
package from https://www.grants.gov, complete it offline, and then 
upload and submit the application via the Grants.gov site. We will not 
accept e-mail submissions. If you are having technical difficulties in 
Grants.gov, you may reach them by e-mail at https://
www.support@grants.gov">www.support@grants.gov, or by phone at 1-800-518-4726 (1-800-GRANTS). 
The Customer Support Center is open from 7 a.m. to 9 p.m. eastern time, 
Monday through Friday.
    HHS/CDC recommends that you submit your application to Grants.gov 
early enough to resolve any unanticipated difficulties prior to the 
deadline. You may also submit a back-up paper submission of your 
application. We must receive any such paper submission in accordance 
with the requirements for timely submission detailed in Section IV.3. 
of the grant announcement.
    You must clearly mark the paper submission: ``BACK-UP FOR 
ELECTRONIC SUBMISSION.''
    The paper submission must conform to all requirements for non-
electronic submissions. If we receive both electronic and back-up paper 
submissions by the deadline, we will consider the electronic version 
the official submission.
    We strongly recommended that you submit your grant application by 
using Microsoft Office products (e.g., Microsoft Word, Microsoft Excel, 
etc.). If you do not have access to Microsoft Office products, you may 
submit a PDF file. You may find directions for creating PDF files on 
the Grants.gov Web site. Use of files other than Microsoft Office or 
PDF could make your file unreadable for our staff.
    OR
    Submit the original and two hard copies of your application by mail 
or express delivery service to the following address: Technical 
Information Management-AA009, CDC Procurement and Grants Office, U.S. 
Department of Health and Human Services, 2920 Brandywine Road, Atlanta, 
GA 30341.

V. Application Review Information

V.1. Criteria

    Applicants must provide 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 these measures of 
effectiveness with the application, and they will be an element of 
evaluation.
    We will evaluate your application against the following criteria:
    1. Understanding the issues, principles and systems requirements 
involved in delivering community and home-based confidential CT which 
provides access to the whole population of a district in the context of 
Uganda (25 points)
    Does the applicant display knowledge of the five-year strategy and 
goals of the President's Emergency Plan, such that it can build on 
these to develop a comprehensive, collaborative project to reach 
underserved populations? Does the applicant demonstrate an 
understanding of the ethical, clinical, social, managerial and other 
practical issues involved in delivering comprehensive, confidential CT 
in a cost-effective and sensitive manner in the setting of a Ugandan 
district?
    2. Ability to carry out the proposal (25 points)
    Does the applicant demonstrate the capability to achieve the 
purpose of this proposal?
    3. Work Plan (25 points)
    Is the plan appropriate to the social, political and cultural 
context in Uganda? Does the applicant describe activities which are 
realistic, achievable, time-framed and culturally appropriate to 
complete this program in Uganda? Does the applicant describe strategies 
that are pertinent and match those identified in the five-year strategy 
of the President's Emergency Plan and the national HIV/AIDS strategy of 
the Government of the Republic of Uganda?
    4. Personnel (15 points)
    Are the personnel, including qualifications, training, 
availability, and experience adequate to carry out the proposed 
activities?
    5. Management and Accounting Plan (10 points)
    Is there a plan to manage the resources of the program, prepare 
reports, monitor and evaluate activities and audit expenditures? Is the 
plan to account for, prepare reports, monitoring and audit expenditures 
under this agreement adequate to manage the resources of the program 
and to produce, collect and analyze performance data?
    6. Budget (not scored)
    Is the budget for conducting the activity itemized, well-justified 
and consistent with the five-year strategy and goals of the President's 
Emergency Plan activities in Uganda, and the national HIV/AIDS strategy 
of the Government of the Republic of Uganda?

V.2. Review and Selection Process

    The HHS/CDC Procurement and Grants Office (PGO) staff will review 
applications for completeness, and 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. The panel may include both 
Federal and non-Federal participants.
    In addition, the following factors could affect the funding 
decision:
    It is possible for one organization to apply as lead grantee with a 
plan that includes partnering with other organizations, preferably 
local. Although matching funds are not required, preference will be go 
to organizations that can leverage additional funds to contribute to 
program goals.
    Applications will be funded in order by score and rank determined 
by the review panel. HHS/CDC will provide justification for any 
decision to fund out of rank order.

V.3. Anticipated Announcement and Award Dates

    The anticipated award date is August 31. 2005.

[[Page 43879]]

VI. Award Administration Information

VI.1. Award Notices

    Successful applicants will receive a Notice of Award (NoA) from the 
CDC Procurement and Grants Office. The NoA shall be the only binding, 
authorizing document between the recipient and CDC. The NoA will be 
signed by an authorized Grants Management Officer, and mailed to the 
recipient fiscal officer identified in the application.
    Unsuccessful applicants will receive notification of the results of 
the application review by mail.

VI.2. Administrative and National Policy Requirements

45 CFR Part 74 and Part 92
    For more information on the Code of Federal Regulations, see the 
National Archives and Records Administration at the following Internet 
address: https://www.access.gpo.gov/nara/cfr/cfr-table-search.html.
    The following additional requirements apply to this project:
     AR-4 HIV/AIDS Confidentiality Provisions
     AR-6 Patient Care
     AR-8 Public Health System Reporting Requirements
     AR-10 Smoke-Free Workplace Requirements
     AR-11 Healthy People 2010
     AR-12 Lobbying Restrictions
     AR-14 Accounting System Requirements
    Applicants can find additional information on these requirements on 
the HHS/CDC Web site at the following Internet address: https://
www.cdc.gov/od/pgo/funding/ARs.htm.
    You need to include an additional Certifications form from the 
PHS5161-1 application needs to be included in the Grants.gov electronic 
submission only. Please refer to https://www.cdc.gov/od/pgo/funding/
PHS5161-1-Certificates.pdf. Once you have filled out the form, it 
should be attached to the Grants.gov submission as Other Attachments 
Form.

VI.3. Reporting Requirements

    You must provide HHS/CDC with an original, plus two hard copies of 
the following reports:
    1. Semi-annual progress reports not more than 30 days after the end 
of the reporting period.
    2. Interim progress report, due no less than 90 days before the end 
of the budget period. The progress report will serve as your non-
competing continuation application, and must contain the following 
elements:
    a. Current Budget Period Activities Objectives.
    b. Current Budget Period Financial Progress.
    c. New Budget Period Program Proposed Activity Objectives.
    d. Budget.
    e. Measures of Effectiveness, including progress against the 
numerical goals of the President's Emergency Plan for AIDS Relief for 
Uganda.
    3. Financial status report, no more than 90 days after the end of 
the budget period.
    4. Final financial and performance reports, no more than 90 days 
after the end of the project period.
    Recipients must mail these reports to the Grants Management or 
Contract Specialist listed in the ``Agency Contacts'' section of this 
announcement.

VII. Agency Contacts

    We encourage inquiries concerning this announcement.
    For general questions, contact: Technical Information Management 
Section, CDC Procurement and Grants Office, U.S. Department of Health 
and Human Services, 2920 Brandywine Road, Atlanta, GA 30341, Telephone: 
770-488-2700.
    For program technical assistance, contact: Jonathan Mermin, MD, 
MPH, Global AIDS Program [GAP], Uganda Country Team, National Center 
for HIV, STD and TB Prevention, Centers for Disease Control and 
Prevention [CDC], HHS, PO Box 49, Entebbe, Uganda, Telephone: +256-
41320776, E-mail: jhm@cdc.gov.
    For financial, grants management, or budget assistance, contact: 
Shirley Wynn, Contract Specialist, CDC Procurement and Grants Office, 
U.S. Department of Health and Human Services, 2920 Brandywine Road, 
Atlanta, GA 30341-4146, Telephone: 770-488-1515, E-mail: zbx6@cdc.gov.

VIII. Other Information

    Applicants can find this and other HHS funding opportunity 
announcements on the HHS/CDC Web site, Internet address: https://
www.cdc.gov (Click on ``Funding'' then ``Grants and Cooperative 
Agreements''), and on the Web site of the HHS Office of Global Health 
Affairs, Internet address: https://www.globalhealth.gov.

    Dated: July 25, 2005.
William P. Nichols,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention, U.S. Department of Health and Human Services.
[FR Doc. 05-15003 Filed 7-28-05; 8:45 am]
BILLING CODE 4163-18-P