Supporting the provision of person-centered, equitable, high-quality, and integrated service delivery towards a sustainable and resilient HIV/TB response in the Kingdom of Eswatini under PEPFAR

The funding opportunity titled Supporting the Provision of Person-Centered, Equitable, High-Quality, and Integrated Service Delivery Towards a Sustainable and Resilient HIV and TB Response in the Kingdom of Eswatini aims to strengthen HIV and tuberculosis prevention, care, and treatment services. Under PEPFAR, this program targets facilities and surrounding communities to ensure a transition from an emergency response model to a sustainable, locally led approach over a five-year performance period. The United States Centers for Disease Control and Prevention expects the program to address service delivery gaps, enhance health systems, and improve the quality of life for individuals at risk of or affected by HIV and tuberculosis. The program will focus on delivering person-centered and integrated health services at selected facilities and community service points. Strategies include scaling up differentiated HIV testing methods to close gaps in case finding, improving linkage to care, and ensuring continuity of HIV and tuberculosis treatment. Comprehensive prevention services will include voluntary medical male circumcision, pre-exposure prophylaxis, post-exposure prophylaxis, screening and treatment for sexually transmitted infections, and gender-based violence prevention and response. Efforts will also address co-morbidities, such as advanced HIV disease, non-communicable diseases, and cervical cancer. To support uninterrupted service delivery, logistical and technical assistance will be provided in areas such as laboratory systems, commodity management, and data management. Activities include strengthening bi-directional referrals, supporting facility and regional staff planning, and implementing risk mitigation strategies to address disruptions in laboratory services and commodity stockouts. Collaborations with local health institutions, community-based organizations, and groups of people living with HIV will enhance service quality and improve patient satisfaction. Community engagement activities will focus on increasing awareness, reducing stigma, and designing approaches to meet the needs of key and vulnerable populations. The total expected funding for the first year is four million dollars, with the possibility of one to three cooperative agreements being awarded. Eligible applicants include domestic and foreign entities, such as government institutions, nonprofit organizations, educational institutions, and small businesses. Applicants must propose projects that align with the program's objectives and demonstrate capacity to deliver integrated services across priority regions, particularly Manzini and Lubombo. Proposals must include a clear work plan, detailed budget narrative, and performance measurement strategy that outlines key indicators, outcomes, and evaluation activities. Applications will be evaluated based on approach, organizational capacity, and data monitoring and evaluation plans. The merit review will assess the extent to which proposals demonstrate evidence-based strategies, risk mitigation measures, and collaborative approaches to service delivery. Additional points will be awarded to applicants meeting the PEPFAR local partner definition, which prioritizes organizations with majority local ownership, staffing, and governance. Proposals that address gaps in service delivery, ensure community engagement, and promote sustainability will be prioritized for funding. Applications are due by March 5, 2025, at 11:59 PM Eastern Time and must be submitted through Grants.gov. The period of performance begins on September 30, 2025, and runs for up to five years, contingent on annual funding availability and satisfactory progress. Post-award reporting requirements include regular performance updates, financial reports, and adherence to CDC and PEPFAR monitoring and evaluation guidelines. Successful applicants will work in close collaboration with Eswatini’s Ministry of Health and other stakeholders to achieve program outcomes, with the overarching goal of reducing HIV and tuberculosis incidence and mortality while strengthening health systems for long-term sustainability.