Sustaining HIV Epidemic Control through Efficient Case Finding and Quality Care and Treatment Services in Malawi under the President’s Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH22 2254

Opportunity Information: Apply for CDC RFA GH22 2254

This funding opportunity, titled "Sustaining HIV Epidemic Control through Efficient Case Finding and Quality Care and Treatment Services in Malawi under PEPFAR," is a CDC-led cooperative agreement (Funding Opportunity Number CDC RFA GH22-2254) under CFDA 93.067. It is designed to support direct HIV service delivery in CDC-supported districts in Malawi with the goal of closing remaining treatment gaps and maintaining HIV epidemic control, consistent with the strategic direction and targets laid out in the PEPFAR Country Operational Plan. The emphasis is on practical, on-the-ground program implementation that improves how quickly people are identified, started on treatment, and kept in care, while also strengthening service quality and long-term sustainability within district health systems.

Funding is structured in a way that signals flexibility rather than a fixed per-award cap. The notice lists an award ceiling for Year 1 as "0 (none)," meaning there is no stated maximum award size for the first year. At the same time, CDC indicates an anticipated total funding amount of about $20,000,000 for Year 1, contingent on available funds. CDC expected to make up to three awards. The opportunity was categorized as discretionary funding and uses a cooperative agreement instrument, which typically means CDC plans to remain substantially involved in program guidance, monitoring, and technical direction rather than simply providing funds with minimal ongoing engagement.

Programmatically, the core purpose is to improve access to and uptake of HIV prevention, testing, care, and treatment services across the full HIV care continuum, with a strong focus on retention and treatment outcomes. The approach is explicitly client-centered and efficiency-oriented, recognizing that reaching and sustaining epidemic control requires more than simply increasing the number of people tested or started on antiretroviral therapy. Recipients are expected to tailor interventions to specific sites and populations, using methods that account for local service delivery realities and the distinct barriers faced by different groups. A major theme is prioritizing patients who are at higher risk of dropping out of care or experiencing poor clinical outcomes, then providing targeted support to keep them stable and virally suppressed.

To do this, the CDC describes several preferred implementation strategies. These include differentiated service delivery models that adjust how and where services are provided based on client stability and need (for example, less frequent clinic visits for stable patients and more intensive follow-up for those at risk). The opportunity also highlights case management approaches and risk stratification tools, which are used to identify individuals more likely to have sub-optimal treatment outcomes so programs can focus resources where they will have the greatest impact. In addition, recipients are expected to implement innovative service delivery models to optimize antiretroviral treatment and retention, including expanding access to more advanced HIV services, decongesting high-volume clinics to reduce waiting times and improve patient experience, and raising the overall quality of clinical services.

Another central expectation is strong use of routine data at the site level. The funding description underscores that ongoing data collection and analysis should not be treated as a reporting exercise alone, but as a management tool to guide continuous improvement. Recipients are expected to use site-level data to detect performance issues early, identify barriers to care (such as missed appointments, gaps in viral load monitoring, or service bottlenecks), and adjust program activities accordingly. This focus aligns with the broader PEPFAR emphasis on data-driven targeting and accountability for results, particularly around retention and viral suppression.

Sustainability is also built into the design of the award. Recipients are expected to support a gradual transition of direct service delivery responsibilities to local district health systems. In practical terms, this implies strengthening district-level capacity, aligning implementation with government systems and standards, and planning for continuity beyond external support. Rather than creating parallel structures, the intent is to leave behind stronger routine services that districts can manage over time.

Finally, the opportunity acknowledges operational realities under COVID-19 and requires additional site-level support to maintain safe and uninterrupted service delivery. This includes ensuring infection prevention and control measures, as well as screening, testing, and treatment support for clients as needed. The inclusion of COVID-related support reflects an expectation that HIV programs must be resilient during public health disruptions, protecting both patients and health workers while preserving continuity of HIV testing, treatment initiation, medication access, and follow-up.

Key administrative details include an open eligibility statement (unrestricted, meaning any entity type may apply unless further limited in additional eligibility text), a posting date of December 27, 2021, and an original application deadline of February 25, 2022, with electronic submissions due by 11:59 pm Eastern Time. The awarding agency is the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Center for Global Health.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Sustaining HIV Epidemic Control through Efficient Case Finding and Quality Care and Treatment Services in Malawi 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 Dec 27, 2021.
• Applicants must submit their applications by Feb 25, 2022 Electronically submitted applications must be submitted no later than 1159 pm ET on the listed application due date.. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• The number of recipients for this funding is limited to 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.

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