Opportunity Information: Apply for CDC RFA GH18 1824
This funding opportunity, issued by the U.S. Centers for Disease Control and Prevention (CDC) under PEPFAR, focuses on expanding and strengthening Zambia's HIV laboratory services so the country can make faster progress toward the UNAIDS 90-90-90 targets. In practical terms, the grant is designed to improve the full laboratory pathway that supports HIV diagnosis and treatment monitoring, with a major emphasis on scaling up viral load (VL) testing. VL testing is central to determining whether people on antiretroviral therapy are achieving viral suppression, which is the "third 90" and a key indicator of treatment success and reduced transmission risk.
A central theme of the opportunity is fixing bottlenecks across all phases of the viral load testing cascade: pre-analytical, analytical, and post-analytical. Pre-analytical improvements include strengthening demand creation (so providers and patients understand when VL testing is needed and request it), making specimen collection and processing more consistent, and ensuring samples are handled, stored, and prepared correctly. The grant also targets weaknesses in sample referral systems, which often determine whether specimens collected in remote sites actually reach testing laboratories quickly and in usable condition. This includes upgrading transportation and logistics so samples move reliably from clinics to laboratories and so results can move back to the point of care without unnecessary delays.
On the analytical side, the opportunity emphasizes increasing and optimizing testing capacity. That includes addressing procurement challenges for reagents, consumables, and equipment, ensuring laboratories have the right ancillary equipment to operate efficiently, and helping labs run at full functional capacity. The recipient is expected to support the establishment and operation of fully functional HIV laboratories, which implies not only equipment and infrastructure needs but also the staffing required to run services at scale. The language of the announcement makes clear that qualified staff are part of the expected deliverables, along with support for implementing a quality management system (QMS) so that test results are accurate, reliable, and produced consistently across sites.
Post-analytical improvements are another major focus, because testing alone does not improve health outcomes unless results reach clinicians and are acted upon. The opportunity specifically calls out strengthening the return and uptake of results, meaning results should be delivered to the right facility and used in clinical decision-making, such as identifying treatment failure, initiating enhanced adherence counseling, or switching regimens when appropriate. Monitoring and evaluation of the viral load cascade is also highlighted, with the intent of using data to find where breakdowns occur (for example, samples collected but not received, tests run but results not returned, or results returned but not used) and to drive ongoing quality improvement.
Although viral load scale-up is the headline priority, the same investments are intended to build capacity for early infant diagnosis (EID) for children born to mothers living with HIV. EID requires timely, high-quality testing systems because early identification of HIV in infants is critical for immediate treatment initiation and survival. The opportunity also notes broader support for other HIV-related laboratory services, indicating that the work should strengthen the overall laboratory network and not create a narrow, single-test system.
At the national and system level, the grant aims to support universal availability of HIV-related laboratory tests and strengthen national quality oversight of HIV testing. That suggests coordination with national laboratory leadership, standard-setting, proficiency testing, accreditation or stepwise quality improvement approaches, and harmonized protocols across the network. Increasing awareness of VL and EID testing is also explicitly included, which ties back to ensuring maximum coverage: people eligible for VL monitoring and infants needing EID should actually be reached by the system, not just theoretically covered by policy.
Administratively, this opportunity is a discretionary cooperative agreement (meaning CDC anticipates substantial involvement during implementation rather than a hands-off grant). It was released under Funding Opportunity Number CDC RFA GH18 1824 within CFDA 93.067, with unrestricted eligibility, an anticipated single award, and an award ceiling of $5,000,000. The original closing date listed is October 16, 2017, and the issuing office is CDC's Center for Global Health (CGH). Overall, the grant is structured to help Zambia build a more reliable, higher-quality, and higher-throughput laboratory and sample transport system so that viral load monitoring and early infant diagnosis are accessible, timely, and clinically useful, directly supporting the 90-90-90 goals.Apply for CDC RFA GH18 1824
- The Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Scaling Up Laboratory Services to Provide High Quality HIV Diagnosis, Care, Treatment, and Monitoring towards the Achievement of the 90-90-90 Goals in Zambia 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 2017-08-16.
- Applicants must submit their applications by 2017-10-16. (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 $5,000,000.00 in funding.
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: Unrestricted.
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Frequently Asked Questions (FAQs)
What is this funding opportunity trying to achieve?
This CDC funding opportunity under PEPFAR is focused on expanding and strengthening HIV laboratory services in Zambia so the country can move faster toward the UNAIDS 90-90-90 targets. The practical goal is to improve the full laboratory pathway that supports HIV diagnosis and treatment monitoring, with a major emphasis on scaling up viral load (VL) testing.
Which organization is issuing the opportunity?
The opportunity is issued by the U.S. Centers for Disease Control and Prevention (CDC), through its Center for Global Health (CGH), under PEPFAR.
What type of award is this?
This is a discretionary cooperative agreement. That means CDC expects to have substantial involvement during implementation, rather than operating as a hands-off funder.
What is the Funding Opportunity Number (FOA number)?
The Funding Opportunity Number listed is CDC RFA GH18 1824.
What CFDA number is associated with this opportunity?
The CFDA number provided is 93.067.
Who is eligible to apply?
Eligibility is described as unrestricted in the opportunity summary.
How many awards does CDC anticipate making?
The opportunity anticipates a single award.
What is the maximum award amount?
The award ceiling listed is $5,000,000.
What was the original closing date for applications?
The original closing date listed is October 16, 2017.
What country is the work intended to support?
The work described is intended to support Zambia, specifically by strengthening the national HIV laboratory network and related systems.
How does this opportunity relate to the UNAIDS 90-90-90 targets?
The grant is structured to strengthen HIV laboratory services in ways that support faster progress toward 90-90-90, with particular emphasis on viral load testing that underpins the "third 90" (viral suppression among people on treatment).
Why is viral load (VL) testing such a central focus?
Viral load testing is central to confirming whether people on antiretroviral therapy are achieving viral suppression. Viral suppression is a key indicator of treatment success and reduced transmission risk, and it is the core measure for the third 90 target.
What parts of the viral load testing process does the opportunity aim to strengthen?
The opportunity targets bottlenecks across all phases of the viral load testing cascade: pre-analytical, analytical, and post-analytical.
What does "pre-analytical" strengthening include?
Pre-analytical improvements include strengthening demand creation (so providers and patients understand when VL testing is needed and request it), making specimen collection and processing more consistent, and ensuring samples are handled, stored, and prepared correctly before testing.
Does the opportunity address specimen transport and referral systems?
Yes. A stated focus is improving sample referral systems so specimens from remote sites reliably reach testing laboratories quickly and in usable condition. This includes upgrades to transportation and logistics and improving the flow of results back to the point of care without unnecessary delays.
What does "analytical" strengthening include?
On the analytical side, the opportunity emphasizes increasing and optimizing testing capacity. This includes addressing procurement challenges for reagents, consumables, and equipment; ensuring laboratories have necessary ancillary equipment; and helping labs run at full functional capacity.
Is establishing or operating laboratories part of what the recipient is expected to support?
Yes. The recipient is expected to support the establishment and operation of fully functional HIV laboratories. The description implies attention to equipment and infrastructure as well as the staffing required to run services at scale.
Does the opportunity include expectations related to staffing?
Yes. The announcement language indicates that qualified staff are part of the expected deliverables needed to operate services at scale.
What is the role of a quality management system (QMS) in this grant?
The recipient is expected to support implementation of a quality management system so test results are accurate, reliable, and produced consistently across sites.
What does "post-analytical" strengthening include?
Post-analytical improvements focus on strengthening the return and uptake of results. The opportunity highlights that results should get back to the right facility and be used in clinical decision-making, since testing only improves health outcomes when results are acted upon.
What does "uptake of results" mean in practical clinical terms?
In the opportunity description, uptake refers to using VL results to guide care, such as identifying possible treatment failure, initiating enhanced adherence counseling, or switching regimens when appropriate.
How does monitoring and evaluation (M&E) fit into the work?
Monitoring and evaluation of the viral load cascade is highlighted as a key element. The intent is to use data to identify where breakdowns occur (for example, samples collected but not received, tests run but results not returned, or results returned but not used) and to drive ongoing quality improvement.
Is the grant only about viral load testing?
No. While VL scale-up is the headline priority, the investments are also intended to build capacity for early infant diagnosis (EID) and provide broader support for other HIV-related laboratory services, strengthening the overall laboratory network rather than creating a single-test system.
How does early infant diagnosis (EID) fit into the opportunity?
The same system improvements are intended to support EID for children born to mothers living with HIV. The description emphasizes that EID depends on timely, high-quality testing systems because early identification is critical for immediate treatment initiation and infant survival.
What does the opportunity say about national-level laboratory systems and oversight?
At the system level, the opportunity aims to support universal availability of HIV-related laboratory tests and strengthen national quality oversight of HIV testing. The description suggests coordination with national laboratory leadership, standard-setting, proficiency testing, accreditation or stepwise quality improvement approaches, and harmonized protocols across the laboratory network.
Does the opportunity include awareness and demand creation for VL and EID?
Yes. Increasing awareness of VL and EID testing is explicitly included, tying back to coverage goals so that eligible people and infants are actually reached by testing services.
What is the overarching problem this opportunity is designed to solve?
Overall, the grant is designed to reduce bottlenecks and delays across the lab and logistics pathway so Zambia has a more reliable, higher-quality, and higher-throughput laboratory and sample transport system. The goal is to make viral load monitoring and early infant diagnosis accessible, timely, and clinically useful.
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