Public Health Surveillance of Recent HIV Infection and Response under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH19 1942

Opportunity Information: Apply for CDC RFA GH19 1942

The grant opportunity "Public Health Surveillance of Recent HIV Infection and Response under the President's Emergency Plan for AIDS Relief (PEPFAR)" (CDC RFA GH19-1942) is a CDC-led cooperative agreement designed to help PEPFAR-supported countries build and run systems that can identify and track recent HIV infections in near real time. The main public health goal is to sharpen epidemic intelligence: finding where transmission is happening now, detecting changes in transmission patterns early, and using that information to target prevention and treatment actions that move countries closer to epidemic control. Rather than relying only on overall HIV prevalence or routine case counts, the program emphasizes measuring recency of infection so programs can distinguish ongoing transmission from infections that occurred years earlier.

A central feature of this opportunity is the use of point-of-care tests for recent HIV infection. These tests are intended to classify newly diagnosed people as having a "recent" infection (on average, seroconversion within roughly the past six months) versus a non-recent infection, and they deliver results within minutes. The practical value is that recency results can be immediately actionable at the testing site and also highly informative when aggregated for surveillance. When these recency data are compiled across facilities, they can reveal transmission hot spots, emerging clusters, or geographic and demographic pockets where incidence appears to be rising. The surveillance outputs are meant to translate directly into smarter program decisions, such as where to intensify prevention services, where to optimize testing strategies, and which populations may need more focused outreach.

The NOFO also highlights linking recent infection surveillance to HIV case-based surveillance, which is the ongoing collection of person-level HIV diagnosis and clinical information used for routine monitoring of the epidemic. Connecting these systems can strengthen national monitoring by allowing recency data to be analyzed alongside other information, such as location, age, sex, risk factors, treatment status, and service delivery data. With these linkages, programs can better track trends over time, evaluate whether interventions are reducing transmission, and identify gaps in the continuum of services that may be fueling new infections.

Another key component is the expectation that surveillance will be paired with a "response" that uses the information to reduce transmission quickly. The opportunity describes several examples of how results might be used programmatically: enhanced counseling at the time of diagnosis, rapid or immediate initiation of antiretroviral therapy (ART) to reduce viral load and onward transmission, prioritization of index testing (offering testing to partners and contacts of people newly diagnosed), and other targeted prevention interventions. The underlying logic is that identifying recent infections is a signal of where transmission is happening now, and rapid, focused responses can interrupt those chains of transmission.

Because this is framed as a high-priority PEPFAR activity, the award anticipates substantial coordination across disciplines and across the health system. The NOFO explicitly calls for a multi-disciplinary team, reflecting the reality that recent infection surveillance is not just a laboratory add-on. It requires surveillance design and oversight, laboratory capacity and quality systems, HIV testing services integration, prevention and treatment program alignment, strong health informatics for secure data capture and linkage, robust data management and analytics for timely interpretation, and supply chain systems to ensure consistent availability of test kits and related commodities. The funded work is expected to cover planning, implementation, and impact evaluation, meaning recipients should be prepared to help countries set up the system, operate it reliably, and assess whether it is improving decision-making and contributing to better epidemic outcomes.

From an administrative standpoint, the opportunity was offered by the Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), under CFDA 93.067, as a discretionary cooperative agreement. Eligibility is listed as unrestricted (open to any type of entity, subject to any additional eligibility language in the full announcement). The original posting indicates an anticipated maximum award amount (ceiling) of up to $20,000,000, with an expectation of four awards. The funding announcement was created on June 1, 2018, with an original application deadline of July 31, 2018, and electronic submissions required by 11:59 p.m. Eastern Time on the due date.

Overall, this NOFO is focused on making HIV surveillance more immediate and more actionable by adding recent infection testing and tying those findings to rapid prevention and treatment responses. The intended end state is a stronger, more responsive public health system in PEPFAR countries that can spot ongoing transmission quickly, deploy targeted interventions efficiently, and monitor whether those interventions are actually bending the curve toward epidemic control.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Public Health Surveillance of Recent HIV Infection and Response 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 Jun 01, 2018.
• Applicants must submit their applications by Jul 31, 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 4 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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