[Federal Register Volume 67, Number 202 (Friday, October 18, 2002)]
[Notices]
[Pages 64379-64381]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-26534]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 02102]


Prevention of Human Immunodeficiency Virus (HIV/AIDS) Through 
Interpersonal Communication and Community Mobilization To Promote 
Voluntary Counseling and Testing (VCT), Prevention of Mother to Child 
Transmission (PMTCT), Tuberculosis (TB) Preventive Therapy and Access 
to Care and Support Programs in the Republic of Botswana; Notice of 
Award of Funds

A. Purpose

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2002 funds for a cooperative agreement 
with the National AIDS Coordinating Agency (NACA) to implement Total 
Community Mobilization (TCM) Project in the Republic of Botswana.
    The purpose of this announcement is to mobilize community members 
in the Republic of Botswana and empower them to prevent HIV/AIDS 
transmission and improve access to support programs.
    Measurable outcomes of the program will be in alignment with one or 
more of the following performance goals for the Global AIDS Program 
(GAP) Working with other countries, United States Agency for 
International Development (USAID), international, and U.S. government 
agencies, reduce the number of new HIV infections among 15 to 24 year 
olds in sub-Saharan Africa from an estimated two million by 2005. This 
program will enhance and expand the use of interpersonal communication 
and community mobilization to promote voluntary testing and counseling 
(VCT), prevention of mother to child transmission program (PMTCT), the 
national rollout of the Isoniazid Preventive Therapy (IPT) program, and 
improve access to care and treatment programs in Botswana. The program 
will also play an integral role in the implementation of the CDC MARCH 
(Modeling and Reinforcement to Combat HIV/AIDS) strategy for behavior 
change.
    These collaborative activities if mobilized at the community level 
could profoundly impact the scope and intensity of the implementation 
of the National AIDS Policy. Cooperative efforts could lead to greater 
use of counseling and testing services in all areas of the country, 
increase in enrollment in the IPT and PMTCT programs, and greater use 
of existing programs for care and support throughout the nation.
    Interpersonal communications can reinforce the messages and 
modeling which is taking place through behavior change communications 
such as the radio serial drama, ``Magabeneg''. The U.S. Government 
seeks to reduce the impact of HIV/AIDS and related conditions in 
specific countries within sub-Saharan Africa, Asia, and the Americas 
through its Leadership and Investment in Fighting an Epidemic (LIFE) 
initiative. Through this program, CDC has initiated its Global AIDS 
Program (GAP)to strengthen capacity and expand activities in the areas 
of (1) HIV primary prevention; (2) HIV care, support, and treatment; 
and (3) capacity and infrastructure development, especially for 
surveillance. Targeted countries represent those with the most severe 
epidemics and the highest number of new infections. They also represent 
countries where the potential for impact is greatest and where U.S. 
government agencies are already active. Botswana is one of these 
targeted countries. To carry out its activities in these countries, CDC 
is working in a collaborative manner with national

[[Page 64380]]

governments and other agencies to develop programs of assistance to 
address the HIV/AIDS epidemic. CDC's program of technical assistance to 
Botswana focuses on several areas including scaling up promising 
prevention and care strategies, such as VCT, PMTCT, and IPT, supporting 
behavior change communication projects (MARCH strategy), such as the 
radio serial drama, and other capacity building efforts. Botswana is 
experiencing one of the world's most severe AIDS crises that looms as a 
disaster of unprecedented proportions. The global burden of HIV/AIDS in 
Botswana is the highest in sub-Saharan Africa, where 83 percent of the 
world's AIDS deaths have occurred, and where four-fifths of all HIV-
positive women live. Despite a relative stabilization of infection 
rates in some countries in West Africa, the HIV/AIDS epidemic continues 
to grow at an alarming rate in Southern Africa. Like many countries in 
this region, Botswana has been disproportionately affected by the AIDS 
pandemic. Over 20 percent of the population are believed to be HIV 
positive and the Botswana National Aids Co-ordinating Agency's 2000 
Sentinel Surveillance reports 38.5 percent HIV infection in 
participating pregnant women. Botswana estimates that as many as 25 
babies a day are born with HIV. AIDS-related conditions are responsible 
for 10 percent of annual deaths, with women and adolescents 
particularly at risk. TB is by far the single leading cause of death 
among adults with AIDS in Botswana.
    Based on Sentinel surveys in 1999, an estimated 19 percent of the 
total population and 29 percent of the economically productive age 
group (15-49 years old) are living with HIV infection. The rate of TB 
infection in Botswana (537/100,000 in 1999) is one of the highest in 
the world. Botswana has taken many positive steps to address the AIDS 
epidemic. The President has recognized HIV/AIDS as ``the greatest 
challenge Botswana has faced'' and has warned Botswana that HIV/AIDS 
``threatens the country with annihilation.'' The Botswana government 
pays for up to 80 percent of all HIV/AIDS activities in the country. 
This full-scale national response has generated many examples of 
creative programming and international collaborations. The government 
of Botswana will be among the first African countries to launch a TB 
prevention program using Isoniazid Preventive Therapy (IPT) for HIV 
infected individuals. A Pilot program of IPT was implemented in October 
2000 and planning for nation-wide implementation is underway. In 1999 
the MOH launched a pilot project for PMTCT in Gaborone and Francistown 
is now undertaking full scale implementation. In 2000 The BOTUSA 
Project in collaboration with the MOH launched the nationwide network 
of VCT centers, ``Tebelopele'' which means to look into the future. The 
government is also in the process of introducing ARV treatment and 
fully supports the MARCH strategy through Information Broadcasting. 
These programs are all new to the communities and providing information 
to the population using interpersonal communication can enhance uptake 
and empower the population to utilize these services.
    The Botswana MOH and CDC collaboration was established in 1995 and 
is known as the ``The BOTUSA Project'' and is a successful example of 
MOH and international collaboration. BOTUSA is a strong supporter of 
the IPT program and is providing technical assistance, training for 
health care workers, supplying educational materials, and supporting 
program monitoring and evaluation. BOTUSA's collaboration includes 
support for the national PMTCT program through the provision of 
technical assistance, counseling space, equipment, and materials for 
prenatal clinics throughout the country. BOTUSA also supports in 
collaboration with the MOH, voluntary counseling and testing and a 
radio serial drama for behavior change.
    However, despite the support of the government to fight the 
epidemic and the collaboration with international partners, the 
prevalence of HIV infection appears to have increased substantially in 
Botswana from 1997 to 2002 and the epidemic cannot yet be characterized 
as having stabilized. The capacity of the government to expand their 
pilot projects for prevention and extend the reach of their activities 
to the entire nation will have a substantial impact on the epidemic.

B. Eligible Applicants

    Assistance will be provided only to the NACA for support of the TCM 
Project, as implemented by the NACA and the Humana People to People 
Foundation currently funded by the NACA of Botswana. No other 
applications are solicited.
    The NACA is the only appropriate and qualified organization to 
fulfill the requirements set forth in this announcement because:
    1. Through NACA, the Government of Botswana (GOB) has a cooperative 
agreement with Humana People to People for the implementation of door-
to-door community mobilization. In Botswana this program will be 
implemented under the name TCM. Humana People to People has been 
requested to find a partner to pay for twenty percent of the cost.
    2. The TCM Project is uniquely positioned, in terms of support from 
the GOB. The NACA has the ability to financially and technically 
oversee the TCM project, and to provide implementation of a large scale 
interpersonal communication project as well as a mandate from GOB. The 
NACA has mandated Humana People to People to implement nationwide 
coverage of community mobilization and interpersonal communication 
through the TCM project. They have the ability to collect information, 
train staff and advocate for the programs implemented in the National 
AIDS Strategic Plan and disseminate personalized ``one on one'' 
communication to support the fight against HIV/AIDS in Botswana.
    3. The GOB assisted by The Botswana/U.S. of America (BOTUSA) 
Project evaluated the TCM project in 2001. The results led the GOB to 
fund Humana People to People to undertake national community 
mobilization against HIV/AIDS. Therefore, Humana People to People is 
the only available organization approved by the GOB to implement door-
to-door community mobilization, the TCM program, and specific services.
    4. The specific services which the TCM project will deliver are 
directly associated with the CDC prevention strategies implemented 
under the Global AIDS Program in Botswana and integrated into the TCM 
project.

C. Availability of Funds

    Approximately $700,000 is available in FY 2002, to fund twenty 
percent of the TCM project by the NACA. The GOB will fund the remaining 
80 percent of the agreement. It is expected that the award will begin 
on or about September 1, 2002 and will be made for a 12-month budget 
period within a project period of two years.
    Continuation award within the approved project period will be made 
on the basis of satisfactory progress as evidenced by required reports 
and the availability of funds.

Use of Funds

    Funding to be administered by the NACA for TCM include:
    Provision of salaries and short-term contracts for technical and 
support staff needed to scale up current pilot programs in the 
community to a nation

[[Page 64381]]

wide level. Funding for training, materials, and supervision in the 
field for the TCM community mobilization staff.
    Funds received will not be used for the direct purchase of drugs to 
treat active TB disease. The purchase of antiretrovirals, reagents, and 
laboratory equipment for antiretroviral treatment projects requires 
preapproval from the GAP headquarters.
    The applicant may contract with other organizations under these 
cooperative agreements, 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).
    The costs that are generally allowable in grants to domestic 
organizations are likewise allowable to foreign institutions and 
international organizations, with the following exceptions:

    1. Alterations and Renovations: Unallowable.
    2. Customs and Import Duties: Unallowable. This includes 
consular fees, customs surtax, value added taxes, and other related 
charges.
    3. Indirect Costs: With the exception of the American 
University, Beirut, the Gorgas Memorial Institute, and the World 
Health Organization, indirect costs will not be paid (either 
directly or through a sub-award) to organizations located outside 
the territorial limits of the U.S. or to international organizations 
regardless of their location.

    All requests for funds, including the budget contained in the 
application, shall be stated in U.S. dollars. Once an award is made, 
the Department of Health and Human Services (DHHS) will not compensate 
foreign grantees for currency exchange fluctuations through the 
issuance of supplemental awards.
    No funds appropriated under this Act shall be used to carry out any 
program of distributing sterile needles or syringes for the hypodermic 
injection of any illegal drug. Matching funds is not a requirement for 
this program announcement.

D. Where To Obtain Additional Information

    This and other CDC announcements can be found on the CDC home page 
address--http://www.cdc.gov. Click on ``Funding'' then ``Grants and 
Cooperative Agreements.''
    If you have questions after reviewing the contents of all the 
documents, business management technical assistance may be obtained 
from: Cynthia Collins, Grants Management Specialist, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention, 2920 Brandywine Road, Room 3000, Atlanta, GA 30341-4146, 
Telephone number: (770) 488-2757, E-mail address: [email protected].
    For program technical assistance, contact: Ethleen S. Lloyd, Global 
AIDS Program (GAP), c/o U.S. Embassy Gaborone, 2170 Gaborone Place, 
Washington DC 20521, Telephone number: (868)633-2065, E-mail address: 
[email protected].

    Dated: October 9, 2002.
Edward J. Schultz,
Deputy Director, Procurement and Grants Office, Center for Disease 
Control and Prevention.
[FR Doc. 02-26534 Filed 10-17-02; 8:45 am]
BILLING CODE 4163-18-P