[Federal Register Volume 69, Number 121 (Thursday, June 24, 2004)]
[Notices]
[Pages 35364-35369]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-14309]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Implementation of Programs for Prevention of Mother to Child HIV 
Transmission Through Indigenous Non-Governmental Organizations (NGOs) 
in Kenya

    Announcement Type: New.
    Funding Opportunity Number: PA 04262.
    Catalog of Federal Domestic Assistance Number: 93.941.
    Key Dates:
    Letter of Intent Deadline: Not required.
    Application Deadline: July 26, 2004.

I. Funding Opportunity Description

    Authority: This program is authorized under Sections 307 and 
317(k)(2)of the Public Health Service Act, [42 U.S.C. Sections 242l 
and 247b(k)(2)] as amended and under Public Law 108-25 (United 
States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 
2003) [22 U.S.C. 7601].

    Purpose: The Centers for Disease Control and Prevention (CDC) 
announces the availability for Fiscal Year (FY) 2004 funds for a 
cooperative agreement program to provide technical assistance and 
funding to local organizations in Kenya to enable them to support the 
implementation of a

[[Page 35365]]

Prevention of Mother-to-Child HIV Transmission (PMTCT) program in 
Ministry of Health (MOH) facilities and other facilities offering 
Maternal and Child Health services (MCH).
    This program should include HIV counseling and testing in the 
antenatal clinics (ANC) and maternity wards, provision of prophylactic 
antiretroviral (ARV) drugs, basic medical care including prevention and 
treatment of opportunistic infections and anti-retroviral therapy (ART) 
for HIV infected women and their families (PMTCT+).
    The Global AIDS Program (GAP) has established field operations to 
support national HIV/AIDS control programs in 25 countries. The CDC's 
GAP exists to help prevent HIV infection, provide care and support, and 
build capacity to address the global AIDS pandemic. GAP provides 
financial and technical assistance through partnerships with 
governments, community- and faith-based organizations, the private 
sector, and national and international entities working in the 25 
resource-constrained countries. CDC/GAP works with the Health Resources 
and Services Administration (HRSA), the National Institutes of Health 
(NIH), the U.S. Agency for International Development (USAID), the Peace 
Corps, the Departments of State, Labor and Defense, and other agencies 
and organizations. These efforts complement multilateral efforts, 
including UNAIDS, the Global Fund to Combat HIV, TB and Malaria, World 
Bank funding, and other private sector donation programs.
    The U.S. Government seeks to reduce the impact of HIV/AIDS in 
specific countries within sub-Saharan Africa, Asia, and the Americas 
through the Presidential Emergency Plan for AIDS Relief (PEPFAR). 
Through this new initiative, CDC's GAP will continue to work with host 
countries to strengthen capacity and expand activities in the areas of: 
(1) Primary HIV prevention; (2) HIV care, support, and treatment; and 
(3) capacity and infrastructure development, especially for 
surveillance and training. Targeted countries represent those with the 
most severe epidemics where the potential for impact is greatest and 
where U.S. government agencies are already active. Kenya is one of 
these targeted countries.
    To carry out its activities in these countries, CDC is working in a 
collaborative manner with national governments and other agencies to 
develop programs of assistance to address the HIV/AIDS epidemic.
    The goal of the Kenya government PMTCT program is to increase 
access of PMTCT services so as to reach at least 50 percent of all 
health facilities by the end of 2005 and at least 80 percent by 2007. 
This will require involvement of all sectors in implementation. To date 
indigenous NGOs have contributed significantly in supporting 
implementation in both government and non-government facilities. These 
indigenous organizations bring special expertise to the process by 
virtue of their knowledge of the Kenyan health systems and the local 
culture. There is added advantage in working with these groups due to 
their long and on-going presence on the ground and their intimate 
direct experience of the effects of the epidemic.
    CDC proposes to enhance the capacity of these organizations to 
support the implementation of PMTCT programs in Kenya. CDC Kenya is 
committed to strengthening and supporting indigenous NGOs to continue 
to facilitate implementation of PMTCT services in various facilities in 
Kenya.
    The measurable outcomes of the program will be in alignment with 
goals of the GAP to reduce HIV transmission and improve care of persons 
living with HIV. They will also contribute to the goals of the PEPFAR 
which are: (1) Within five years treat more than two million HIV-
infected persons with effective combination of anti-retroviral therapy 
(ART); (2) care for seven million HIV-infected and affected persons 
including those orphaned by HIV/AIDS; and (3) prevent ten million new 
infections. Some of the specific measurable outcomes from this program 
will be: (1) The number of antenatal and maternity clients receiving 
counselling and testing; (2) number of HIV positive women and their 
children who receive prophylactic antiretroviral drugs; (3) the number 
of patients receiving basic care packages; (4) the number of new 
patients served with anti-retroviral treatment and the number of 
patients on ART receiving continuous care for more than 12 months; and 
(5) the number of health care workers trained in PMTCT and PMTCT+ 
services.
    Activities: Awardee activities for this program are as follows:
     To provide technical assistance in program implementation 
to managers of maternal and child health services at MOH facilities and 
other facilities in Kenya.
     To train service providers in HIV counseling and testing 
in the ANC and maternity wards, on prophylactic anti-retroviral 
regimens, in prevention and treatment of opportunistic infections and 
on lifelong antiretroviral therapy for HIV infected women and their 
families.
     To provide supportive supervision and ensure that PMTCT 
services are being implemented according to the national and 
international standards.
     Where necessary, to hire extra personnel to alleviate 
problems of implementation due to staff shortages.
     To enhance the capacity of health facilities to integrate 
PMTCT data into the national reporting system.
     To assist the facilities in report writing on the program.
     To collaborate with the District health management teams 
and local stakeholders including associations of people living with HIV 
in sensitizing the communities on PMTCT through community education, 
male involvement and establishment of community support structures.
     To develop strategies to improve the capacity of the 
facilities to maintain the PMTCT services independently.
    Awardee will ensure that all of the above activities integrate into 
the national HIV/AIDS strategy.
    In a cooperative agreement, CDC staff is substantially involved in 
the program activities, above and beyond routine grant monitoring.
    CDC Activities for this program are as follows:
     Provide technical assistance in clinical, counseling and 
laboratory issues, training, data management, and program monitoring 
and evaluation.
     Collaborate with the recipient, as needed, in the 
development of an information technology system for medical record 
keeping and information access and in the analysis of data derived from 
those records.
     Assist, as needed, in monitoring and evaluation of program 
and in development of further appropriate initiatives.
     Provide fiscal oversight and technical assistance in the 
areas of financial management, administration, personnel management, 
data management and other aspects of institution strengthening.
     Monitor project and budget performance to ensure 
satisfactory progress towards the goals of the project.
    Technical assistance and training may be provided directly by CDC 
staff or through organizations that have successfully competed for 
funding under a separate CDC contract.

II. Award Information

    Type of Award: Cooperative Agreement. CDC involvement in this 
program is listed in the Activities Section above.
    Fiscal Year Funds: 2004.
    Approximate Total Funding: $5,000,000 (This amount is for the 
entire project period.).

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    Approximate Number of Awards: Two to Three.
    Approximate Average Award: $300,000 (This amount is for the first 
12-month budget period, and includes only direct costs).
    Floor of Award Range: $250,000.
    Ceiling of Award Range: $500,000.
    Anticipated Award Date: August 15, 2004.
    Budget Period Length: 12 months.
    Project Period Length: 5 years.
    Throughout the project period, CDC's commitment to continuation of 
awards will be conditioned on the availability of funds, evidence of 
satisfactory progress by the recipient (as documented in required 
reports), and the determination that continued funding is in the best 
interest of the Federal Government.

III. Eligibility Information

III.1. Eligible Applicants

    Applications may only be submitted by indigenous Kenyan 
organizations, indigenous universities or colleges, and indigenous 
Kenyan faith-based organizations that meet the following criteria:
    1. Have at least three years of documented experience in 
implementing PMTCT programs in Kenya.
    2. Have an existing program in Kenya because it is critical that 
this activity commences quickly.

III.2. Cost Sharing or Matching

    Matching funds are not required for this program.

III.3. Other

    If you request a funding amount greater than the ceiling of the 
award range, your application will be considered non-responsive, and 
will not be entered into the review process. You will be notified that 
your application did not meet the submission requirements.

IV. Application and Submission Information

IV.1. Address to Request Application Package

    To apply for this funding opportunity use application form PHS 
5161. Application forms and instructions are available on the CDC Web 
site, at the following Internet address: www.cdc.gov/od/pgo/forminfo.htm.
    If you do not have access to the Internet, or if you have 
difficulty accessing the forms on-line, you may contact the CDC 
Procurement and Grants Office Technical Information Management Section 
(PGO-TIM) staff at: 770-488-2700. Application forms can be mailed to 
you.

IV.2. Content and Form of Submission

    Application: You must include a project narrative with your 
application forms. The narrative must be submitted in the following 
format:
     Maximum number of pages: 15. If your narrative exceeds the 
page limit, only the first pages, which are within the page limit, will 
be reviewed.
     Font size: 12 point unreduced.
     Paper size: 8.5 by 11 inches.
     Double spaced.
     Page margin size: One inch.
     Printed only on one side of page.
     Held together only by rubber bands or metal clips; not 
bound in any other way.
     All pages should be numbered, and a complete index to the 
application and any appendices must be included.
     Submitted in English
    Your narrative should address activities to be conducted over the 
entire project period, and should consist of, as a minimum, a plan, 
objectives, activities, methods, an evaluation framework, a budget 
highlighting any supplies mentioned in the Program Requirements and any 
proposed capital expenditure. The budget justification will not be 
counted in the page limit state above. Guidance for completing your 
budget can be found on the United States government Web site at the 
following address: http://www.cdc.gov/od/pgo/funding/budgetguide.htm.
    Additional information is optional and may be included in the 
application appendices. The appendices will not be counted toward the 
narrative page limit. Additional information could include but is not 
limited to: organizational charts, curriculum vitas, letters of 
support, etc.
    You are required to have a Dun and Bradstreet Data Universal 
Numbering System (DUNS) number to apply for a grant or cooperative 
agreement from the Federal government. The DUNS number is a nine-digit 
identification number, which uniquely identifies business entities. 
Obtaining a DUNS number is easy and there is no charge. To obtain a 
DUNS number, access www.dunandbradstreet.com or call 1-866-705-5711.
    For more information, see the CDC Web site at: http://www.cdc.gov/od/pgo/funding/pubcommt.htm.
    If your application form does not have a DUNS number field, please 
write your DUNS number at the top of the first page of your 
application, and/or include your DUNS number in your application cover 
letter.
    Additional requirements that may require you to submit additional 
documentation with your application are listed in section 
``Administrative and National Policy Requirements.''

IV.3. Submission Dates and Times

    Application Deadline Date: July 26, 2004.
    Explanation of Deadlines: Applications must be received in the CDC 
Procurement and Grants Office by 4 p.m. Eastern Time on the deadline 
date. If you send your application by the United States Postal Service 
or commercial delivery service, you must ensure that the carrier will 
be able to guarantee delivery of the application by the closing date 
and time. If CDC receives your application after closing due to: (1) 
Carrier error, when the carrier accepted the package with a guarantee 
for delivery by the closing date and time, or (2) significant weather 
delays or natural disasters, you will be given the opportunity to 
submit documentation of the carriers guarantee. If the documentation 
verifies a carrier problem, CDC will consider the application as having 
been received by the deadline.
    This announcement is the definitive guide on application submission 
address and deadline. It supersedes information provided in the 
application instructions. If your application does not meet the 
deadline above, it will not be eligible for review, and will be 
discarded. You will be notified that your application did not meet the 
submission requirements.
    CDC will not notify you upon receipt of your application. If you 
have a question about the receipt of your application, first contact 
your courier. If you still have a question, contact the PGO-TIM staff 
at: 770-488-2700. Before calling, please wait two to three days after 
the application deadline. This will allow time for applications to be 
processed and logged.

IV.4. Intergovernmental Review of Applications

    Executive Order 12372 does not apply to this program.

IV.5. Funding Restrictions

    Restrictions, which must be taken into account while writing your 
budget, are as follows:
     Funds may be used for: Hiring of staff needed to provide 
services; Training service providers; Coordination of the program; 
purchase of supplies, equipment, and commodities (including 
antiretroviral drugs) needed to provide the services; renovation of 
clinical facilities at site of program implementation; and

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sensitization of the community on PMTCT services.
     Antiretroviral Drugs--The purchase of antiretrovirals, 
reagents, and laboratory equipment for antiretroviral treatment 
projects require pre-approval from the GAP headquarters.
     Needle Exchange--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.
     Funds may be spent for reasonable program purposes, 
including personnel, training, travel, supplies and services. Equipment 
may be purchased and renovations completed if deemed necessary to 
accomplish program objectives; however, prior written approval by CDC 
officials must be requested in writing.
     All requests for funds contained in the budget shall be 
stated in U.S. dollars. Once an award is made, CDC will not compensate 
foreign grantees for currency exchange fluctuations through the 
issuance of supplemental awards.
     The costs that are generally allowable in grants to 
domestic organizations are allowable to foreign institutions and 
international organizations, with the following exception: With the 
exception of the American University, Beirut, and the World Health 
Organization, Indirect Costs will not be paid (either directly or 
through sub-award) to organizations located outside the territorial 
limits of the United States or to international organizations 
regardless of their location.
     The applicant may contract with other organizations under 
this program, however, the applicant must perform a substantial portion 
of the activities, including program management and operations, and 
delivery of prevention and care services for which funds are requested.
     An annual audit of these funds is required by a U.S. based 
audit firm with international branches and current licensure/authority 
in country, and in accordance with International Accounting Standards 
or equivalent standard(s) approved in writing by CDC. The audit should 
specify the use of funds and the appropriateness and reasonableness of 
expenditures.
     A fiscal Recipient Capability Assessment may be required 
with the potential awardee, pre or post award, in order to review their 
business management and fiscal capabilities regarding the handling of 
U.S. Federal funds.
     Prostitution and Related Activities
    The U.S. Government is opposed to prostitution and related 
activities, which are inherently harmful and dehumanizing, and 
contribute to the phenomenon of trafficking in persons.
    Any entity that receives, directly or indirectly, U.S. Government 
funds in connection with this document (``recipient'') cannot use such 
U.S. Government funds to promote or advocate the legalization or 
practice of prostitution or sex trafficking. Nothing in the preceding 
sentence shall be construed to preclude the provision to individuals of 
palliative care, treatment, or post-exposure pharmaceutical 
prophylaxis, and necessary pharmaceuticals and commodities, including 
test kits, condoms, and, when proven effective, microbicides. A 
recipient that is otherwise eligible to receive funds in connection 
with this document to prevent, treat, or monitor HIV/AIDS shall not be 
required to endorse or utilize a multisectoral approach to combating 
HIV/AIDS, or to endorse, utilize, or participate in a prevention method 
or treatment program to which the recipient has a religious or moral 
objection. Any information provided by recipients about the use of 
condoms as part of projects or activities that are funded in connection 
with this document shall be medically accurate and shall include the 
public health benefits and failure rates of such use.
    In addition, any foreign recipient must have a policy explicitly 
opposing, in its activities outside the United States, prostitution and 
sex trafficking, except that this requirement shall not apply to the 
Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Health 
Organization, the International AIDS Vaccine Initiative or to any 
United Nations agency, if such entity is a recipient of U.S. government 
funds in connection with this document.
    The following definitions apply for purposes of this clause:
     Sex trafficking means the recruitment, harboring, 
transportation, provision, or obtaining of a person for the purpose of 
a commercial sex act. 22 U.S.C. 7102(9).
     A foreign recipient includes an entity that is not 
organized under the laws of any State of the United States, the 
District of Columbia or the Commonwealth of Puerto Rico. Restoration of 
the Mexico City Policy, 66 FR 17303, 17303 (March 28, 2001).
    All recipients must insert provisions implementing the applicable 
parts of this section, ``Prostitution and Related Activities,'' in all 
subagreements under this award. These provisions must be express terms 
and conditions of the subagreement, acknowledge that each certification 
to compliance with this section, ``Prostitution and Related 
Activities,'' are a prerequisite to receipt of U.S. government funds in 
connection with this document, and must acknowledge that any violation 
of the provisions shall be grounds for unilateral termination of the 
agreement prior to the end of its term. In addition, all recipients 
must ensure, through contract, certification, audit, and/or any other 
necessary means, all the applicable requirements in this section, 
``Prostitution and Related Activities,'' are met by any other entities 
receiving U.S. government funds from the recipient in connection with 
this document, including without limitation, the recipients' sub-
grantees, sub-contractors, parents, subsidiaries, and affiliates. 
Recipients must agree that HHS may, at any reasonable time, inspect the 
documents and materials maintained or prepared by the recipient in the 
usual course of its operations that relate to the organization's 
compliance with this section, ``Prostitution and Related Activities.''
    All primary grantees receiving U.S. Government funds in connection 
with this document must certify compliance prior to actual receipt of 
such funds in a written statement referencing this document (e.g., 
``[Recipient's name] certifies compliance with the section, 
``Prostitution and Related Activities.'') addressed to the agency's 
grants officer. Such certifications are prerequisites to the payment of 
any U.S. Government funds in connection with this document.
    Recipients' compliance with this section, ``Prostitution and 
Related Activities,'' is an express term and condition of receiving 
U.S. government funds in connection with this document, and any 
violation of it shall be grounds for unilateral termination by HHS of 
the agreement with HHS in connection with this document prior to the 
end of its term. The recipient shall refund to HHS the entire amount 
furnished in connection with this document in the event it is 
determined by HHS that the recipient has not complied with this 
section, ``Prostitution and Related Activities.''
    Awards will not allow reimbursement of pre-award costs.

IV.6. Other Submission Requirements

    Application Submission Address: Submit the original and two hard 
copies of your application by mail or express delivery service to:
    Technical Information Management-PA 04262, CDC Procurement and 
Grants

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Office, 2920 Brandywine Road, Atlanta, GA 30341.
    Applications may not be submitted electronically at this time.

V. Application Review Information

V.1. Criteria

    You are required to provide measures of effectiveness that will 
demonstrate the accomplishment of the various identified objectives of 
the cooperative agreement. Measures of effectiveness must relate to the 
performance goals stated in the ``Purpose'' section of this 
announcement. Measures must be objective and quantitative, and must 
measure the intended outcome. These measures of effectiveness must be 
submitted with the application and will be an element of evaluation.
    Your application will be evaluated against the following criteria:
    1. Understanding the issues relating to the HIV prevalence in women 
in Kenya, and developing a creative and innovative approach to 
preventing mother to child HIV transmission (30 points).
    Does the applicant demonstrate an understanding of the social, 
behavioral, and contextual issues relating to the mother to child 
transmission of HIV? Does the applicant demonstrate creative and 
innovative ideas for addressing this problem?
    2. Ability to carry out the proposal (25 points).
    Does the applicant demonstrate the capability to achieve the 
purpose of this proposal? Does the applicant have demonstrated ability 
to set up and operate an intervention program in Ministry of Health 
facilities in Kenya? Does the applicant have demonstrated ability to 
set up and operate an intervention program in non-governmental 
facilities?
    3. Personnel (20 points).
    Are the key technical personnel involved in this project qualified, 
including evidence of at least three years experience in providing 
PMTCT HIV interventions in health facilities in Kenya? Do the technical 
personnel have demonstrated capacity for creative approaches to complex 
problems?
    4. Plans for Administration and Management of the Project (15 
points).
    Does the applicant describe activities, which are realistic, 
achievable, time-framed and appropriate to complete this program?
    5. Administrative and Accounting Plan (10 points).
    Is there a plan to account for, prepare reports, monitor and audit 
expenditures under this agreement, manage the resources of the program 
and produce, collect and analyze performance data?
    6. Budget (not scored, but evaluated).
    Is the itemized budget for conducting the project, along with 
justification, reasonable and consistent with stated objectives and 
planned program activities?

V.2. Review and Selection Process

    Applications will be reviewed for completeness by the Procurement 
and Grants Office (PGO) staff, and for responsiveness by the National 
Center for HIV, STD and TB Prevention (NCHSTP). Incomplete applications 
and applications that are non-responsive to the eligibility criteria 
will not advance through the review process. Applicants will be 
notified that their application did not meet submission requirements.
    An objective review panel will evaluate complete and responsive 
applications according to the criteria listed in the ``Criteria'' 
section above.
    No award will be made without the concurrence of the U.S. Embassy 
and the CDC representative in Kenya.

V.3. Anticipated Announcement and Award Date

    August 15, 2004.

VI. Award Administration Information

VI.1. Award Notices

    Successful applicants will receive a Notice of Grant Award (NGA) 
from the CDC Procurement and Grants Office. The NGA shall be the only 
binding, authorizing document between the recipient and CDC. The NGA 
will be signed by an authorized Grants Management Officer, and mailed 
to the recipient fiscal officer identified in the application.
    Unsuccessful applicants will receive notification of the results of 
the application review by mail.

VI.2. Administrative and National Policy Requirements

45 CFR Part 74 and Part 92
    For more information on the Code of Federal Regulations, see the 
National Archives and Records Administration at the following Internet 
address: http://www.access.gpo.gov/nara/cfr/cfr-table-search.html.
    The following additional requirements apply to this project:
     AR-4 HIV/AIDS Confidentiality Provisions.
     AR-6 Patient Care.
     AR-8 Public Health System Reporting Requirements.
     AR-10 Smoke-Free Workplace Requirements.
     AR-14 Accounting System Requirements.
    Additional information on these requirements can be found on the 
CDC Web site at the following Internet address: http://www.cdc.gov/od/pgo/funding/ARs.htm.

VI.3. Reporting Requirements

    You must provide CDC with an original, plus two hard copies of the 
following reports:
    1. In year one, quarterly progress reports, due 30 days after the 
end of each quarter. In subsequent years, a semi-annual progress 
report, due 30 days after the end of the budget period.
    2. Interim progress report, no less than 90 days before the end of 
the budget period. The progress report will serve as your non-competing 
continuation application, and must contain the following elements:
    a. Current Budget Period Activities Objectives.
    b. Current Budget Period Financial Progress.
    c. New Budget Period Program Proposed Activity Objectives.
    d. Budget.
    e. Additional Requested Information.
    f. Measures of Effectiveness.
    3.Financial status report, no more than 90 days after the end of 
the budget period.
    4.Final financial and performance reports, no more than 90 days 
after the end of the project period.
    These reports must be mailed to the Grants Management or Contract 
Specialist listed in the ``Agency Contacts'' section of this 
announcement.

VII. Agency Contacts

    For general questions about this announcement, contact: Technical 
Information Management Section, CDC Procurement and Grants Office, 2920 
Brandywine Road, Atlanta, GA 30341, Telephone: 770-488-2700.
    For program technical assistance, contact: Dorothy Mbori-Ngacha, 
MBChB, MMed, MPH, Senior Technical Advisor PMTCT, Global Aids Program 
[GAP], Centers for Disease Control and Prevention [CDC], PO Box 606 
Village Market, Nairobi, Kenya, Telephone: 256-20-271-3008, E-mail: 
[email protected].
    For budget assistance, contact: Diane Flournoy, Grants Management 
Specialist, CDC Procurement and Grants Office, 2920 Brandywine Road, 
Atlanta, GA 30341, Telephone: 770-488-2072, E-mail: [email protected].

VIII. Other Information

    None.


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    Dated: June 18, 2004.
William P. Nichols,
Acting Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention.
[FR Doc. 04-14309 Filed 6-23-04; 8:45 am]
BILLING CODE 4163-18-P