The funding opportunity Sustaining HIV and TB Epidemic Control in Lesotho through Health System Strengthening and Technical Assistance under PEPFAR (CDC-RFA-JG-25-0078) aims to reduce HIV and TB incidence and mortality in Lesotho. This initiative will focus on achieving and sustaining the UNAIDS 95-95-95 targets across four key districts: Leribe, Berea, Quthing, and Qacha's Nek. This program emphasizes evidence-based interventions and innovative strategies to build capacity in health systems, improve patient-centered service delivery, and align with the Lesotho Ministry of Health’s goals.

The project’s objectives include strengthening the health system, improving continuous quality improvement (CQI) processes, and enhancing technical assistance in areas like HIV and TB case detection, treatment, prevention, and cervical cancer screening. Efforts will also integrate the management of non-communicable diseases into HIV care. The program's long-term vision aligns with PEPFAR’s strategic goal of eliminating HIV/AIDS as a public health threat by 2030 and ensuring sustainable public health systems.

The program anticipates funding one award with an expected Year 1 budget of $15 million under a cooperative agreement. Funding will span five years, contingent on available resources, project progress, and government priorities. The initiative favors local partnerships, with an additional 15 merit points awarded to applicants meeting PEPFAR's local partner criteria. Eligible applicants include governments, nonprofits, higher education institutions, private entities, and foreign organizations, provided they conduct activities in Lesotho.

To apply, organizations must submit their applications via Grants.gov by February 20, 2025, at 11:59 p.m. ET. Applications must adhere to strict formatting and documentation requirements, including a project narrative (20-page limit), budget narrative, and several attachments (e.g., experience statements, organizational charts). Registrations in SAM.gov and Grants.gov are mandatory before submission.

Applications will be evaluated based on the approach (45 points), organizational capacity (30 points), and data monitoring and evaluation plans (25 points). Special attention will be given to applicants demonstrating innovative, impactful solutions that address clinical cascade gaps and focus on equity in health service delivery. Notifications of award decisions will be provided by August 2025, with projects commencing by September 30, 2025.

Award recipients will need to comply with extensive reporting and monitoring requirements, including annual performance updates, data management plans, and financial reporting. CDC will provide technical oversight and assistance throughout the program, ensuring alignment with Lesotho’s national health goals and PEPFAR guidelines. This opportunity supports an integrated and sustainable approach to HIV and TB epidemic control in Lesotho, with a strong emphasis on collaboration, data-driven decision-making, and health equity.