Acceleration towards Epidemic Control of Comprehensive HIV, TB and Related Infections including Prevention, Treatment and Retention of Prisoners and Staff of Uganda Prisons Service (UPS) under the President's Emergency Plan for AIDS Relief (PEPF | CDC RFA GH20 2067

Opportunity Information: Apply for CDC RFA GH20 2067

This funding opportunity is a CDC cooperative agreement under PEPFAR focused on accelerating epidemic control of HIV while also strengthening prevention, detection, and treatment for TB and other related infections within the Uganda Prisons Service (UPS). The central purpose is to expand and improve comprehensive, continuous care for both prisoners and prison staff, recognizing that prisons are high-risk, high-impact settings where effective testing, rapid treatment, and strong retention systems can quickly reduce new infections, illness, and deaths while also limiting transmission to the broader community when people transfer or are released.

Financially, the notice of funding opportunity (NOFO) lists an award ceiling for Year 1 as "0" (meaning no stated cap), while CDC anticipates approximately $3.5 million in total funding for Year 1, contingent on available funds. The funding mechanism is a cooperative agreement, which typically means CDC expects to be substantially involved in planning, monitoring, and technical direction during implementation rather than simply providing funds and receiving reports. The opportunity (CDC RFA GH20-2067, CFDA 93.067) anticipated a single award, with applications originally due April 21, 2020.

Programmatically, the grant is built around a major scale-up of HIV and TB services across the prison system. The recipient is expected to expand comprehensive HIV/TB service coverage from 55 prison units to 258 prison units, representing a large jump in geographic reach and operational footprint. In parallel, the recipient will support accreditation of antiretroviral therapy (ART) service delivery sites, increasing the number of accredited ART sites from 15 to 30. This accreditation emphasis signals a push not only to increase access points, but to ensure sites meet quality and readiness standards to deliver sustained HIV care, including clinical monitoring and reliable medication management.

A key theme is "service layering" for key and priority populations (KP/PP) within prison contexts, meaning prevention and treatment services are expected to be integrated in ways that address overlapping risks and barriers. Rather than relying on a single entry point into care, the program aims to align multiple steps of the prevention and treatment cascades so that people who test positive can be rapidly linked to treatment, those at risk can access effective prevention, and those already on treatment are supported to remain in care and achieve viral suppression.

For HIV case identification, the NOFO describes a mix of testing approaches tailored to incarceration and movement in and out of facilities. It includes universal HIV testing services (HTS) on entry, complemented by risk-based and other strategies for routine testing during incarceration and testing at exit for prisoners and staff. This reflects the reality that prison populations are dynamic: new entrants may arrive with undiagnosed infection, risk continues during incarceration, and exit points are critical to ensuring continuity of care and preventing loss to follow-up when individuals return to communities.

For TB, the focus is on early and routine screening and effective management across the spectrum of disease severity. The program emphasizes timely case identification through TB symptom screening on entry and routinely thereafter, recognizing overcrowding and ventilation challenges that can accelerate TB transmission in correctional settings. The recipient is expected to support management of both drug-susceptible TB and drug-resistant forms, including MDR TB, which typically require more complex diagnostics, longer treatment, and stronger adherence support. A major scale-up component is prioritization of TB preventive therapy (TPT) for prison communities, signaling an intent to expand preventive care for people at risk of developing active TB, particularly among individuals living with HIV and other high-risk groups in congregate settings.

On HIV treatment, retention, and viral suppression, the opportunity highlights several specific approaches. The recipient is expected to scale up same-day ART initiation to reduce delays between diagnosis and treatment start, a strategy associated with improved outcomes and reduced onward transmission. Treatment literacy is also emphasized, suggesting structured education and counseling so clients understand ART benefits, adherence expectations, side effects, and the importance of ongoing monitoring. The NOFO explicitly includes promoting "Undetectable = Untransmittable" (U=U) messaging, which can strengthen motivation for adherence, reduce fear and misinformation, and directly address stigma by communicating that sustained viral suppression prevents sexual transmission of HIV.

The program also calls for strengthening peer navigation, which in prison settings often means training and supporting peers to help others move through testing, linkage, clinic visits, adherence, and follow-up, especially when formal health staffing is limited. Viral load (VL) monitoring is identified as a priority area for scale-up, with the goal of improving treatment quality, retention, and the proportion of clients who achieve viral suppression. Strong VL systems usually require reliable specimen collection and transport, timely result return, clinical action on unsuppressed results, and adherence interventions when needed.

Data and continuity of care are also central. The recipient is expected to roll out key population data reporting tools, which implies improvements in how services are documented and disaggregated to track program performance and identify gaps. The NOFO further stresses strengthening referrals and linkage to treatment both within UPS facilities and at exit, addressing one of the most common failure points in correctional health: people who start or continue treatment while incarcerated may interrupt care when transferred or released unless there is active planning, referral documentation, and connection to receiving clinics and community programs.

Finally, the opportunity goes beyond HIV and TB by explicitly naming additional issues that commonly intersect with infection risk and access to care in prisons. It calls for attention to stigma and discrimination as barriers that reduce testing uptake, disclosure, and retention in treatment. It also notes hepatitis, drug use, violence, and other sexually transmitted infections (STIs), signaling an integrated public health approach rather than a narrow disease-specific model. In practice, this framing points toward a comprehensive package that addresses co-infections, behavioral and structural risks, and the social environment in which health services are delivered, with the overall objective of driving measurable progress toward HIV epidemic control and improved infectious disease outcomes in the prison system and the communities connected to it.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Acceleration towards Epidemic Control of Comprehensive HIV, TB and Related Infections including Prevention, Treatment and Retention of Prisoners and Staff of Uganda Prisons Service (UPS) under the President's Emergency Plan for AIDS Relief (PEPF" 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 Feb 21, 2020.
• Applicants must submit their applications by Apr 21, 2020 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.)
• The number of recipients for this funding is limited to 1 candidate(s).
• Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).

Apply for CDC RFA GH20 2067

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