CFPs: Elimination of vertical transmission of HIV, Syphilis, Hepatitis B and Chagas in Endemic Areas

Deadline Date: March 12, 2024

Donor Name: UNITAID

Grant Size: Not Available

Unitaid is pleased to announce this call for proposals aimed at catalyzing uptake of country-led and context-specific intervention packages to eliminate vertical transmission and improve maternal and newborn health.

Vertical (mother-to-child) transmission of HIV, syphilis, and hepatitis B virus (HBV) contributes to significant morbidity and mortality in low- and middle-income countries (LMICs) and is targeted for elimination through an integrated approach. This vision for “Triple Elimination” is grounded in evidence demonstrating that linking interventions for HIV with services for other sexually transmitted infections, including syphilis and HBV, improves uptake and optimizes the use of limited resources. The three diseases also share many features, including their epidemiology, routes of transmission, and the core interventions for addressing them. In regions where Chagas is endemic, Triple Elimination is expanded to include congenital Chagas (‘EMTCT Plus’).

The main objectives of this Call for Proposals are the following:

• To support countries to design and deploy integrated elimination programming and generate evidence on effective and scalable implementation models in diverse settings.
• To overcome market barriers that limit access to critical commodities, including availability and affordability challenges impacting diagnostic and treatment products.
• To build demand for integrated elimination programs through people-centered and locally tailored roll-out approaches, including strong, funded community engagement, advocacy and literacy activities.

Scope

• Proposals are solicited for the following intervention.
  • Implementation work to accelerate demand and adoption of new and underutilized commodities for eliminating vertical (mother-to-child) transmission as part of integrated national strategies
  • Proposals should include large scale, multi-country implementation work to drive adoption of programs and recently available WHO guidelines. Activities should focus on developing pragmatic integrated approaches in a variety of contexts. Evidence generation on the feasibility, cost-effectiveness and impact of delivering an optimal mix of tools and delivery strategies will be critical for accelerating uptake and help provide a roadmap for introduction that overcomes traditional programmatic silos (e.g. HIV, STIs, Maternal and Child Health, Chagas, Immunization programs) and maximizes the overlap between tools and platforms.
  • Program design should build on the recently launched WHO Framework for Triple Elimination and aim to capture lessons learned for how best to introduce, integrate, and transition to scale programs within care platforms, including antenatal and postnatal services. Context-specific optimal packages of interventions can leverage newly available and quality-assured screening and diagnostic tools, such as single and dual HIV/syphilis RDTs and HBV surface antigen (HBsAg) RDTs to quickly identify women at risk of vertical transmission and facilitate linkage to care.
  • Activities should build on and integrate with existing systems such as integrated diagnostic platforms and data management systems. In Chagas endemic regions, packages could incorporate new or existing molecular screening platforms to accelerate treatment access. Innovations in service delivery should be considered, where there are opportunities to facilitate more rapid, consistent, and equitable access to interventions. This could include implementation research on:
    • Delivery of integrated services for HIV, syphilis, HBV and Chagas (where endemic) within national programs, including optimal packages of care.
    • Hepatitis B birth dose introduction, including strategies to reach infants born at lower-level facilities and in the community.
    • Simplified hepatitis B screening and care strategies.
    • Improved Chagas disease screening, diagnosis and treatment strategies for newborns.
    • Self-care and self-testing approaches, particularly for syphilis, as well as partner and household testing and notification.
    • Targeted behavioral interventions, informed by person-centered and differentiated service delivery approaches, to drive adoption among patients and care providers.

Impact they are seeking

• Through this Call for Proposals, Unitaid aims to reduce vertical (mother-to-child) transmission of HIV, syphilis, hepatitis B (HBV) and Chagas in endemic areas by driving the adoption of comprehensive and integrated elimination of vertical transmission programs. In particular, Unitaid seeks to:
  • Support countries in the design, execution, and transition-to-scale of integrated elimination programs, including generating evidence on effective and scalable implementation models in diverse settings.
  • Address market barriers by improving affordability, availability, and access to essential commodities for eliminating vertical transmission.
  • Amplify demand for integrated elimination initiatives with community-driven, locally-adapted strategies.
• The objectives outlined above will lead to:
  • improved maternal and neonatal health outcomes stemming from increased treatment coverage and the effectiveness of eliminating vertical (mother-to-child) transmission programs,
  • economic efficiencies within health systems through the expansion of integrated elimination strategies at primary care levels and through the deployment of new products, and
  • increased equitable access to cost-effective vaccines, diagnostics, and treatments in LMICs.
• The goal is to enable widespread access to a comprehensive care package through scale-up by governments and partners, to contribute to the global health response to diseases that predominantly affect mothers and children in LMICs.

Criteria

• Unitaid considers working with communities a critical part of generating demand and strongly encourages adopting inclusive approaches, and the early and continued meaningful engagement of communities towards improving the lives and health of the most vulnerable people.
• Unitaid sees value in proposals from South-based lead implementers with experience in leading the implementation of large-scale multi-country projects that support access to health products in LMICs. They also support the meaningful inclusion of South-based sub-implementers, where feasible and relevant, in proposed project implementation consortia.
  • Unitaid is committed to climate and environmental action in its investments and expects its partners to make similar commitments. Proposals should clearly indicate:
    • Efforts that will be made to minimize carbon emissions from project activities;
• Potential opportunities to contribute to broader climate and/or environmental co-benefits, in synergy with core project objectives.
• Proposals should demonstrate value for money and measurable impact. Proposals should also include analysis of pathways to impact, scalability, and sustainability of key interventions.
• Areas out of scope for this Call include: product development, single-country interventions.

For more information, visit Unitaid.