CFAs: Global Resilience against Drug-Resistant Tuberculosis

Deadline Date: May 31, 2024

Donor Name: United States Agency for International Development (USAID)

Grant Size: More than $1 million

The United States Agency for International Development (USAID) is currently inviting applications for the Global Resilience against Drug-Resistant Tuberculosis program to support USAID TB countries to improve DR-TB detection, treatment, and prevention through the development and implementation of innovative approaches and practices, and the provision of specialized technical assistance to the local partners and National TB programs.

Additionally, the Activity will support countries to fulfill their commitments set at the 2023 UNHLM on TB in line with WHO’s End TB Strategy and USAID’s Global TB Strategy 2023- 2030. As a result, this Activity will reduce the DR-TB burden through improved rapid detection, treatment, and prevention activities, while building a sustainable and resilient system using local organizations and approaches that are equitable, inclusive, and accessible.

Drug-resistant TB (DR-TB) is a severe form of TB that occurs when resistance is developed to core anti-TB medications and requires treatment with a novel combination of drugs referred to as second line drugs (SLDs). The prevention, diagnosis, and treatment of DR-TB is one of the key priorities of USAID’s Global TB Strategy for 2023-2030 as well as the United Nations High Level (UNHLM) meeting on TB. By the end of 2030, USAID strives to reach, detect, and enroll on treatment at least 90% of the estimated drug-sensitive (DS) and DR-TB cases and successfully and appropriately treat 90% of those individuals in priority TB countries.


  • The Activity provides comprehensive technical assistance (TA) to local organizations and the NTPs and Ministries of Health in the 24 USAID designated priority countries to address the DR-TB epidemic. The Activity will assist countries with the development of equitable strategies and inclusive approaches for DR-TB response, assist with in-depth analysis of DR-TB data and statistics, support the development of focused short and long-term DR-TB action plans, and provide comprehensive TA throughout the implementation of these plans. In addition, the Activity will provide rapid response and on-demand short-term TA to both 24 TB priority countries and the 32 Global Fund TA (GFTA) TB countries to assist with improving performance of the Global Fund (GF) TB grants.
  • The Activity will achieve results under the following objectives: 
    • Objective 1: Strengthened capacity of local organizations to lead the DR-TB response at the national and sub-national level through enhanced partnerships with NTPs and other key stakeholders:
      • Under this Activity, comprehensive technical assistance, training and mentoring to national, subnational local organizations is a priority to enable them to lead national and sub-national TB responses through policy development and comprehensive implementation. To that end, the Activity aims to provide targeted technical assistance to local organizations and sub-national entities to enhance their technical and programmatic capabilities to address DR-TB among marginalized, underrepresented, vulnerable and high-risk populations for both short-term on-demand requests and long-term continued efforts. Specific technical support and interventions will be determined by the local partner in consultation with the NTP and USAID Missions. Technical support will be aligned with the NSP and based on action plans developed through evidence-generated analyses and assessments. The types of local organizations that will be supported by the Activity may vary based on the country landscape and the priorities of the NTP.
      • Expected Results: 
        • Strengthened capacity of local organizations to provide support for DR-TB detection, treatment, and prevention;
        • Improved capacity of private sector entities to deliver DR-TB detection, treatment and prevention services; 
        • Increased involvement of community workers and organizations in the provision of DR-TB services; and 
        • Strengthened linkages between local organizations and NTP and other key stakeholders.
    • Objective 2: Improved quality of host country governments’ DR-TB program at the national and sub national level:
      • The Activity will engage all levels of the NTP including National and Regional TB Reference Labs, central and regional levels of the NTP, as well as district level healthcare providers. Technical support and interventions may then be carried forward and incorporated into the next GF grant cycle, NSP, country guidelines, and local partner implementation plans to ensure continuity and sustainability of the technical support.
      • Expected Results: 
        • Strengthened and improved host country government organizational and technical capacity to manage the DR-TB program; 
        • Strengthened capacity of medical advisory committees and other treatment entities to advice on advanced and complicated TB clinical cases; 
        • Improved DR-TB detection, treatment and prevention approaches that are innovative, equitable, inclusive, and accessible and meet international standards; 
        • Improved data and information systems for the DR-TB program; and 
        • Expanded approaches for vulnerable groups to access quality DR-TB services that are integrated in the delivery of primary healthcare services.
    • Objective 3: Enhanced knowledge management through on-demand specialized tool development, evidence-based approaches, and tailored trainings at the global and regional levels:
      • DR-TB diagnosis, treatment, and prevention is rapidly evolving due to new evidence, tools and approaches through global and regional research efforts that have resulted in changes in international policies and guidelines. In order to operationalize these innovations, there is a need to translate the policies and guidelines quickly and efficiently into practical implementation at the country level. This may involve adaptation of guidelines and development of standard operating procedures (SOPs), training of trainer plans, and other support to ensure a more rapid uptake. This may include the introduction of new diagnostic equipment, application of novel medicines and treatment options, as well as preventive approaches for people affected by DR-TB.
      • Expected Results: 
        • Developed and deployed new evidence and guidance through innovative tools and approaches; 
        • Strengthened capacity of key stakeholders to adopt and rapidly roll-out new evidence and guidance including monitoring of alignment with international standards on a routine basis; and 
        • Improved availability of information and increased knowledge sharing across countries on DR-TB evidence-based approaches.

Funding Information

  • USAID intends to provide $90,000,000.00 in total USAID funding. 
  • The anticipated period of performance is five years. 

Geographic Focus

  • It is anticipated that approximately 85% of the technical support via this Activity will be country specific with the remaining 15% being technical support at the global or regional level. Of the country specific work, more than 80% is estimated to be in the 24 USAID TB priority countries with the remaining work in the 32 TB GF TA countries.
  • Africa, comprised of the following countries: Democratic Republic of Congo, Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Africa, Tanzania,
  • Uganda, Zambia, Zimbabwe, Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Eswatini, Ghana, Guinea, Lesotho, Liberia, Mali, Madagascar, Namibia, Niger, Republic of Congo, Rwanda, Senegal, Sierra Leone, Somalia, South Sudan.
  • Asia, comprised of the following countries: Afghanistan, Bangladesh, Burma, Cambodia, India, Indonesia, Pakistan, Philippines, Vietnam, Nepal, Mongolia.
  • Eurasia and Central Asia, comprised of the following countries: Kyrgyz Republic, Tajikistan, Ukraine, Uzbekistan, Armenia, Azerbaijan, Georgia, Kazakhstan, Moldova.

Eligibility Criteria

  • Eligibility for this NOFO is full and open competition without restriction; thus, open to all eligible and qualified U.S., local and international non-governmental entities. 
  • Profit is not allowable for recipients or sub recipients under this award. While for-profit organizations may participate, pursuant to 2 CFR 700.13(a)(1), “Prohibition against Profit”, no profit/fee will be paid to any entity/organization receiving or administering Federal financial assistance as a recipient or sub recipient (consortium partner). Applicant/recipient is responsible for complying with all applicable U.S. and Host Governments’ laws and regulations. 
  • USAID welcomes applications from organizations that have not previously received financial assistance from USAID. Faith-based organizations are eligible to apply for federal financial assistance on the same basis as any other organization and are subject to the protections and requirements of Federal law.
  • The Applicant is reminded that the U.S. Executive Orders and U.S. law prohibits transactions with, and the provision of resources and support to, individuals and organizations associated with terrorism. It is the legal responsibility of the Recipient to ensure compliance with these Executive Orders and laws.
  • A cost share is required under this potential award. USAID has established a mandatory Recipient cost share for this award at a minimum 2% of the projected award amount of $90,000,000.00 (i.e. minimum cost share amount is $1,800,000.00). Such funds may be provided directly by the Recipient; other multilateral, bilateral, and foundation donors; host governments; and local organizations, communities and private businesses that contribute financially and in-kind to implementation of activities at the country level.

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