Transitioning and Integrating Laboratory Services for High Quality HIV Diagnosis, Care, Treatment, and Monitoring to the Ministry of Health (MOH) to Sustain Achievement of the 95-95-95 Goals in Zambia under PEPFAR | CDC RFA GH 23 0010

Opportunity Information: Apply for CDC RFA GH 23 0010

This funding opportunity (CDC RFA GH 23 0010) is a PEPFAR-supported cooperative agreement from the U.S. Centers for Disease Control and Prevention (CDC) focused on helping Zambia transition key HIV-related laboratory systems and services from donor support to full Government of the Republic of Zambia (GRZ) ownership, primarily through the Ministry of Health (MOH). The overall intent is to protect and sustain progress toward the HIV 95-95-95 targets by ensuring that laboratory services for diagnosis, treatment initiation, and long-term monitoring remain reliable, timely, and high quality as responsibilities shift to national systems. Although the notice lists an award ceiling of 0 for Year 1 (meaning no formal cap was stated), CDC anticipated approximately USD 9,000,000 in total Year 1 funding, dependent on available funds, with a single award expected.

The core of the work is a stepwise, planned transition of PEPFAR-supported laboratory functions to GRZ, paired with targeted technical assistance to strengthen national capacity to manage, operate, and continuously improve these systems. The recipient is expected to work closely with CDC guidance and MOH priorities to make the diagnostic network more resilient and adaptable, including the ability to respond to immediate needs such as outbreaks of new or emerging diseases, expanded surveillance expectations, and evolving international reporting requirements. In practical terms, this means supporting laboratory governance, standardization, performance management, and operational readiness so Zambia can sustain high-quality testing services beyond external support.

A major emphasis is on ensuring continuity and quality across the HIV testing and monitoring cascade, especially viral load (VL) testing and early infant diagnosis (EID). The transition planning and assessment are expected to cover the full chain from sample collection and referral to testing, results reporting, and use of results for patient management. This includes strengthening sample transport and referral systems, ensuring stable testing and results return mechanisms, and maintaining the infrastructure needed for consistent turnaround times and coverage, particularly for remote and high-burden areas where logistics can undermine program performance.

Data systems integration is another central pillar. The opportunity calls for support to laboratory information management systems (LIMS) and their integration with national platforms, specifically SmartCare (Zambia's health information system used widely for HIV care), eLABS, and DHIS2. The goal is to ensure that laboratory data flows accurately and securely from testing sites to clinicians and program managers, improving clinical decision-making, cohort monitoring, and national reporting. This also supports accountability for the 95-95-95 goals by improving the completeness and timeliness of indicators like viral suppression monitoring and EID result return.

Laboratory quality and accreditation-related functions are explicitly included. The transition assessments and strengthening activities are expected to address external quality assurance (EQA) systems aligned with ISO 17043 implementation, quality management systems (QMS), and continuous improvement processes that keep testing accurate across the network. The scope also includes rapid test continuous quality improvement (RTCQI), specifically noted as linked to baseline viral load activity, which reflects a broader intent to maintain confidence in point-of-care and rapid testing quality as testing strategies evolve.

The opportunity also covers the operational backbone required to keep laboratories functional day to day. This includes diagnostic equipment maintenance programs, calibration facilities and systems, and broader equipment lifecycle management. It also highlights courier vehicle replacement, salvage, and maintenance programs, recognizing that transport fleets are often essential for sample movement, specimen integrity, and results delivery. Waste management and backup power systems are included as well, reflecting the practical realities that biosafety, continuity of operations, and infrastructure stability are foundational to reliable testing.

Biosafety and biosecurity programming is another required component, ensuring laboratories have the policies, training, and facility-level safeguards to handle infectious materials safely and to reduce risks related to pathogen exposure, accidental release, or misuse. This is especially relevant given the stated expectation that the diagnostic system should be adaptable for novel disease outbreaks and expanded surveillance demands, which can increase the range and complexity of testing performed.

The notice also points to laboratory-specific supply chain management as a transition priority. This focuses on the systems that forecast, procure, store, distribute, and monitor reagents, consumables, and other critical inputs needed for uninterrupted testing. Supply chain weaknesses frequently cause testing interruptions, instrument downtime, and backlogs, so this area is directly tied to sustaining viral load coverage, EID performance, and reliable routine diagnostics.

Finally, the opportunity frames laboratory services as increasingly integrated rather than siloed, explicitly including integrated testing that can incorporate services like human papillomavirus (HPV) and tuberculosis (TB) alongside HIV-related testing where appropriate. This reflects a health systems approach, where investments in specimen referral, quality systems, information systems, maintenance, and workforce capacity can support multiple disease programs while still protecting HIV outcomes.

By the end of the project period, the recipient is expected to complete two major assessments to support sustainable handover and long-term planning. First is a capacity assessment of GRZ to carry out all laboratory system functions, identifying what can already be absorbed by MOH and where additional strengthening is still required. Second is a cost assessment to fully understand the financial requirements of sustaining the laboratory system over time, which is critical for domestic budgeting, medium-term expenditure planning, and reducing reliance on external financing. Together, these deliverables are meant to give MOH and partners a realistic roadmap for full transition while preserving the laboratory performance needed to maintain and extend Zambia's progress toward the 95-95-95 HIV targets.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Transitioning and Integrating Laboratory Services for High Quality HIV Diagnosis, Care, Treatment, and Monitoring to the Ministry of Health (MOH) to Sustain Achievement of the 95-95-95 Goals in Zambia under PEPFAR" 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 Jan 25, 2023.
• Applicants must submit their applications by Mar 26, 2023 Electronically submitted applications must be submitted no later than 1159 pm 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: Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled Additional Information on Eligibility.

Apply for CDC RFA GH 23 0010

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