Delivering Comprehensive and Sustainable HIV/AIDS Clinical and Community Services to Achieve HIV Epidemic Control in Subnational Units in Nigeria under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH22 2234

Opportunity Information: Apply for CDC RFA GH22 2234

This funding opportunity, titled "Delivering Comprehensive and Sustainable HIV/AIDS Clinical and Community Services to Achieve HIV Epidemic Control in Subnational Units in Nigeria under PEPFAR" (Funding Opportunity Number CDC RFA GH22 2234), is a CDC cooperative agreement designed to support Nigeria in reaching and sustaining HIV epidemic control. It sits within the PEPFAR framework and focuses on strengthening high-quality HIV care and treatment services at both facility and community levels across multiple Nigerian states, with an explicit emphasis on performance, equity, and long-term sustainability in partnership with the Government of Nigeria (GON).

The funding structure is a bit unusual on paper: the Year 1 award ceiling is listed as 0 (meaning CDC is not setting a maximum cap per award in that field), but CDC anticipates about 160,000,000 USD in total FY funding for Year 1 across all awards, subject to funds being available. Rather than applying for the entire 160,000,000 USD, applicants are instructed to apply to the approximate average one-year award amount of 40,000,000 USD. Applicants are expected to build a workplan and budget that spends roughly 40,000,000 USD to implement activities in 4 to 5 states, and those states must include at least one high-burden state. CDC anticipates making about 4 awards, and the final funding level and the exact geographic scope for each recipient will be set at the time of award based on programmatic decisions and available funds.

Programmatically, the goal is to help the GON achieve HIV epidemic control across CDC-supported states, with results monitored within age and sex bands to ensure progress is not masking gaps for specific groups (for example, adolescents, men, or other populations that may have lower testing or treatment coverage). Implementing partners are expected to deliver comprehensive HIV care and treatment services that push toward the UNAIDS 95-95-95 targets by 2030: 95 percent of people living with HIV knowing their status, 95 percent of those diagnosed receiving sustained antiretroviral therapy (ART), and 95 percent of those on ART achieving viral suppression. The opportunity recognizes Nigeria has made important gains, but argues that epidemic control will require continued, accelerated ART scale-up paired with proven prevention, treatment, and retention approaches to reduce new infections and HIV-related deaths.

A central theme is client-centered service delivery using differentiated service delivery (DSD) models. In practice, this typically means tailoring how care is delivered to different patient needs and contexts rather than using a single uniform clinic model for everyone. The NOFO highlights the use of evidence-based, client-centered models supported by real-time data collection, analysis, and continuous quality improvement (QI). The intent is to improve program performance and accountability, identify problems quickly (like treatment interruptions, low viral load coverage, or poor retention in certain sites or populations), and rapidly implement fixes using data-driven management approaches.

Another key feature is integration. The NOFO explicitly promotes integrating HIV service delivery with the management of other infectious and non-communicable diseases, calling out tuberculosis (TB) and COVID-19 in particular. This reflects the reality that people living with HIV often need services that intersect with TB screening and treatment, respiratory infection management, and broader chronic care systems. Integration is also positioned as a way to make programs more resilient and efficient, reduce fragmentation for patients, and strengthen health systems rather than building isolated HIV-only service lanes.

The opportunity also emphasizes prioritizing at-risk and marginalized populations through targeted, client-centered interventions. While the summary text does not list specific population categories, the direction is clear: partners should design approaches that actively reach people who are frequently missed by standard facility-based services, address barriers such as stigma or access limitations, and ensure that the scale-up of testing, treatment initiation, and retention does not leave behind groups with historically lower coverage and worse outcomes.

Finally, sustainability is not treated as an add-on but as a required direction of travel. Recipients are expected to jointly develop a phased sustainability framework with the GON to guide implementation across all sub-national units (SNUs). The idea is to move beyond short-term service delivery outputs and strengthen local ownership, local partnerships, and the operational commitments needed to maintain epidemic control over time. In a cooperative agreement context, this also implies substantial CDC involvement in strategic direction and collaboration, with recipients working closely with CDC and national and subnational stakeholders to align with Nigeria's HIV response architecture.

Administrative details from the source data include that this is a discretionary funding opportunity under CFDA 93.067, issued by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH). Eligibility is listed as unrestricted (open broadly to entity types, subject to any specific clarifications in the full notice). The opportunity was created December 28, 2021, with an original application closing date of February 28, 2022, and electronically submitted applications due by 11:59 pm Eastern Time on the deadline date.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Delivering Comprehensive and Sustainable HIV/AIDS Clinical and Community Services to Achieve HIV Epidemic Control in Subnational Units in Nigeria under the President's Emergency Plan for AIDS Relief (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 Dec 28, 2021.
• Applicants must submit their applications by Feb 28, 2022 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 4 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.

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