Opportunity Information: Apply for CDC RFA GH18 1816
The funding opportunity titled "Center of Excellence for Comprehensive Integrated HIV Care and Treatment Services in Lilongwe, Malawi under PEPFAR" (Funding Opportunity Number: CDC RFA GH18-1816) is a U.S. Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS) cooperative agreement focused on strengthening advanced, high-quality HIV service delivery in Lilongwe. It is designed around a practical reality in HIV programming: while Malawi and other countries have made major gains by expanding antiretroviral therapy (ART), the next phase of impact depends on delivering care that is more tailored to different patient needs without losing the efficiency and reach of a public health approach. In other words, the goal is not simply to provide ART at scale, but to ensure that people living with HIV receive the right level of clinical attention and wraparound support based on age, gender, stage of disease, and treatment stability.
At the center of the award is implementation support for two purpose-built, referral-level Lighthouse Trust clinics in Lilongwe. These clinics are intended to function as a specialized hub or "center of excellence" where comprehensive HIV testing and treatment services can be delivered at consistently high quality, especially for patients who need more advanced clinical management than what is typically available at primary facilities. The work emphasizes a structured set of core service packages covering both early and late stages of HIV infection, as well as differentiated care for stable patients doing well on ART and unstable patients who require closer follow-up. A major feature is the prevention, early detection, and management of acute comorbidities, recognizing that clinical outcomes depend heavily on identifying and treating complications that can derail adherence and survival.
A defining element of the opportunity is service integration. The supported model is not limited to HIV care alone; it intentionally links HIV services with tuberculosis (TB) services, sexually transmitted infection (STI) services, reproductive health, and priority non-communicable disease (NCD) interventions. This approach reflects the overlapping burden faced by patients and the efficiency gained when one visit addresses multiple health needs. Integrated care also supports better retention and continuity because patients are less likely to drop out when services are coordinated, accessible, and responsive to what they actually experience day to day.
The award also prioritizes program strategies that improve the full cascade of care. This includes stronger case identification (finding people who do not yet know their HIV status or are not engaged in care), active linkage to treatment services after diagnosis, early initiation of ART, and adherence support designed to help patients remain on therapy and achieve durable viral suppression. Viral suppression is emphasized as a key endpoint because it is central to both individual health outcomes and HIV transmission reduction at population level. The clinics are expected to use targeted interventions for specific populations to close gaps in testing, linkage, retention, and suppression outcomes.
Because referral-level sites often care for more complex cases, the recipient is expected to provide specialist clinical review for patients requiring second-line and third-line ART regimens. This component addresses treatment failure, resistance concerns, and the need for careful regimen selection and monitoring when first-line therapy is no longer effective. In many settings, these cases require higher clinical expertise, stronger laboratory and monitoring systems, and more intensive adherence counseling, so the cooperative agreement supports an environment where complicated treatment decisions can be made reliably and in alignment with national guidelines.
Beyond direct clinical services, the opportunity includes explicit health system investments. These include capacity building (such as training, mentorship, and supportive supervision to strengthen the clinical and management workforce), development of eHealth activities (to improve data use, patient tracking, reporting, and potentially clinical decision support), and direct support to national HIV and TB program management functions. This reflects the idea that better outcomes are not achieved only through individual patient encounters, but also through stronger systems for planning, monitoring, and quality improvement.
The work is meant to be carried out in close collaboration with Malawi's Ministry of Health (MOH), specifically the Department of HIV and AIDS. A core expectation is that the recipient will help generate and document evidence-based best practices from implementation at the Lighthouse Trust clinics and translate those lessons into guidance that can inform the national program. The practical intent is to use the clinics as learning sites that test and refine high-performing models of differentiated, integrated care, then spread what works to support national scale-up. This evidence-to-policy link is tied to Malawi's progress toward the UNAIDS 90-90-90 targets, which focus on increasing the proportion of people living with HIV who know their status, are on sustained ART, and are virally suppressed.
Administratively, this is a discretionary award using a cooperative agreement mechanism, which generally implies substantial CDC involvement and ongoing collaboration during implementation rather than a hands-off grant. The CFDA number is 93.067. The opportunity anticipated a single award (Expected Awards: 1) with an award ceiling of $7,000,000. The NOFO was created on October 10, 2017, with an original application closing date of December 9, 2017 (electronically submitted applications due by 11:59 p.m. ET). Eligibility is listed broadly as "Others" with additional eligibility details referenced in the full announcement.Apply for CDC RFA GH18 1816
- The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Center of Excellence for Comprehensive Integrated HIV Care and Treatment Services in Lilongwe, Malawi 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 Oct 10, 2017.
- Applicants must submit their applications by Dec 09, 2017 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.)
- Each selected applicant is eligible to receive up to $7,000,000.00 in funding.
- 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).
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