Health Systems Strengthening and HIV/AIDS Prevention, Care and Treatment under the President's Emergency Plan for AIDS Relief


Fund human resources for health, quality improvement and other health system strengthening activities in countries hit hardest by HIV/AIDS through the President’s Emergency Plan for AIDS Relief (PEPFAR). Objectives include:
(1) Training and technical assistance to build and strengthen care programs and health systems, so that affected countries can maintain programs over time and deliver quality HIV/AIDS care; build infrastructures such as clinic monitoring, health information systems, and medical and nursing education.
(2) Enhance models of medical, nursing and midwifery education.
(3) Develop partnerships—between experts in the U.S. and people and institutions overseas—to build skills and prepare host countries so that they may better manage their own programs over the long term.

Health Systems Strengthening Programs:
(1) Global HIV/AIDS Nursing Initiative/Nursing Capacity Building Program Cooperative Agreement (CoAg)
(2) International Twinning Center (CoAg)
(3) Quality Improvement Capacity for Impact Project (CoAg)
(4) International AIDS Education and Training Center (CoAg)
(5) Medical Education Partnership Initiative (4 Grants)
(6) Medical Education Partnership Initiative Coordinating Center (CoAg).
(7) High Impact Workforce Interventions (Mechanisms TBD).

General information about this opportunity
Last Known Status
Program Number
Federal Agency/Office
Agency: Department of Health and Human Services
Office: Health Resources and Services Administration
Type(s) of Assistance Offered
Cooperative Agreements; Project Grants
Program Accomplishments
Not Applicable.
Sections 301(a) and 307 of the Public Health Service Act (42 U.S.C. §241(a), 242l), and the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (Public Law 110-293) and the PEPFAR Stewardship and Oversight Act of 2013 (S.1545/ H.R. 3177).
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
Eligibility varies depending on the specific program. Applicants should review the individual HRSA funding opportunity announcements issued under this CFDA for specific eligibility requriments.
Beneficiary Eligibility
Beneficiaries are foreign governments, foreign public or private institutions or organizations, or foreign individuals.
Applicants should review the individual HRSA funding opportunity announcement issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. 2 CFR 200, Subpart E - Cost Principles applies to this program.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is required. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.
Application Procedure
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. For governmental organizations both the OMB Circular No. A-87 and No. A-102 (45 CFR Part 92) apply to this program. For universities or nonprofit non-governmental organizations, OMB Circular No. A-110 (45 CFR Part 74) and No. A-122 apply.

HRSA requires all applicants to apply electronically through

Award Procedure
All qualified applications will be forwarded to an objective review committee. Based on the advice of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions.

Notification is made in writing (electronic) by a Notice of Award.
Contact the headquarters or regional office, as appropriate, for application deadlines.
Approval/Disapproval Decision Time
3-6 months.
Not Applicable.
Grants are typically awarded for up to a three or five year project period. Competitive awards are made every 3 to 5 years.
How are proposals selected?
Applications will be evaluated on the extent to which proposed objectives are specific, measurable, time-phased, and consistent with the stated purpose of this program; the extent to which the applicant's capability is sufficient in the areas of clinical care, drug and health commodities, laboratory services, training, community mobilization and behavior, health information systems, health systems strengthening, monitoring and evaluation and sustainability; feasibility of their expansion plan; extent to which the organizational structure, management and staffing is appropriate and sound and the presentation of a reasonable budget.
How may assistance be used?
Cooperative Agreements or grants will be awarded to organizations that execute one or more of the objectives above.
What are the requirements after being awarded this opportunity?
Annual program reports (non-competing continuation applications – NCC) are required. No cash reports are required. Quarterly or semi-annual progress reports may also be required. Reports should provide progress on achieving objectives and modifications or new objectives. The Federal Financial Report is to be submitted within 90 days after the close of each budget period and a final Federal Financial Report is required 90 days following the end of the project period. Expenditure reports may be required. No performance monitoring is required.
In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503.
Grantees are required to maintain grant accounting records 3 years after the date they submit the Federal Financial Review (FFR). If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.
Other Assistance Considerations
Formula and Matching Requirements
Statutory formulas are not applicable to this program.
Matching requirements are not applicable to this program.
MOE requirements are not applicable to this program.
Length and Time Phasing of Assistance
Grants are typically awarded for up to a three or five year project period with 12-month budget periods. See the following for information on how assistance is awarded/released: Grantees drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.
Who do I contact about this opportunity?
Regional or Local Office
See Regional Agency Offices.
Headquarters Office
Harold Phillips 5600 Fishers Lane, Suite 7-90, Rockville, Maryland 20857 Phone: (301) 443-3650
Website Address
Financial Information
Account Identification
(Cooperative Agreements) FY 14 $99,037,052; FY 15 est $60,000,000; and FY 16 est $60,000,000. (Project Grants) FY 14 $7,400,000; FY 15 est $0; and FY 16 Estimate Not Available
Range and Average of Financial Assistance
Global HIV/AIDS Nursing Initiative -
Floor $500,000; Ceiling $20,000,000; Average $10,000,000

International Twinning Center -
Floor $500,000; Ceiling $10,000,000; Average $10,000,000

Quality Improvement Capacity for Impact Project -
Floor $6,00,000; Ceiling $20,000,000; Average $10,000,000

International AIDS Education & Training Center
Floor $1,000,000; Ceiling $60,000,000; Average $55,000,000

MEPI – (ending 8/31/15)
Floor $1,000,000; Ceiling $2,000,000; Average $1,500,000

MEPI Coordinating Center - (ending 8/31/15)
Floor $1,000,000; Ceiling $3,000,000; Average $2,000,000.

High Impact Workforce Initiative – (TBD)
Up to $10 million annually.
Regulations, Guidelines and Literature
Effective December 26, 2014, all administrative and audit requirements and the cost principles that govern federal monies associated with this award will be subject to the Uniform Guidance 2 CFR 200 as codified by HHS at 45 CFR 75, which supersede the previous administrative and audit requirements and cost principles that govern federal monies.

HRSA awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at

Examples of Funded Projects
Fiscal Year 2014: Global HIV/AIDS Nursing Initiative; International Twinning Center; International AIDS Education and Training Center; Medical Education Partnership. Fiscal Year 2015: No Current Data Available Fiscal Year 2016: No Current Data Available


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