Supporting Laboratory Systems Strengthening Activities in Ghana under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH21 2110

Opportunity Information: Apply for CDC RFA GH21 2110

Supporting Laboratory Systems Strengthening Activities in Ghana under the President's Emergency Plan for AIDS Relief (PEPFAR) is a CDC cooperative agreement funding opportunity designed to strengthen the systems that make HIV-related laboratory testing reliable, timely, and scalable in Ghana. It sits within the broader PEPFAR effort to help countries reach and sustain HIV epidemic control by improving the quality of testing services, ensuring results move quickly through the health system, and building national capacity that can be maintained over time. The opportunity is administered by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), under CFDA 93.067, and was released as CDC RFA GH21 2110.

The public health rationale is tied to Ghana's HIV context. Ghana has an estimated population of about 29.3 million and roughly 330,000 people living with HIV (UNAIDS 2018). The epidemic is described as mixed, with higher prevalence in urban settings than rural areas, higher prevalence among women than men, and much higher prevalence in key populations. The notice cites an estimated adult prevalence of 1.7% (Spectrum 2019), with substantially higher rates among men who have sex with men (about 18.1% based on GMS II 2017) and female sex workers (about 6.9% based on IBBSS 2016). In that environment, laboratory systems matter because testing volume, specimen movement, turnaround time, and data quality directly affect whether clients are diagnosed early, linked to treatment, and monitored effectively through viral load testing.

The award is structured as a cooperative agreement, which typically means CDC expects substantial involvement during implementation, such as joint planning, technical guidance, and performance monitoring. Eligibility is listed as unrestricted (open to any entity type), with the usual caveat that applicants must follow any additional eligibility clarifications contained in the full announcement. The opportunity anticipated a single award (ExpectedAwards: 1), meaning one recipient would likely be responsible for delivering the full set of activities in coordination with government and partners.

Funding details in the notice include a somewhat unusual presentation that is important to interpret carefully. The listing states an "Award Ceiling" of 250,000, while also noting that the "Award Ceiling for Year 1 is 0 (none)" and that CDC anticipates an approximate total fiscal year funding amount of $250,000 for Year 1, subject to the availability of funds. In practical terms, the key takeaway is that CDC projected about $250,000 in first-year funding depending on appropriations and internal allocations, with final amounts ultimately determined at the time of award. Applications were due by March 8, 2021, submitted electronically by 11:59 p.m. Eastern Time.

Programmatically, the opportunity is focused on strengthening the backbone of HIV laboratory services rather than delivering direct clinical care. A central piece is the national sample transport system. Ghana established a national sample transport system in fiscal year 2019 to move specimens for HIV testing and viral load using the national postal courier. Building on that, CDC's planned work emphasizes continued monitoring and iterative updates to that transport network so samples can move consistently from collection sites to testing laboratories and results can return in a timeframe that supports clinical decision-making. This is the kind of systems work that often determines whether viral load monitoring can function at scale, especially when specimens must travel from peripheral facilities to centralized testing platforms.

Another core emphasis is viral load data management. Viral load testing is only as useful as the system that captures, transmits, reconciles, and uses the results. The announcement highlights monitoring, updates, and implementation of a viral load data management system, pointing toward activities such as strengthening electronic data flows, improving data completeness and accuracy, reducing result backlogs, and making sure laboratories and treatment sites can reliably match results to patients. In PEPFAR programs, this often includes improving interfaces between laboratory information systems and national health information systems, standardizing identifiers and result formats, and training staff on data quality and routine use of reports for performance management.

The opportunity also prioritizes laboratory quality improvement and long-term capacity. It calls for capacity building of laboratories toward international accreditation, which typically involves structured quality management systems, documentation practices, internal audits, equipment maintenance programs, and standardized operating procedures aligned to recognized standards. Alongside accreditation readiness, the notice mentions proficiency testing and corrective action training. Proficiency testing is a way to verify that laboratories can produce accurate results on standardized samples, while corrective action training focuses on what laboratories do when performance problems are detected, such as root cause analysis, retraining, instrument troubleshooting, and follow-up monitoring to confirm issues are resolved. Together, these activities are aimed at making viral load and other HIV-related test results dependable enough to guide treatment decisions and program planning.

Geographically, the notice explains that beginning in fiscal year 2020, PEPFAR activities concentrated on one priority region, the Western Region, with support from a backup laboratory at Korle Bu in Accra. The intent was to demonstrate that epidemic control could be achieved through evidence-based interventions in a defined area, generating lessons that the Government of Ghana could then replicate nationally. This grant opportunity continues that strategic approach by supporting laboratory systems that serve the Western Region focus while also strengthening national-level systems like sample transport and data management that can be expanded and sustained.

Coordination is presented as a major operating principle of the project. CDC notes close collaboration with the Ghana Health Service, the Ghana AIDS Commission, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, other CDC divisions, and other development partners. That matters because laboratory strengthening overlaps with multiple disease programs and funding streams, and duplication can quickly occur if partners are not aligned on platforms, sample referral routes, data tools, and quality standards. The opportunity is therefore as much about harmonizing and optimizing existing systems as it is about introducing new tools.

In summary, this CDC PEPFAR opportunity funds a single recipient to help Ghana strengthen the laboratory systems that underpin HIV testing and viral load monitoring, with particular attention to the national sample transport network, viral load data management, and laboratory quality systems (including accreditation preparation and proficiency testing with corrective actions). The work is positioned to support a focused PEPFAR implementation area in the Western Region while reinforcing national structures that can be replicated and scaled, and it is designed to be implemented in tight coordination with Ghana's government institutions and major partners like the Global Fund.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Supporting Laboratory Systems Strengthening Activities in Ghana 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 Jan 08, 2021.
• Applicants must submit their applications by Mar 08, 2021 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 $250,000.00 in funding.
• 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.

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