Strengthening the Quality, Accessibility, and Sustainability of the National Health Laboratory Services (NHLS) in United Republic of Tanzania under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH18 1812

Opportunity Information: Apply for CDC RFA GH18 1812

The funding opportunity titled "Strengthening the Quality, Accessibility, and Sustainability of the National Health Laboratory Services (NHLS) in United Republic of Tanzania under the President's Emergency Plan for AIDS Relief (PEPFAR)" is a U.S. Centers for Disease Control and Prevention (CDC) cooperative agreement aimed at improving how Tanzania's national laboratory system functions and how well it supports HIV and TB programs. The core premise is that a strong health system depends on timely, accurate, and consistently available laboratory results, because those results guide diagnosis, treatment decisions, patient monitoring, and public health surveillance. This award is designed to reinforce Tanzania's NHLS across a six-tier network, spanning from the national level down through zonal, regional, district, health center, and dispensary levels, with the goal of making laboratory services more reliable, more accessible to patients, and more sustainable over time.

The program focuses heavily on technical assistance that improves laboratory quality and performance in priority diagnostic and monitoring areas. A major component is strengthening quality assurance for HIV rapid testing, which is often performed at decentralized sites and therefore requires standardized procedures, training, supervision, proficiency testing, and ongoing quality monitoring to prevent false positives or false negatives. The opportunity also targets tuberculosis diagnostics by supporting quality improvements in TB microscopy and GeneXpert testing, both of which are critical for detecting TB and drug-resistant TB, and for ensuring results are accurate and delivered quickly enough to affect patient care.

Another central emphasis is expanding and maintaining Early Infant Diagnosis (EID) and Viral Load (VL) testing. EID is essential for identifying HIV infection in infants as early as possible so that treatment can begin promptly, while viral load testing is the cornerstone for monitoring treatment effectiveness and detecting treatment failure. The FOA highlights both the establishment and the scale-up of EID and VL monitoring programs, implying support not just for adding capacity, but also for keeping these services functional over time through routine maintenance, quality systems, staffing support, and reliable supply chains. In practical terms, this kind of work typically involves strengthening testing networks, improving turnaround times, ensuring appropriate specimen handling, and monitoring performance metrics that show whether results are reaching clinicians and patients quickly enough.

Because Tanzania's lab network includes many facilities that cannot perform advanced testing onsite, the opportunity also prioritizes building an efficient sample referral and transport system. This includes establishing and maintaining specimen transport routes, clarifying responsibilities across tiers of the network, improving packaging and cold-chain practices where needed, and creating tracking mechanisms so specimens and results do not get lost or delayed. A strong referral system is especially important for EID and VL samples that may originate in remote settings but must be tested at higher-tier laboratories, and it directly affects equity and access by enabling people in rural or underserved areas to benefit from the same laboratory services available in major centers.

The FOA places significant weight on implementing Laboratory Quality Management Systems (QMS) and Laboratory Information Management Systems (LIMS). QMS implementation is aimed at standardizing how laboratories work so that quality is not dependent on individual staff members or ad hoc practices; it typically covers documentation, standard operating procedures, internal quality control, external quality assessment, equipment management, safety, corrective actions, and continuous improvement. LIMS implementation focuses on strengthening data capture, sample tracking, workflow management, and reporting, which can reduce transcription errors, speed up result delivery, and provide better visibility into laboratory performance. Together, QMS and LIMS are intended to improve the credibility of results, increase efficiency, and make the system more durable by embedding best practices into routine operations.

Commodity security is another explicit priority area. The opportunity calls for improved quantification and forecasting of laboratory commodities, which is essential to avoid stockouts of test kits, reagents, consumables, and other supplies that can halt services or force rationing. Better forecasting supports continuity of testing, stabilizes turnaround time, and reduces emergency procurement costs. This complements the broader sustainability objective by improving planning and reducing disruptions that undermine confidence in the health system.

The FOA also includes HIV Drug Resistance Surveillance as a technical focus. Drug resistance surveillance uses laboratory testing and structured monitoring to detect emerging resistance patterns that can compromise antiretroviral therapy regimens. Strengthening this area helps national programs adjust guidelines, improve treatment outcomes, and protect the effectiveness of available drugs. Alongside this, the opportunity stresses the effective use of laboratory data for program management, meaning that laboratory information should not only be generated but also analyzed and applied to decision-making. That can include using data to identify gaps in coverage, monitor turnaround times and quality indicators, plan procurement, target supportive supervision, and measure progress toward national HIV and TB goals.

Administratively, this is a discretionary funding opportunity issued by CDC under the Center for Global Health (CGH) as a cooperative agreement, indicating CDC expects substantial involvement and collaboration during implementation rather than a fully hands-off grant model. The opportunity number is CDC RFA GH18-1812, listed under CFDA 93.067. Eligibility is described as unrestricted, meaning a wide range of applicant organizations could apply. The original closing date was October 23, 2017. The award ceiling is $5,165,000, and CDC anticipated making two awards, suggesting an implementation model that could involve multiple partners supporting different components, regions, or technical areas within the national laboratory strengthening agenda.

Overall, the opportunity is structured around a systems-strengthening approach: improving test quality, expanding access to critical HIV and TB diagnostics and monitoring, building robust referral and transport networks, institutionalizing quality and information systems, securing commodities, advancing drug resistance surveillance, and ensuring that laboratory data actually informs program decisions. The combined effect is intended to improve patient care and public health outcomes by making laboratory services across Tanzania more dependable, better connected, and more resilient over the long term under PEPFAR-supported priorities.

• The Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Strengthening the Quality, Accessibility, and Sustainability of the National Health Laboratory Services (NHLS) in United Republic of Tanzania 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 2017-08-02.
• Applicants must submit their applications by 2017-10-23. (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 $5,165,000.00 in funding.
• The number of recipients for this funding is limited to 2 candidate(s).
• Eligible applicants include: Unrestricted.

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