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Application Process


Only local academic institutions and/or other local NGOs with demonstrated expertise in health-related research and U.S institutions that are the prime recipients of HHS/NIH funding (either academic institutions or NGOs) for research are eligible to submit an application to be prime subawardees of the National Academies. When appropriate, U.S. NGOs applying as a prime partner are encouraged to include U.S. academic institutions as partners that can assist in building capacity and stronger technical collaborations with partner country academic institutions. To apply as a prime subawardee, a U.S. institution must have a current history of working in Mozambique and/or Malawi or demonstrate a substantial understanding of implementing CCS&PT and voluntary family planning programming in the region and demonstrate a partnership capable of rapid implementation in the partner country. As noted above, this application must be submitted as a joint application between the local partner and U.S. partner with separate budgets included for each. Both the U.S. institution and the local institution will be prime subawardees of the National Academies. The joint application should present a coherent description of how the activities in each application will complement one another. Local organizations that do not have expertise in implementation research or U.S or other international organizations that do not receive HHS/NIH funding for research can be part of the application as sub-partners of the prime subawardees, but cannot be prime subawardees.

The local partner that is a prime subawardee of the National Academies will play a key role in designing, conducting, and analyzing results from implementation research, as well as in helping with real-time translation of results into policy and programs within the country. The U.S. institution that is a prime subawardee will collaborate with the local partner on the research components, including specific activities designed to strengthen the local institution’s research capacity. To ensure efficient implementation, the U.S institution and/or potentially the local partner (if it has a strong track record of managing large implementation projects), will be expected to make subawards to one or more additional implementing organizations that have demonstrated capacity to support integrated family planning and CCS&PT in low-income countries in sub-Saharan Africa, preferably in diverse regions of Malawi or Mozambique. Details of available funding support for these awards are outlined in Section III: Available Funding Support.

As noted earlier, while a substantial proportion of the funding should support implementation research, the majority of funding should be utilized to improve service delivery, including through supporting implementation and scale-up of innovative or improved technologies and approaches. With regard to support for implementation, forming consortia of partners with complementary expertise is encouraged. Such consortia would include one or more NGOs with proven expertise in implementation of new technologies for CCS&PT, local NGOs that support government health facilities, and other implementers that support health facilities operated by the private sector, such as networks of facilities operated by faith- and/or community-based organizations. Opportunities to engage with the for-profit, private sector in a consortium could be explored, including with manufacturers of relevant CCS&PT products or technologies as well as with commercial outlets to reach patients, such as local drug shops or private clinics.

Protecting Life in Global Health Assistance (Formerly known as the Mexico City Policy)
On January 23, 2017, a Presidential Memorandum was issued reinstating the 2001 Presidential Memorandum on the Mexico City Policy for USAID family planning assistance and directing the Secretary of State to implement a plan to extend the requirements of the Mexico City Policy to “global health assistance furnished by all Departments or Agencies.” USAID began implementing the policy, now known as the Protecting Life in Global Health Assistance policy on May 15, 2017, for grants and cooperative agreements that provide global health assistance. The policy requires foreign NGOs to agree, as a condition of receiving global health assistance, that they will not perform or actively promote abortion as a method of family planning and will not provide financial support to any other foreign NGO that conducts such activities. To implement the Protecting Life in Global Health Assistance Policy, USAID issued a new standard provision on May 15, 2017, which is publicly available here: This provision must be included in all new USAID awards that include global health assistance.

Timeline and Application Process

The timeline of this PEER award spans four phases as outlined in the table below:
Phase I
Competition and Partner Selection
November 1, 2018National Academies releases Partnership RFA for full and open competition among potential partners.
December 11, 2018Partnership proposals from U.S. institutions are due to National Academies via online submission platform.
December 12, 2018 – January 31, 2019National Academies convenes independent technical merit review of proposals and partners are selected.
February 2019Negotiations lead to finalization of the terms of the grants between National Academies and new awardees.
Phase II
March 2019National Academies organizes a kick-off forum for the Principal Investigators (PIs) and key team members from the funded projects, to be held in Malawi and Mozambique with the participation of USAID and HHS/NIH representatives. At this meeting both U.S. and country partners will be asked to begin finalizing a joint work plan and budget for the program.
March-May 2019Multi-stakeholder engagement to inform research activities. Research protocols are finalized and approved.
March-May 2019Visits of National Academies staff and experts to local partners to assess, address, and support priority steps and activities as needed related to organizational capacity building, such as strengthening financial management. U.S research institutions also work during this time to further assess the local partners’ research capacity and other areas like IT systems and data sharing platforms and develop plans for strengthening those aspects.
March-May 2019Initial support for programmatic implementation can begin as indicated (e.g., training of staff, lab strengthening, and procurement of needed commodities by the U.S. or local institutional partners).
Phase III Implementation and ResearchJune-August 2019Research studies commence following protocol finalization with activities such as training of research staff completed during this period.
September 2019-March 2021Research studies continue with support for program implementation and administrative compliance continuing throughout the entire period. Site visits as needed by the National Academies’ program manager and USAID staff will be scheduled.
Phase IV
Analysis, Dissemination, and Close-out
March 2021-
September 2021
Data cleaning, analysis, and dissemination. Technical assistance and other support provided to incorporate findings into national policy and global recommendations as applicable. National Academies will convene a final forum in Africa for the PIs, key team members, USAID and HHS/NIH representatives, and important local or regional stakeholders to facilitate the sharing of findings and recommendations by the participants.

Available Funding Support

For CCS&PT activities, USAID anticipates a total of U.S. $10,200,000 for subawards from the National Academies under the PEER Program. Of this total, a maximum of U.S. $5,100,000 is intended for subawards to be made for work in Malawi and U.S. $5,100,000 for subawards in Mozambique.

Applications should be submitted as a joint application between one U.S. institution and one local partner that plan to work together, with each presenting its own budget and the total amount of the two budgets combined not to exceed $5,100,000. For the proposal that receives funding, both the U.S. and local partner will receive a prime subaward from the National Academies. At least 70% of the total budget of the two prime partners combined should be allocated to strengthening implementation of CCS&PT integrated within voluntary family planning, and the introduction of new technologies for CCS&PT. Up to 30% of the budget can include costs specific to conducting, analyzing, and disseminating the embedded implementation research, including engaging stakeholders throughout the research-to-use process and ensuring findings are incorporated into policies and programs in real-time. Dissemination plans for activities in Mozambique should include plans to prepare and disseminate materials in both English and Portuguese. Budgets should delineate the costs that are specific to implementation and those that are specific to research. More information on allowable and unallowable costs can be found in Section VII: Budget Form and Justification. Final budgets for Malawian, Mozambican, and U.S. partners will be developed as part of a work-planning process to commence in the first half of calendar year 2019. The National Academies, in consultation with USAID and NCI, will approve the final budget for all subawardees. Allocation of funds to all recipients is contingent upon meeting required standards to receive and properly manage U.S. Government funds.

A cost share of 10% will be required of U.S. institutions applying as prime subawardees. This can be in the form of in-kind and/or financial contributions. Some examples of possible cost share might include provision of equipment, space, or staff time; private sector donations of technologies to support the project; or reduction of overhead costs.

The program description of the joint application submitted by the U.S. partner and the local partner should not exceed 25 pages in Times New Roman 12-point font, single-spaced with 1-inch margins. However, applicants may include additional information in Appendices (e.g., Key Personnel CVs, letters of support, detailed budgetary information, etc.).

About the Application Template

The program description of the joint application submitted by the U.S. partner and the local partner should not exceed 25 pages in Times New Roman 12 point font single-spaced with 1 inch margins. However, applicants may include additional information in Appendices (e.g., Key Personnel CVs, letters of support, detailed budgetary information, etc.).

Institutional Capability, Partnerships, and Management Plan

In this section, please describe the background that the two prime partners bring to the proposed project, including expertise in support for implementation of voluntary family planning provision, CCS&PT interventions, and the integration of the two, as well as expertise in implementation research and research capacity building. Please clearly outline the roles of the two prime subawardees, one U.S. and one local, as well as the roles of any subawardees included in your partnership. Please include relevant expertise in other key areas such as biostatistics, laboratory, health policy, supply chain and program management in low-income countries, highlighting relevant experience in Malawi and/or Mozambique.

Proposed projects should seek to add value by augmenting existing efforts in country, helping to fill critical gaps in evidence and availability, and assisting country partners to build their own capacity to overcome bottlenecks to impact and scale. Therefore, the proposals should clearly outline how the proposed activities would leverage, complement, and link to other investments related to CCS&PT currently being made, or anticipated, in Malawi and Mozambique. This includes investments from the country governments and partners such as the HHS/NIH, PEPFAR, Global Fund for AIDS, Tuberculosis, and Malaria, International Atomic Energy Agency, UNITAID, as well as from the private-sector investments, including from private philanthropic foundations/ organizations. Though funding cannot be provided under this RFA for invasive cervical cancer treatment or palliative care, partners are highly encouraged to find other resources to support invasive cervical cancer treatment and palliative care, and leveraging of such support will be included in the evaluation criteria (see Section XII below).

Proposals should demonstrate an understanding of the overall landscape of cervical cancer prevention, treatment, research, and care activities in the country, spanning from HPV vaccination to screening and treatment of precancerous lesions to treatment of invasive cancer and palliative care, including providing specific information as it is available about what other funding is being invested in these areas. A table that clearly summarizes this information is recommended.

Proposals should include a management plan which articulates the processes by which the various partners involved will manage the activities, as well as the structure that they partners will use to coordinate different elements of the projects and ensure accountability.

Implementation Research

In this section, please describe how the proposed implementation research activities will be conducted and justify the reasons for the approaches used. As part of this, it is essential that applicants outline a clear theory of change to guide the implementation research activities they propose, and the overall set of activities in which the research is embedded.

Research activities under the project should use a mix of quantitative and qualitative methods to generate practical data that can be applied to program implementation, with an emphasis on relevance to programs within the partner country. Proposals should focus on research designs and questions that are feasible, appropriate, and adequately powered to test a small number of clear hypotheses that fall within the broad objectives listed in Section V above.

Applications should outline a clear process by which the projects will conduct ongoing multi-stakeholder engagement according to best practices to refine research questions and activities. This will help ensure research is locally-owned and that the findings are disseminated and translated in real-time into national plans, policies, and programs throughout the course of the research. Dissemination should take into consideration language requirements relevant to both local and global populations, at minimum English and Portuguese (for Mozambique). Proposals should clearly explain which stakeholders will be engaged, how and when they will be engaged, and what support will be provided for translating research findings into use over the course of the projects. Please also see this link as a reference that outlines some best practices for multi-stakeholder engagement for implementation research in LMIC.

Research activities should be consistent with the “research-to-use” approach outlined in USAID’s Global Health Research and Development Strategy 2017-2021, which outlines USAID’s global health R&D goals across product development, introduction, and scale up; implementation science; and research capacity building. Implementation research should seek to understand both which approaches work, and which approaches do not work in different contexts including clinical and community-based settings in rural and urban areas. Proposals should also include clear utilization plans. If applicable to local context, mobile and static service-delivery approaches should both be evaluated. The research-to-use effort should also identify and disseminate key lessons for programs, promising innovations, and useful practices and tools for them to adopt. While the focus of the implementation research should be on identifying how best to implement interventions in different settings, the process should also gather information about processes that may be effective for building capacity of health systems for CCS&PT.

Applicants should clearly define proposals for two types of implementation research:
  1. Implementation research embedded within programs to evaluate and improve approaches to integrating and linking CCS&PT with voluntary family planning programs. Implementation research should assess the impact of different approaches on both CCS&PT and voluntary family planning outcomes and seek to identify solutions that work in specific settings to improve uptake and impact of both types of health services. The primary focus of these activities should be on service-delivery approaches at the primary care level implemented through clinical and community-based platforms. Activities should also include efforts to raise demand and awareness of CCS&PT and address social norms that are barriers to women accessing cervical cancer prevention. However, applicants are also encouraged to include activities to explore how improvements in referral networks might improve outcomes for women with cervical precancerous lesions and cancer. They are also encouraged to assess how improvements in health workforce, equipment, and supply chain capacity might increase the uptake of both CCS&PT and voluntary family planning. A secondary focus of these activities could expand to include older women, for example by studying how increasing the acceptability of cervical cancer screening in younger women accessing voluntary family planning could be leveraged to increase screening for older women. This would address the concern that over-reliance on voluntary family planning services for screening may result in disparities in cervical cancer mortality between younger and older women. In the former case, women screened under those services may assume that there is no need to continue screening after they finish childbearing and/or enter menopause. As a result, no screening mechanisms are put in place for older women, who have the highest rates of invasive cancer.
  2. Implementation research to utilize improved technologies and pathologic confirmation for cervical cancer screening and preventive therapy sustainably and at scale. This should include exploring innovative ways to deploy these technologies to decrease burdens on women’s health providers, health systems, and supply chains while increasing the health impact of screening, testing, and triage. One high priority is to test the feasibility and cost-effectiveness of different approaches to implementing HPV-DNA testing, including evaluating self-collection of HPV-DNA test samples through delivery channels like static clinics, mobile outreach, community health workers, or drug shops. As technologies receive global endorsement, additional studies could determine the feasibility and affordability of coupling HPV-DNA testing with more portable ablation devices. If indicated by country needs and interest, support could also be provided to assess low-cost ways to improve accuracy of visual assessment of the cervix, such as approaches that utilize mHealth and artificial intelligence, and/or to improve diagnostic pathology services and laboratory medicine at higher levels of the health system. Pathology and lab medicine systems are a key component of accurate diagnosis and treatment. Applications should include a quality assurance plan addressing test turnaround time, test report availability, and tissue diagnosis of procedural specimens to inform patient selection and procedure effectiveness.

Service Delivery of CCS&PT Integrated with Voluntary Family Planning

Applications should provide plans to support activities that will build partner countries’ capacity to (1) integrate CCS&PT with voluntary family planning programs and (2) introduce new technologies that can make CCS&PT more efficient and effective. In accordance with global guidelines, programs should focus on CCS&PT in population of women 30 year and older, unless there is a clear reason to provide services to women under the age of 30 (i.e., testing positive for HIV). Given the importance of having a strong platform in place as soon as possible to evaluate the best approaches to integration and introduction of new technologies, the projects are encouraged, as needed, to begin to provide support for staff training and new technology and supplies procurement prior to the official start of research activities, but not prior to confirmation of the award.

This may include assisting partner countries in strengthening their capacity to implement CCS&PT through support for the following areas, depending on country needs: (1) training and supervision (including working alongside partner countries to harmonize policies and guidelines for integrated service delivery and the development of new training materials/ guidance for providers of integrated services); (2) quality improvement approaches to increase implementation fidelity and referrals of patients with cancer to specialized sites; (3) strengthening systems for monitoring and evaluation (including cancer registries if indicated); (4) improving supply chains for cervical cancer prevention commodities including support as needed for demand forecasting, market shaping, and in-country logistics; and (5) integrating social and behavior change activities into existing platforms to increase demand for voluntary family planning and CCS&PT.

Also of importance are activities to assist countries in strengthening their capacity to evaluate, introduce, and scale-up improved technologies for CCS&PT. These technologies might include HPV-DNA testing, improved diagnostic capabilities, and more affordable, more portable technologies for ablation of cervical precancerous lesions. Examples of these activities could include the following, depending on country needs: (1) providing and building capacity to provide training, mentorship, and supervision of health providers and technicians in the new technologies; (2) strengthening laboratory and health system capacity to roll-out HPV-DNA tests and cervical cancer diagnostic technology that is suitable to the country context; (3) developing clinical and other guidelines, standard operating procedures, and training materials for screening and treatment, HPV-DNA testing, diagnosis, referrals, or new ablation technology; (4) quality assurance or validation; (5) coordinating delivery of HPV-DNA tests and other needed commodities for CCS&PT; (6) expediting in-country registration of new technologies, in collaboration with medicines regulatory authorities and other stakeholders like WHO; (7) utilizing market shaping opportunities to increase the efficiency of markets for improved product availability and affordability of new technologies on a faster timeframe; and (8) strengthening monitoring and evaluation, including strengthening outreach and follow up, systems to report and respond to possible adverse events from cryotherapy or thermocoagulation.

Additional service delivery requirements for inclusion of cytology and histopathology
Cervical cancer prevention, diagnosis, and treatment programs frequently include components related to cytology, pathology, and laboratory medicine services. While it is unclear whether the future of exfoliative cervical cytology (Pap tests) is limited, especially given improvements in technology such as liquid-based cytology, histopathology remains the standard of diagnosis of precancerous lesions targeted by screening. Maintaining high-quality cervical histopathology is often challenging in the context of developing countries, but strengthening of these services will in the short- and long-term lead to better quality and patient outcomes. When designing and validating screening and treatment methods, it is essential to (1) compare screening methods to accurate endpoints of “precancer,” which is then (2) treated appropriately with an excisional or ablative therapy and (3) followed up. Once a screening method is validated, an option might be for “see and treat” strategies to not include histopathology, if acceptable to local authorities. However, where appropriate and within national-level guidelines and policies, regional or national histopathology services should be established and strengthened, teaming with international experts, in a few centers within the country. This would permit local evaluation of new screening technologies against a truth standard, leading to continuation of those screening services without routine need for expert histopathology.

For projects funded under this RFA, if consistent with partner country policies, plans, and guidelines, periodic checks of screening and immediate treatment against a histopathology standard must be introduced as quality assurance, even when histopathology is not performed as part of the routine screening practice. This is essential to avoid both over-treatment and under-treatment. For example, in some previous program assessments, the lack of premalignant pathology on LEEP specimens was an indicator of over-diagnosis in a VIA program. On the other hand, under-diagnosis can lead to invasive cancer being inappropriately treated with ablation. Incomplete treatment can also occur for other reasons, such as inadequate depth of treatment with both cryotherapy and thermal coagulation. If consistent with partner country policies, guidelines, and plans, to help mitigate the risks of over-treatment and under-treatment, projects must include a planned interval follow up for all women treated and a quality assessment program that includes pre-procedure biopsy on a subset of patients. This planned interval follow-up will not guide individual patient decision-making at the time of treatment. Instead, it will provide validation of screening, feedback on case selection at the program level, and assessment of the appropriateness of treatment. If (1) a high percentage of high-grade precancerous lesions or invasive cancers are identified in the treatment population; (2) a high percentage of women in the treatment population have negative pathology; (3) women return with invasive disease; or (4) there is a high loss to follow up rate, this will serve as a safety signal indicating the need to modify screening, change case selection criteria, reconsider treatment algorithms or strengthen follow up and outreach.

Capacity Building

In this section please describe activities to support individuals as well as institutional capacity of local partners that are not otherwise described in the sections above. In this regard, we are looking for U.S. partnership proposals that go beyond traditional training and exchange models to truly build human and institutional capacity. For additional reference, we encourage applicants to review: USAID Human and Institutional Capacity Handbook. Please describe special resources/expertise that can be leveraged from the applying U.S. institution to support proposed capacity building activities.

SUB-SECTION 5: Monitoring and Evaluation
Proposals should outline their overall framework or approach for monitoring and evaluation and describe how partners will work together to collect, analyze, and utilize data to track program progress. This should include activities related to data quality assurance. The focus should be on working within and strengthening national monitoring and evaluation systems, and activities should strengthen ability of providers and policy makers to analyze and use data for decision-making. Activities should avoid contributing to the development of parallel data systems, though it is understood that research activities may require the use of short-term approaches to collect indicators that are not available within the existing national systems. Proposals are encouraged to include elements to build capacity for providers to utilize data to change how their facilities operate.

Proposals should define specific, measurable, realistic outcomes, and indicators that will enable the projects to determine whether there is a change in:
  • Number of cervical cancer screenings completed;
  • Number of cases where histopathologic quality assessment indicated discrepant results between screening and pathology;
  • Number of precancerous lesions ablated (compared with previously-existing protocols);
  • Improved quality of pathologic services as measured by acceptable sensitivity and specificity for detection of cervical dysplasia, and increased inter-observer reproducibility;
  • Number of women who follow up, and are contacted for follow up, after screening and treatment;
  • Number of women diagnosed with high-grade precancerous or cancerous lesions;
  • Number of women accepting CCS&PT and voluntary family planning;
  • Uptake of voluntary family planning by method;
  • Changes to facility-level contraceptive method mix (if any);
  • Quality of counseling or service delivery (ex. measurement of facility wait times);
  • Cost per user of voluntary family planning and CCS&PT services delivered, including by method of voluntary family planning adopted;
  • Provider/client satisfaction; and
  • Other priority outcomes/indicators as appropriate to the project or partner country.

Draft Budget Form and Justification
Using the budget form provided, each of the two prime partners involved in the submission of a joint application should submit its own itemized draft budget in U.S. dollars. The sum of the two budgets cannot be greater than the U.S. dollar amount described for activities outlined in Section III. These itemized budgets can be submitted separately from one another or together depending on the partners’ preference. However, it is recommended, though not required, that the two partners submit a summary joint budget that displays how the proposed expenditures of the U.S. partner and Malawi or Mozambique partner budgets are complementary. Unless otherwise agreed upon, all project activities must be completed by September 30, 2021. Equipment and other direct costs may be supported by either the U.S. partner budget or the Malawi/Mozambique partner budget as needed. Final budgets for partners will be developed as part of a work-planning process in the Q1/2 of the 2019 calendar year. The National Academies, in consultation with USAID, will approve the final budget for all subawardees.

The draft budget table should list estimated annual costs by year. The following budget requests are not allowed:
  • Costs for the construction of new buildings or the repair, renovation, or refurbishment of existing buildings;
  • Contingency costs; and
  • Customs duties, as normally awards supported with USAID funds are exempt from duties in countries receiving U.S. assistance. If the items to be bought will not be exempt from such duties, funds to pay these charges must come from other non-PEER sources.
Draft budget request justification
In addition to the budget request form, provide an explanation and justification for support requested in the following categories:
  1. Labor: Applicants requesting salary coverage in their project budgets must include a list of positions to be supported, an explanation of their roles, and the percentage of their time that would be devoted to the project. For salaries of U.S. faculty members, it is expected that their home institution would participate in cost sharing. Please make sure to document the cost sharing amounts in the budget form under “Other Contributions.”
  2. Equipment: Proposals for the purchase of equipment required for research, training, and service delivery are allowed. Costs for new technologies related to HPV testing and the ablation of precancerous cervical lesions, including machines and ablation devices can be a substantial part of the budget (up to 25%) if this is needed for implementation (costs of associated reagents should be included in the materials and supplies line of the Other Direct Costs section of the budget). Cost of instruments for histopathologic sampling; sample media; sample transport; and costs of training and lab upfitting for cytology and/or histopathology testing may also be included, but should not exceed more than 5% of the budget, though partners could include additional pathology-related costs as part of cost share. Where possible, projects should leverage existing durable equipment and infrastructure. Requests for new durable equipment (items with an individual cost of U.S. $5,000 or more) should be justified in terms of importance to successful implementation of the proposed program. Please also include plans for maintenance of the equipment during and beyond the project period.
  3. Travel Costs: Provide the number, duration, location, and purpose for any project-related trips for which funds are requested, along with the titles or positions of the travelers. International air travel must be by U.S. air carriers to the maximum extent such service is available as required under the Fly America Act,(, so applicants should estimate their air travel budgets accordingly. First class or business class travel is not permitted.
  4. Other Direct Costs: Explain any costs for materials and supplies (including smaller pieces of equipment costing less than U.S. $5,000), Internet or telephone services, publications costs, the organization of workshops or conferences, computer services, non-travel training costs, subawards, or other direct costs that have been included in this section of the budget form.
  5. Indirect Costs: If requested, indirect costs (costs supporting overall institutional operations and management) should be kept to a minimum and must be fully explained and justified in the budget justification section of the full proposal, with details provided on what specific institutional infrastructure elements or support services are covered. If your institution has an official Negotiated Indirect Costs Rate Agreement (NICRA) with a U.S. federal agency, that rate can be used, and documentation of that NICRA will need to be uploaded in the application.
  6. Cost share: As applicable, please describe what costs the applicant will share.
Key Personnel
Please attach CVs for all members of the leadership team who will be involved in managing and providing technical direction and oversight for the proposed activities at the applicant’s institution. Project Coordinator positions are strongly encouraged. Each CV should be no more than three pages in length.

Letters of Support
Please attach a separate letter of support from an official at the primary U.S. partner institution, the primary African partner institution, and the implementing partner organization who is legally authorized to make commitments on the institution’s behalf. These letters must be signed and written on official institutional letterhead and must include the following elements:
  • Confirmation that the institution supports the participation of its staff in the proposed project and would be willing to receive and administer any grant funds awarded;
  • A brief description of the institution’s structures and practices for project management and financial oversight; and
  • A brief description of resources that the institution would be making available (if any) to facilitate the project, whether in cash or in kind, for example, by paying the salary of any staff members involved for the time they work on the program, providing substitute instructors to cover their other duties so they are free to work on the program, or providing laboratory or office space, access to equipment, or office support staff.
Additional letters of support for the proposed program are encouraged but not required.

Submission Instructions

Proposals must be submitted through the application system by 5:00 PM U.S. Eastern Standard Time on December 11, 2018. The U.S. and Malawian or Mozambican partners involved in each project should work together to prepare one complete joint proposal, which may be submitted by either side to the PEER online site.

Applicants should not reach out to USAID or HHS/NIH directly during the RFA process, as this would be in violation of USAID’s procurement rules. Applicants should direct all questions or comments on the PEER/Building Capacity for Cervical Cancer Screening and Treatment of Precancerous Lesions through Innovative Approaches program or RFA to the U.S. National Academies (

Applicants are kindly requested to send an e-mail stating their intent to apply to, with the subject line “Intent to Apply: PEER Cervical Cancer,” by November 27, 2018.