Health Resources and Services Administration HIV/AIDS Bureau Division of Training and Capacity Development Global Health Systems Strengthening Branch Pre-Review Conference Call Competitive Grant Application: #HRSA PROGRAMMATIC OVERVIEW CAPT Ray Goldstine (GLOBAL BRANCH CHIEF) Mr. Richard Poole (PROJECT OFICER, TWINNING )

Background Intention of the Twinning Center Funding Opportunity The intention of this funding opportunity is to provide facilitation, management and technical support for the continuation and/or formation of institutional, peer-to-peer partnership (i.e., “Twinning”) activities to combat HIV/AIDS by addressing objectives of the President’s Emergency Plan for AIDS Relief (PEPFAR) for strengthening health systems workforce and country ownership. 2

Background The Twinning Program (TP) Supported by PEPFAR funding through the Health Resources and Services Administration (HRSA) since 2004, through two successive 5- year cooperative agreements The Twinning Program currently manages over 30 active partnerships in 10 African countries and the Caribbean Region, primarily building workforce capacity across HIV/AIDS technical areas including: Clinical Pharmacy, Nursing, Emergency Medicine and Pediatric Urgent Care, Laboratory, Medical Technology, Social Work and Para-Social Work, Mass Media, Clinical Associates, and Case Management Working closely with Ministries of Health, US in-country teams, and other key stakeholders, Twinning Center partnerships strengthen pre- and in-service training programs at existing institutions to address HIV/AIDS-related workforce development goals 3

Background The Twinning Model Types of Twinning Partnerships o North-South: U.S.-African/Caribbean Region Partnerships o South-South: Partnerships between In-country/region and regional institutions Twinning Institutions o Participating partner institutions include universities, hospitals, professional associations, community- and faith-based organizations, and ministries of health Selection of Partnering Institutions o Each partner institution must exhibit a high level of dedication and commitment to the collaborative, proactive, and voluntary process that is the hallmark of Twinning partnership programs o In the case of US donor partners, this includes a commitment to contribute significant in-kind resources, thereby reinforcing the volunteer nature of the Twinning model Sustainability and Country Ownership o Flexible and non-prescriptive, Twinning empowers host communities by giving them ownership of the programs they create jointly with their partners, thereby encouraging sustainable capacity development on individual, institutional, and systemic levels 4

Background Epidemiology of HIV/AIDS* in Areas Served by Twinning More than 35 million people now live with HIV/AIDS worldwide. Seventy (70) percent of all people living with HIV--25 million-- live in sub-Saharan Africa, including 88 percent of the world’s HIV-positive children. In 2012, an estimated 1.6 million people in the region became newly infected. An estimated 1.2 million adults and children died of AIDS, accounting for 75 percent of the world’s AIDS deaths in Approximately 12,000 people became newly infected in the Caribbean Region in 2012, bringing the total number of people living with HIV/AIDS there to more than 250,000. AIDS claimed an estimated 11,000 lives in * Source: UNAIDS Fact Sheet 2013

Background Guiding Principles (mentioned in Twinning FOA) PEPFAR’s Blueprint for Creating an AIDS-Free Generation Focus on women and girls to increase gender equality in HIV services End stigma and discrimination against people living with HIV and key populations, improving their access to and uptake of comprehensive HIV services Set benchmarks for outcomes and programmatic efficiencies through regularly assessed planning and reporting processes to ensure goals are being met 6 Make strategic, scientifically sound investments to rapidly scale-up core HIV prevention, treatment and care interventions and maximize impact Work with partner countries, donor nations, civil society, people living with HIV, faith- based organizations, the private sector, foundations and multilateral institutions to effectively mobilize, coordinate and efficiently utilize resources to expand high-impact strategies

Background Types of Partner Institutions Partner institutions work on a peer-to-peer basis, with donor institutions providing necessary expertise and training and recipient organizations benefitting from their assistance and oversight. Both types of organizations may include: Governmental and non-governmental organizations (NGOs); Schools and academically-based health science centers; Professional organizations; Civil society organizations (CSOs), including community-based organizations (CBOs) and faith-based organizations (FBOs) 7

Primary Target: Global HIV/AIDS-related workforce training programs, as developed by institution-to-institution (i.e., “Twinning”) partnerships in key areas including, but not limited to: o Clinical Pharmacy o Nursing o Clinical Associates o Emergency Medicine and Pediatric Urgent Care o Laboratory and Medical Technology o Social Work and Para-Social Work o Mass Media o Case Management o Hospital Strengthening, etc. 8 Program Expectations Targeted Activities

Program Expectations Goal(s) of the Twinning Program To identify and build the capacity of all recipient country-/regional organizations so that, before the end of this ( ) cooperative agreement, these organizations will achieve sustainability—having the necessary foundations, systems and expertise to: Apply for USG or other funding; Broker, facilitate and provide management support and technical assistance (TA) for the establishment, maintenance, and graduation of Twinning partnerships; and/or Become fully integrated into their respective national/regional healthcare and professional systems 9

Program Expectations Monitoring & Evaluation (M&E): Key Criteria for Determining Effective Partner Development The awardee will be expected to work closely with in-country and/or regional teams to ensure that processes are in place to carry out M&E activities for regularly reporting on the status of developing Twinning- based workforce training, as carried out by recipient partner institutions. Criteria will include: Strong Organizational Structure Demonstrated Expertise/Experience Management Capacity Sound Governance Cultural Sensitivity Capability in Effective Self-Monitoring/Reporting of Performance Measures Progress in Achieving Programmatic and Financial Sustainability/Country Ownership 10

Cooperative Agreement Basics Summary of Funding Opportunity This program will provide funding during Federal fiscal years A maximum of $16,000,000 is expected to be available annually to fund one (1) grantee Start Date: April 1, 2014 Project Period: April 1, 2014 – March 31, 2019 The cost of oversight, management, and transition of this program will need to be reasonable and will be funded from various PEPFAR Country Operational Plan (COP)/Regional Operational Plan (ROP) allocations Funding beyond the first year is dependent on: o Availability of appropriated funds in subsequent fiscal years o Recipient satisfactory performance (as documented in required reports to HRSA) o Decision that continued funding is in the best interest of the Federal government--as determined by the annual PEPFAR review and approval process for COPs and ROPs, as managed by the Office of the Global AIDS Coordinator (OGAC) 11

Cooperative Agreement Basics Funding Restrictions A maximum five-year cooperative agreement award While the budget period is for ONE year, applicants are required to submit budgets for each of the subsequent (four) budget periods Award funds may not be used to pay the salary of an individual at a annual salary rate in excess $179,700 (P.L ); this restriction also applies to subawards/subcontracts Other funding restrictions (e.g., alcohol, entertainment costs, lobbying, meals, etc.) are all described on pages 25 and 26 Additionally (as mentioned in the FOA/HRSA , page 13), funds cannot be used for construction 12

Common Acronyms 13 CBO Community-based Organization COI Conflict of Interest COPCountry Operational Plan CQIContinuous Quality Improvement CSOCivil Society Organization DGMO Division of Grants Management Operations DIRDivision of Independent Review DTCD Division of Training and Capacity Development DUNS Data Universal Number System EHBElectronic Handbook FBOFaith-based Organization FOAFunding Opportunity Announcement GMS Grants Management Specialist HABHIV/AIDS Bureau HRSAHealth Resources and Services Administration M&EMonitoring and Evaluation NGONon-governmental Organization PEPFAR President’s Emergency Program for AIDS Relief OGACOffice of the Global AIDS Coordinator PO Project Officer ROPRegional Operational Plan SAMSystem for Award Management TATechnical Assistance TP Twinning Program

On behalf of HAB/DTCD and its Global Health Systems Strengthening Branch… THANK YOU! 14