Expanding Access to Quality Laboratory Service (EQUALS) in the Kingdom of Lesotho under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH20 2044

Opportunity Information: Apply for CDC RFA GH20 2044

The grant opportunity, titled "Expanding Access to Quality Laboratory Service (EQUALS) in the Kingdom of Lesotho under the President's Emergency Plan for AIDS Relief (PEPFAR)," is a CDC cooperative agreement (Funding Opportunity Number CDC RFA GH20 2044) focused on strengthening Lesotho's laboratory system as a core part of the country's HIV response. It sits within the health funding category under CFDA 93.067 and is designed to support PEPFAR goals by improving the availability, reliability, and overall quality of HIV-related laboratory testing services. The application window for this opportunity opened January 8, 2020, with an original closing date of March 8, 2020 (applications due by 11:59 p.m. ET). Eligibility is listed as unrestricted, meaning a wide range of entity types may apply as long as they meet any additional criteria described in the full notice.

The public health context driving the award is Lesotho's generalized HIV epidemic. The opportunity description cites an estimated 319,000 people living with HIV, with very high adult prevalence among ages 15 to 59 (25.6) and an adult incidence of 1.1. While PEPFAR support has helped Lesotho scale up prevention, treatment, and strategic information systems, and while laboratory support has already contributed to real gains in diagnostic and monitoring services, the notice makes clear that significant gaps remain. Those gaps relate less to whether services exist in some form and more to whether they consistently meet national demand with the quality and speed required for effective clinical care and epidemic control.

The purpose of EQUALS is to expand access to laboratory services and raise their quality so that testing is accurate, reliable, and timely across the network of supported laboratories. The notice emphasizes system strengthening rather than one-off procurement. Key approaches include supporting the implementation of national laboratory policies and strategic plans, strengthening quality management systems, and moving laboratories along a pathway toward accreditation. In practical terms, this implies improving and standardizing laboratory operations, reinforcing quality assurance and quality control practices, and ensuring that laboratories can sustain performance over time. The opportunity also highlights the need for laboratories to have the right enabling conditions: adequate infrastructure, appropriate diagnostic technologies, trained and skilled staff, and functioning information systems that support proper documentation, reporting, and use of results.

A central rationale for the investment is that strong laboratory capacity is essential to achieving and sustaining the HIV 95-95-95 targets: diagnosing people living with HIV, initiating and maintaining treatment, and achieving viral load suppression. Reliable testing underpins each step, from initial diagnosis to monitoring treatment effectiveness. By strengthening labs and improving turnaround times and result quality, the award is positioned to support both individual patient management and broader program performance, which is critical for maintaining epidemic control in a high-burden setting like Lesotho.

The opportunity is structured as a cooperative agreement, which generally signals substantial involvement by the CDC during implementation. The recipient is expected to work closely with the Government of Lesotho's Ministry of Health, PEPFAR partners, and other stakeholders, aligning all activities with national policies, strategic plans, and guidelines, as well as PEPFAR priorities in Lesotho. That coordination requirement is important because laboratory systems cut across many services and partners; success depends on shared standards, interoperable information systems, consistent training approaches, and coordinated quality improvement efforts rather than parallel, fragmented investments.

On funding, the notice lists an approximate total funding amount of $1,500,000 for Year 1, dependent on the availability of funds, with an expectation of one award. It also states that the "Award Ceiling for Year 1 is 0 (none)," which typically indicates that CDC did not set an upper cap in the posting even though an estimated funding level is provided. In other words, applicants should treat the $1.5 million figure as the planning assumption for the first year while understanding that final amounts depend on appropriations and CDC decisions.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Expanding Access to Quality Laboratory Service (EQUALS) in the Kingdom of Lesotho 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, 2020.
• Applicants must submit their applications by Mar 08, 2020 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.)
• 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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