Strengthen the Capacity of Republican Narcology Center of Tajikistan on Practical Applications of Medication-Assisted Treatment (MAT) Programs under the President's Emergency Plan for AIDS Relief (PEPFAR) | CDC RFA GH20 2128

Opportunity Information: Apply for CDC RFA GH20 2128

This funding opportunity, titled "Strengthen the Capacity of Republican Narcology Center of Tajikistan on Practical Applications of Medication-Assisted Treatment (MAT) Programs under the President's Emergency Plan for AIDS Relief (PEPFAR)," is a CDC cooperative agreement focused on expanding and improving medication-assisted treatment services in Tajikistan, especially for people who inject drugs (PWID). The effort is designed to support the Republican Narcology Center (RNC) as the central implementing partner, with an emphasis on practical, on-the-ground improvements to service delivery rather than purely planning or research activities. The broader public health purpose aligns with PEPFAR goals: reducing HIV transmission and improving HIV treatment outcomes among populations at high risk, particularly PWID.

Financially, the notice indicates an approximate total funding amount of $500,000 for the first year, contingent on the availability of funds, with an expectation of a single award. A notable administrative detail is that the "Award Ceiling for Year 1 is 0 (none)," which typically signals that the agency is not setting a formal upper limit per application in the usual way, even though it also provides an estimated total amount it expects to distribute. The funding instrument is a cooperative agreement, meaning CDC anticipates having substantial involvement beyond simply issuing funds, such as providing technical direction, collaboration on implementation approaches, monitoring, and performance management. The opportunity is categorized as discretionary, falls under the health activity category, and is associated with CFDA number 93.067.

Programmatically, the NOFO is centered on strengthening access to and the quality of MAT for PWID. MAT generally refers to evidence-based treatment for opioid use disorder using medications (often methadone or buprenorphine) alongside counseling and supportive services, with the aim of reducing illicit opioid use, overdose risk, and related harms. In the PEPFAR context, MAT is also treated as a structural and clinical intervention that can improve HIV outcomes by stabilizing individuals and making it easier for them to start and stay on HIV treatment. The NOFO explicitly connects MAT scale-up to improved antiretroviral therapy (ART) outcomes, highlighting goals to increase ART enrollment and retention and to increase viral suppression among people living with HIV (PLHIV) who are also PWID. Viral suppression is a key endpoint in HIV programming because it improves individual health and dramatically reduces the likelihood of HIV transmission.

A major operational theme in the description is integration and linkage across services that often operate in silos. The NOFO emphasizes strengthening promotion and active linkage of PWID who are already engaged at ART and tuberculosis (TB) sites to MAT services. In practical terms, this implies building referral pathways, improving coordination between HIV/TB clinics and addiction treatment providers, training staff to identify opioid use disorder and to refer or initiate MAT, and reducing drop-offs during referral. The focus on TB sites is particularly relevant in many settings where HIV, TB, and substance use overlap; people with opioid use disorder may have higher TB risk and poorer treatment adherence, so integrating or linking services can improve outcomes across conditions.

The opportunity also calls for expanding integrated MAT and ART service delivery, which goes beyond referral and points toward co-located or tightly coordinated care models. Integrated delivery can include shared case management, combined clinical visits, harmonized patient records and follow-up systems, and patient-centered scheduling that reduces the burden of attending multiple separate clinics. The underlying intent is to improve continuity of care, reduce missed appointments, and address common barriers such as stigma, transportation costs, and fragmented services. By improving the experience and feasibility of staying in care, integrated models are often used to increase retention in both MAT and ART, which is essential for achieving sustained viral suppression.

Another distinctive element is the introduction and expansion of MAT for PWID in prison settings. This reflects a recognition that incarceration is a high-risk period for interruption of HIV treatment and for relapse and overdose after release, and that prisons can be strategic sites for initiating or maintaining MAT and linking individuals to community services afterward. Implementing MAT in prisons typically requires coordination with correctional authorities, clinical staffing and medication supply systems within facilities, continuity-of-care planning for release, and careful attention to policies and practices that can either support or undermine treatment. Including prisons as a priority setting suggests the program is aiming to close a major gap in the treatment continuum for PWID and to reduce HIV-related and drug-related harms associated with the justice system.

The NOFO also highlights targeted demand creation for MAT, which points to efforts aimed at increasing awareness, acceptance, and willingness to enroll among people who could benefit from MAT. Demand creation can include outreach and education tailored to PWID communities, addressing misconceptions about MAT, reducing stigma, engaging peer educators or community-based organizations, and improving the way services are presented and accessed (for example, simplifying enrollment processes or making clinic hours more accommodating). In many contexts, MAT uptake is limited not only by supply constraints but also by fear of discrimination, concerns about confidentiality, distrust of institutions, and misinformation. Targeted demand creation is meant to complement service expansion so that increased capacity translates into actual enrollment and sustained participation.

From an administrative standpoint, the opportunity is issued by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), specifically within the Center for Global Health (CGH). The funding opportunity number is CDC RFA GH20 2128, and the original application closing date listed is April 27, 2020, with electronic submissions due by 11:59 p.m. Eastern Time on the due date. Eligibility is listed broadly as "Others," with clarification referenced in the full eligibility text, which usually indicates the competition may be limited to specific entities or may require certain institutional qualifications or in-country presence, but the summary provided does not include those details.

Overall, the grant is best understood as a focused, single-award cooperative agreement intended to strengthen the national narcology institution in Tajikistan so it can deliver higher-quality, more accessible MAT and connect that treatment directly to HIV and TB care. The core outcomes the program is aiming to influence are increased MAT access and quality, stronger linkage and integration between MAT and ART services, improved ART enrollment and retention among PWID living with HIV, higher rates of viral suppression, expansion of MAT into prison settings, and increased patient demand and uptake through targeted outreach and engagement.

• The Department of Health and Human Services, Centers for Disease Control - CGH in the health sector is offering a public funding opportunity titled "Strengthen the Capacity of Republican Narcology Center of Tajikistan on Practical Applications of Medication-Assisted Treatment (MAT) Programs 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 Feb 27, 2020.
• Applicants must submit their applications by Apr 27, 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: Others (see text field entitled Additional Information on Eligibility for clarification).

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