USAID's $23.6M AIDS-Free Generation contract aims to scale ART services in Burundi

Contract Overview

Contract Amount: $23,599,579 ($23.6M)

Contractor: Family Health International

Awarding Agency: Agency for International Development

Start Date: 2018-01-01

End Date: 2023-05-31

Contract Duration: 1,976 days

Daily Burn Rate: $11.9K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 3

Pricing Type: COST PLUS FIXED FEE

Sector: Other

Official Description: IGF::CL::IGF THE OBJECTIVE OF THE REACHING AN AIDS-FREE GENERATION ACTIVITY IS TO SCALE UP ANTIRETROVIRAL THERAPY (ART) SERVICES FOR PEOPLE LIVING WITH HIV USING AN INTEGRATED, COMMUNITY-BASED APPROACH IN HIGH-PREVALENCE PROVINCES TO CONTRIBUTE TOWARDS THE GOVERNMENT OF BURUNDI'S GOAL TO ACHIEVE EPIDEMIC CONTROL NATIONALLY.

Plain-Language Summary

Agency for International Development obligated $23.6 million to FAMILY HEALTH INTERNATIONAL for work described as: IGF::CL::IGF THE OBJECTIVE OF THE REACHING AN AIDS-FREE GENERATION ACTIVITY IS TO SCALE UP ANTIRETROVIRAL THERAPY (ART) SERVICES FOR PEOPLE LIVING WITH HIV USING AN INTEGRATED, COMMUNITY-BASED APPROACH IN HIGH-PREVALENCE PROVINCES TO CONTRIBUTE TOWARDS THE GOVERNMENT OF BURUNDI'S… Key points: 1. The contract focuses on scaling up antiretroviral therapy (ART) services using an integrated, community-based approach. 2. It targets high-prevalence provinces in Burundi to contribute to national epidemic control goals. 3. The contract duration is over 1900 days, indicating a long-term commitment to the program. 4. The primary contractor, Family Health International, has a significant role in implementing these critical health services. 5. The contract type is Cost Plus Fixed Fee, which allows for flexibility but requires careful cost management. 6. This initiative aligns with the Government of Burundi's objective to achieve national HIV/AIDS epidemic control.

Value Assessment

Rating: good

The contract's value of $23.6 million over approximately five years for scaling up ART services in a high-prevalence region appears reasonable given the scope. Benchmarking against similar global health initiatives funded by USAID suggests that this level of investment is typical for comprehensive HIV/AIDS prevention and treatment programs. The Cost Plus Fixed Fee structure, while common for complex health projects, necessitates diligent oversight to ensure cost-effectiveness and prevent scope creep. Further analysis would benefit from comparing the per-ART-patient cost against established benchmarks for similar interventions.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

This contract was awarded under full and open competition, indicating that multiple qualified bidders had the opportunity to submit proposals. The presence of three bidders suggests a competitive environment, which generally leads to better pricing and service offerings for the government. The competitive process helps ensure that the selected contractor offers the most advantageous technical and cost proposal, aligning with taxpayer interests.

Taxpayer Impact: Full and open competition ensures that taxpayer funds are used efficiently by fostering a market where multiple capable organizations vie for the contract, driving down costs and improving service quality.

Public Impact

Individuals living with HIV in high-prevalence provinces of Burundi will benefit from scaled-up access to life-saving antiretroviral therapy (ART). The program delivers integrated, community-based healthcare services, aiming to improve treatment adherence and health outcomes. Geographic impact is concentrated in specific high-prevalence provinces within Burundi, addressing critical needs in those areas. The initiative supports the local healthcare workforce by potentially creating or sustaining jobs in program implementation and service delivery.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for cost overruns given the Cost Plus Fixed Fee contract type if not managed rigorously.
Dependency on a single primary contractor (Family Health International) for a critical health program.
Ensuring sustained impact and community integration beyond the contract period requires careful planning.
Monitoring and evaluation of program effectiveness in diverse community settings can be challenging.

Positive Signals

Clear objective to scale up ART services, directly addressing a critical public health need.
Focus on an integrated, community-based approach, which can improve accessibility and adherence.
Awarded through full and open competition, suggesting a robust selection process.
Long contract duration (over 5 years) allows for sustained program implementation and impact.

Sector Analysis

This contract falls within the 'Other Professional, Scientific, and Technical Services' sector, specifically addressing global health initiatives. The market for such services is driven by government funding for international development, health, and humanitarian aid. Comparable spending benchmarks would involve looking at other USAID-funded health programs or similar initiatives by other international development agencies focused on HIV/AIDS prevention and treatment in sub-Saharan Africa. The scale of this contract is significant within its niche, reflecting the complexity and importance of combating HIV/AIDS.

Small Business Impact

There is no indication of small business set-asides or subcontracting requirements mentioned in the provided data. The contract was awarded to Family Health International, a large organization, suggesting that the primary focus was on technical expertise and capacity for large-scale program implementation rather than specifically engaging small businesses. Further investigation into subcontracting opportunities would be needed to assess the impact on the small business ecosystem.

Oversight & Accountability

Oversight for this contract would primarily fall under the Agency for International Development (USAID), likely through its Inspector General's office and program monitoring units. USAID typically employs rigorous oversight mechanisms for its global health programs, including regular reporting requirements, site visits, and performance evaluations. Transparency is generally maintained through public contract databases and program reports, though specific details of cost management and operational effectiveness would be subject to internal review and audit.

Related Government Programs

Global Health Security Agenda
PEPFAR (President's Emergency Plan for AIDS Relief)
USAID Global Health Supply Chain
HIV/AIDS Prevention and Treatment Programs

Risk Flags

Potential for cost overruns due to CPFF contract type.
Sustainability of program impact beyond contract duration.
Challenges in ensuring consistent quality of care in community settings.
Risk of supply chain disruptions for ART medications.
Potential impact of socio-cultural factors and stigma on program uptake.

Frequently Asked Questions

What is this federal contract paying for?

Agency for International Development awarded $23.6 million to FAMILY HEALTH INTERNATIONAL. IGF::CL::IGF THE OBJECTIVE OF THE REACHING AN AIDS-FREE GENERATION ACTIVITY IS TO SCALE UP ANTIRETROVIRAL THERAPY (ART) SERVICES FOR PEOPLE LIVING WITH HIV USING AN INTEGRATED, COMMUNITY-BASED APPROACH IN HIGH-PREVALENCE PROVINCES TO CONTRIBUTE TOWARDS THE GOVERNMENT OF BURUNDI'S GOAL TO ACHIEVE EPIDEMIC CONTROL NATIONALLY.

Who is the contractor on this award?

The obligated recipient is FAMILY HEALTH INTERNATIONAL.

Which agency awarded this contract?

Awarding agency: Agency for International Development (Agency for International Development).

What is the total obligated amount?

The obligated amount is $23.6 million.

What is the period of performance?

Start: 2018-01-01. End: 2023-05-31.

What is the track record of Family Health International in managing large-scale global health contracts, particularly in HIV/AIDS programs?

Family Health International (FHI 360) has a substantial track record in managing complex global health initiatives, including extensive experience with HIV/AIDS prevention, treatment, and care programs across numerous countries. They are a well-established organization known for implementing large-scale projects funded by USAID, CDC, and other international donors. Their expertise often lies in program design, implementation, monitoring, and evaluation, with a focus on community-based approaches and health systems strengthening. While specific performance metrics for this particular contract would require detailed review, FHI 360's general profile suggests a capacity to handle such a significant undertaking. However, as with any large contractor, performance can vary across different projects and regions, necessitating ongoing monitoring.

How does the cost structure (Cost Plus Fixed Fee) compare to other similar HIV/AIDS scaling-up contracts?

The Cost Plus Fixed Fee (CPFF) contract type is common for research and development, as well as complex service contracts where the scope of work may evolve or is difficult to define precisely at the outset, such as large-scale public health interventions. In CPFF contracts, the contractor is reimbursed for allowable costs plus a fixed fee representing profit. Compared to fixed-price contracts, CPFF offers more flexibility for the government if the scope changes but can carry a higher risk of cost overruns if not managed diligently. For HIV/AIDS scaling-up programs, this structure is often chosen because it allows for adaptation to local contexts and evolving public health needs. Benchmarking against other PEPFAR or USAID-funded health programs would likely show a significant number of CPFF or similar cost-reimbursement contracts, indicating it's a standard approach for this type of work.

What are the key performance indicators (KPIs) used to measure the success of the Reaching an AIDS-Free Generation activity?

While the provided data does not explicitly list the Key Performance Indicators (KPIs) for the Reaching an AIDS-Free Generation activity, typical KPIs for such HIV/AIDS scaling-up programs funded by USAID often include: 1. Number of individuals initiated on Antiretroviral Therapy (ART). 2. Number of individuals retained on ART (viral load suppression). 3. Number of HIV-positive pregnant women receiving ART to prevent mother-to-child transmission (PMTCT). 4. Number of individuals receiving HIV testing and counseling. 5. Percentage of ART services delivered through community-based or integrated models. 6. Improvements in health system capacity for ART service delivery. The specific KPIs would be detailed in the contract's Statement of Work and performance monitoring plan, guiding the contractor's reporting and USAID's evaluation of program effectiveness.

What is the historical spending trend for similar HIV/AIDS programs managed by USAID in Burundi or the region?

Historical spending data for USAID's HIV/AIDS programs in Burundi and the broader East African region indicates a significant and sustained commitment to combating the epidemic. While specific figures for Burundi alone require detailed database queries, USAID, through initiatives like PEPFAR, has allocated billions globally towards HIV/AIDS prevention, treatment, and care. In Burundi, spending would likely fluctuate based on national priorities, disease burden, and available funding, but the trend generally reflects a long-term investment strategy. Contracts for scaling up ART services, similar to the Reaching an AIDS-Free Generation activity, represent a substantial portion of this funding, reflecting the critical need for treatment access. Analyzing past spending patterns can help contextualize the $23.6 million award and assess its alignment with historical funding levels and program objectives.

What are the potential risks associated with implementing an integrated, community-based ART approach in Burundi?

Implementing an integrated, community-based ART approach in Burundi presents several potential risks. Firstly, ensuring consistent quality of care across diverse community settings can be challenging, requiring robust training and supervision of community health workers. Secondly, supply chain disruptions for essential medicines and commodities could impact service delivery, especially in remote areas. Thirdly, socio-cultural factors and stigma associated with HIV/AIDS may hinder uptake and adherence to treatment, necessitating culturally sensitive engagement strategies. Fourthly, political instability or security concerns within specific provinces could disrupt program activities. Finally, sustainability beyond the contract period is a risk; ensuring local health system integration and community ownership is crucial for long-term success. USAID and FHI 360 would need comprehensive risk mitigation strategies to address these potential challenges.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Other Professional, Scientific, and Technical Services › All Other Professional, Scientific, and Technical Services

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › MANAGEMENT SUPPORT SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Offers Received: 3

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 359 BLACKWELL ST STE 200, DURHAM, NC, 27701

Business Categories: Category Business, Corporate Entity Tax Exempt, Nonprofit Organization, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $23,599,579

Exercised Options: $23,599,579

Current Obligation: $23,599,579

Actual Outlays: $15,715,530

Subaward Activity

Number of Subawards: 18

Total Subaward Amount: $4,073,282

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Timeline