Implementation Science for Cancer Control in People Living with HIV in Low- and Middle-Income Countries (U01 Clinical Trial Optional) | RFA CA 21 056

Opportunity Information: Apply for RFA CA 21 056

The National Institutes of Health (NIH) Funding Opportunity Announcement (FOA) titled "Implementation Science for Cancer Control in People Living with HIV in Low- and Middle-Income Countries (U01 Clinical Trial Optional)" (Funding Opportunity Number: RFA-CA-21-056) supports research that helps bring proven cancer prevention, screening, and treatment approaches into real-world HIV care settings in low- and middle-income countries (LMICs). The core idea is to use the HIV treatment and prevention infrastructure that already exists in many LMICs as a practical platform for delivering evidence-based cancer control services to people living with HIV (PLWH), who often face elevated cancer risk and additional barriers to care. Rather than focusing only on discovering new clinical interventions, the FOA emphasizes implementation science: understanding what prevents effective uptake in routine practice and testing strategies that make these cancer control interventions more adoptable, better integrated into HIV services, and more sustainable over time.

A key objective of the program is to identify and unpack the real barriers that keep evidence-based cancer control from reaching PLWH in LMIC contexts. These barriers can occur at multiple levels, such as patient-level challenges (stigma, cost, transportation, competing priorities, limited cancer awareness), provider-level issues (training gaps, competing workload, lack of referral pathways), clinic and health system limitations (supply chain problems, weak diagnostic capacity, fragmented data systems), and policy or financing constraints (coverage decisions, reimbursement, national guidelines, regulatory hurdles). Applications are expected to go beyond listing obstacles by using rigorous implementation science methods to measure them, explain why they matter in a specific setting, and design strategies that directly address them in ways that fit local realities.

The FOA specifically seeks projects that develop, adapt, and evaluate implementation strategies to improve adoption, integration, and long-term sustainability of cancer control interventions for PLWH. In practice, this could mean testing approaches like task-shifting and workforce training, building referral networks between HIV clinics and oncology services, integrating cancer screening workflows into routine HIV visits, improving patient navigation and follow-up systems, strengthening supply chains for diagnostics or therapeutics, or using data systems and quality improvement methods to track performance and reduce drop-off along the care pathway. The emphasis is on generating actionable evidence from LMIC settings that can guide effective and equitable implementation both locally and globally, including lessons that could translate to other countries and health systems.

Because the target population is PLWH and the setting is LMICs, the FOA highlights the need for multi-disciplinary research teams with expertise spanning HIV, cancer, and implementation science. Competitive projects are expected to reflect local context and cancer control priorities that matter to PLWH in the proposed country or region, and to involve partnerships capable of working within existing HIV service delivery platforms. The "U01" mechanism indicates a cooperative agreement, meaning NIH program staff typically have substantial scientific and programmatic involvement during the project, often through collaboration on milestones, coordination, or other structured engagement compared with a standard research grant. The "clinical trial optional" label means applicants may propose a clinical trial if it fits the research aims, but a clinical trial is not required.

In terms of administrative details, the opportunity is categorized as discretionary funding and uses the Cooperative Agreement funding instrument type under health and education activity categories. The FOA references CFDA numbers 93.394, 93.395, and 93.399, which correspond to NIH cancer-related assistance programs. The listed award ceiling is $500,000, indicating an upper limit on award size (as stated in the source summary). The original closing date provided is 2021-12-15, and the FOA creation date is 2021-08-25, which signals this specific notice was tied to a defined submission window at that time.

Eligibility is broad and includes many types of U.S.-based and non-U.S. organizations. Eligible applicants include various levels of government (state, county, city/township, special district), public and state-controlled institutions of higher education, private higher education institutions, independent school districts, Native American tribal governments (federally recognized) and tribal organizations (other than federally recognized governments), public housing authorities/Indian housing authorities, nonprofits with or without 501(c)(3) status (other than higher education institutions), for-profit organizations other than small businesses, small businesses, and other entities. The FOA also explicitly calls out additional eligible groups such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISISs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, non-domestic (non-U.S.) entities/foreign organizations, Indian/Native American tribal governments (other than federally recognized), and U.S. territories or possessions. This breadth aligns with the on-the-ground partnership needs typical for implementation research in LMIC health systems, where collaborations among universities, ministries of health, clinics, community organizations, and regional networks can be essential.

Overall, the FOA is designed to close the gap between what is known to work in cancer control and what is actually delivered to PLWH in LMIC settings. It prioritizes practical, context-sensitive implementation research that can strengthen integration of cancer services into HIV platforms, improve equitable access and outcomes, and produce evidence that supports scalable and sustainable cancer control strategies for PLWH worldwide.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Implementation Science for Cancer Control in People Living with HIV in Low- and Middle-Income Countries (U01 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.394, 93.395, 93.399.
• This funding opportunity was created on 2021-08-25.
• Applicants must submit their applications by 2021-12-15. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $500,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for RFA CA 21 056

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