Funding Flexibilities and Guidance to Support Syphilis

Dear Colleague

Cases of syphilis continue to rise in the United States, as do the serious consequences of infection, including congenital syphilis. HHS has recently established a National Syphilis and Congenital Syphilis Syndemic Federal Taskforce and is encouraging the use of a syndemic approach to public health to most effectively and efficiently prevent and treat syphilis. By coordinating and integrating effective interventions we can better prevent syphilis and reduce health inequities by reaching every community experiencing increasing rates.

I am writing to you to highlight that some of the funds you receive from CDC have flexibility in how they can be used, particularly related to implementing a syndemic approach to HIV and syphilis prevention. Guidance is provided below regarding appropriate use of current award resources based on NCHHSTP's syndemic approach to prevention. This guidance can assist you in understanding the parameters of funding and builds on CDC's Flexibilities Guidance for Applicants and Recipients of Federal Financial Assistance.

Recipients funded under the following CDC Notice of Funding Opportunities (NOFOs) may use their grant resources, including funds or staff, for STI activities that are conducted in conjunction with HIV prevention activities:

• PS18-1802, "Integrated Human Immunodeficiency Virus (HIV) Surveillance and Prevention Programs for Health Departments"
• PS20-2010, "Ending the HIV Epidemic"
• PS21-2102 "Comprehensive High Impact HIV Prevention Program for Community Based Organizations"
• PS22-2203 "Comprehensive High Impact HIV Prevention Programs for Young Men of Color Who Have Sex With Men and Young Transgender Persons of Color"
• PS22-2209 "Transgender Status-Neutral Community-to-Clinic Models to End the HIV Epidemic (TRANSCEND)

In addition to these NOFOs, the supplemental funds CDC awarded under CDC-RFA-PS19-1901, "Strengthening STD Prevention and Control for Health Departments," to 59 state, local and territorial Health Department STD Prevention Programs to support Disease Intervention Specialists (DIS) and strengthen the capacity of state, tribal, local, and territorial (STLT) public health departments to mitigate the spread of COVID-19 and other infections, may also be used, if available.

Redirection Requests:

If a recipient is interested in having resources redirected to syphilis and congenital syphilis activities that are not conducted in conjunction with the core work of existing NOFOs, then CDC prior approval of a fiscal redirection request is required. Requests must include a description of the nexus between syphilis and congenital syphilis and activities within the scope of the grant to be approved.

For CDC-RFA-PS19-1901 STD PCHD, STD funds can be redirected to support syphilis activities without prior approval if the proposed changes do not represent a significant rebudgeting of funds (i.e., cumulative changes of 25% of the last approved award budget period).

For all, please review the terms and conditions of your award for more information. Please direct questions about the submission requirement and process to your Grants Management Specialist.

Sincerely,

/ Jonathan H. Mermin /

Jonathan H. Mermin, MD, MPH
RADM and Assistant Surgeon General, USPHS
Director
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
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