State Department Global Health APS Update: Q&A Clarifications and New Philippines Addendum
Updated details on funding, structure, and how the APS is expanding in practice
Since the release of the State Department’s Advancing Global Health APS, a new Round 1 Q&A document—and the addition of Addendum C focused on the Philippines—provide further clarity on how the mechanism is being implemented.
Taken together, the APS, addenda, and Q&A offer a more complete picture of how funding, timelines, and program design are expected to work. And what more we can expect in the coming months.
Below is a consolidated update based on those materials.
1. Current funding available
The Rapid Outbreak Response addendum confirms that up to $290 million is currently available, with up to 10 awards anticipated. Projects are expected to run for a period of up to five years.
In addition, the newly released Addendum C: Advancing Integrated and Sustainable Health Systems in the Philippines introduces a separate funding envelope of up to $200 million, with up to 6 awards anticipated.
These figures reflect funding tied to currently released addenda. Additional funding opportunities may be released over time through future addenda.
2. APS structure: phased and addendum-based
The APS is being implemented as a multi-addendum mechanism, rather than a single, standalone funding opportunity. Each addendum defines a specific technical or programmatic focus area.
The Q&A document makes clear that additional addenda will be released over time. Some addenda may be country-specific and aligned closely with bilateral agreements, while others may focus on cross-cutting services or technical areas.
At this stage, the APS includes both global/thematic addenda and now a country-specific addendum:
Orphans and Vulnerable Children (OVC) / Child Protection
Global Health Security / Rapid Outbreak Response
Addendum C: Philippines (integrated health systems and bilateral health security)
This expansion signals how the APS is being used across different levels—from global priorities to targeted country investments. I would expect to see more country-specific addendums in the future.
3. Application process: two-stage approach
The APS uses a two-step application process.
In Phase 1, applicants submit a Statement of Interest (SOI). The SOI narrative is limited to five pages, although tables, charts, and annexes are allowed and do not count toward this limit within defined parameters.
Following review, a subset of applicants will be invited to move forward. These applicants may either proceed directly to Phase 2 or participate in a consultative program design process before submitting a full application.
In Phase 2, selected applicants will receive additional instructions and submit a full proposal. Not all applicants will receive feedback if they are not selected to advance.
4. Timeline and review process
The APS operates on a quarterly submission and review cycle. All SOIs submitted within a given window are reviewed after that window closes.
The review process includes a technical eligibility screening, a merit review panel, and internal clearance and decision-making steps.
The Q&A notes that the full process—from SOI submission to potential award—may take several months. Timelines may vary depending on the number of submissions and operational factors.
5. Relationship to bilateral MOUs
The APS is designed to function alongside bilateral Memoranda of Understanding (MOUs), which are a central component of the broader U.S. global health strategy. While the State Department has not consolidated these MOUs in a single, easily accessible location—which would significantly improve transparency and stakeholder engagement—the most up-to-date information is currently available through the Kaiser Family Foundation (KFF) website.
According to the Q&A, APS-funded projects may either support the implementation of MOUs or complement MOU priorities without being directly tied to them. Some addenda may be linked to MOU funding, while others may be funded through separate channels.
Importantly, the State Department notes that applicants do not need detailed knowledge of specific MOUs in order to submit a competitive SOI.
6. Geographic scope
The Q&A initially indicated that APS-funded activities are not limited to countries with signed MOUs and that there are no designated priority countries across the early addenda.
Applicants may propose projects in any country eligible for U.S. foreign assistance, and proposals may be designed as single-country or multi-country efforts.
At the same time, the release of Addendum C focused on the Philippines demonstrates that the APS is also being used for targeted, country-specific investments aligned with bilateral priorities. I expect to see more of this in the coming months.
Taken together, the current structure allows for both:
Broad geographic flexibility across global and regional proposals
More defined, country-level opportunities through specific addenda
7. Program design flexibility
Across multiple sections of the Q&A, the State Department emphasizes flexibility in program design.
Applicants may choose to address one or multiple objectives within a given addendum. There is no requirement to use a specific implementation model, and proposals may include a range of approaches such as service delivery, systems strengthening, policy reform, or technical assistance.
Organizations are encouraged to submit concepts that clearly align with the scope and objectives outlined in each addendum.
8. Focus of the outbreak response addendum
The Rapid Outbreak Response addendum focuses on enabling early detection and rapid containment of infectious disease outbreaks.
The document highlights the importance of supporting response activities in the first days and weeks of an outbreak, including surveillance, laboratory capacity, infection prevention and control, case management, logistics, and coordination.
Projects are expected to be time-bound, operationally focused, and capable of adapting to changing outbreak conditions. At the same time, they should contribute to strengthening longer-term national systems for outbreak detection and response.
9. What else is new
The newly released Philippines addendum reflects a more targeted, bilateral approach within the APS.
The program focuses on strengthening disease surveillance, integrating service delivery across programs, expanding domestic financing capacity, and building performance and accountability systems.
In parallel, there is also a pipeline of forecasted global health security funding opportunities expected from the Centers for Disease Control and Prevention. These are not part of the State Department APS, but they are closely aligned in focus and timing.
The forecasted opportunities include:
A global mechanism on strengthening outbreak detection, notification, and response capacity (CDC-RFA-JG-26-0056; ~8 awards expected)
Country-specific programs in:
Kenya (4 awards)
Senegal (4 awards)
Ethiopia (3 awards)
Indonesia (2 awards)
Tanzania (3 awards)
Uganda (3 awards)
Côte d’Ivoire (2 awards)
Ghana (4 awards)
Nigeria (3 awards)
Sierra Leone (3 awards)
Democratic Republic of the Congo (4 awards)
India (multiple opportunities, including outbreak response and HIV/TB systems strengthening)
Regional programming, including:
Central America (2 awards focused on HIV, TB, and broader health priorities)
Cross-cutting technical investments such as:
Surveillance systems and early warning capacity (CDC-RFA-JG-26-0113)
Laboratory systems, diagnostics, and pathogen sequencing (CDC-RFA-JG-26-0058)
All of these opportunities are currently listed as forecasted, with timelines and funding levels still to be confirmed.
Bottom line
The APS is being implemented as a phased, addendum-driven funding mechanism with a defined initial funding envelope and additional opportunities expected over time.
Recent updates—including the Q&A and the addition of the Philippines addendum—show a model that combines global thematic funding windows with more targeted, country-specific investments. At the same time, parallel funding pipelines from other agencies suggest that additional resources for global health security are likely to emerge in the coming months.
While some have criticized this approach as a return to a more traditional, USAID-style model of fragmented funding streams, the reality is that the State Department is now firmly in the lead on global health strategy and implementation. The APS is not a temporary instrument—it is likely to remain a central mechanism for how these programs are funded and operationalized.
This shift also raises important questions for Congress, particularly around how progress will be tracked, how funds are allocated across disease priorities, and whether reporting will maintain the clarity and accountability that have historically underpinned bipartisan support for programs like PEPFAR.
Stakeholders will need to monitor both APS addenda and related funding announcements—as well as evolving oversight and reporting expectations—as this landscape continues to evolve.
To read more - see my Substack on the original APS here: