Food as Medicine: Food Insecurity and HIV-related Comorbidities, Coinfections, and Complications within the Mission of the NIDDK (R01 Clinical Trial Optional) | RFA DK 19 019

Opportunity Information: Apply for RFA DK 19 019

The Food as Medicine: Food Insecurity and HIV-related Comorbidities, Coinfections, and Complications within the Mission of the NIDDK (R01 Clinical Trial Optional) funding opportunity (RFA-DK-19-019) is a National Institutes of Health (NIH) discretionary grant program that supports U.S.-based research focused on the relationship between food insecurity and HIV-associated health outcomes that fall within the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) mission areas. The central idea is to fund studies that clarify how limited or uncertain access to adequate food can contribute to the development, worsening, or persistence of HIV-related comorbidities, coinfections, and complications (often abbreviated as CCCs), particularly when those CCCs overlap with NIDDK priorities such as diabetes, digestive diseases, nutrition-related conditions, and kidney or metabolic complications.

Projects proposed under this announcement are expected to do more than simply document that food insecurity and poor outcomes co-occur. The FOA emphasizes understanding pathways and mechanisms. Applicants can propose research that examines the biological, nutritional, behavioral, and healthcare-related routes through which food insecurity may drive CCC risk, progression, or severity. For example, a project might investigate how nutritional inadequacy (insufficient calories, protein, or micronutrients; poor diet quality; irregular meal patterns) interacts with HIV treatment and metabolism to increase risk for diabetes or kidney disease, or how food insecurity shapes medication adherence, clinic attendance, stress physiology, and other health-related behaviors that indirectly influence HIV-related complications. The announcement also welcomes work that tests or evaluates interventions aimed at alleviating food insecurity and then assesses how those interventions lead to improvements in CCCs, with particular attention to the underlying mechanisms of improvement rather than only top-line outcomes.

The mechanism of support is an R01 research project grant, and clinical trials are optional, meaning applicants may propose either observational/mechanistic studies or interventional studies that meet the NIH definition of a clinical trial, as long as the work aligns with the FOA focus. The activity category is listed under Food and Nutrition and Health, and the program is associated with CFDA number 93.847. The award ceiling is noted as $500,000, indicating a maximum funding level per award (typically understood as a direct cost cap unless otherwise specified in the full announcement). The FOA record lists an original closing date of March 9, 2020, and a creation date of August 30, 2019, which situates the opportunity in that funding cycle.

Eligibility is broad but anchored in U.S. domestic applications. Eligible applicants include many types of government entities (state, county, city or township, and special district governments), federally recognized Native American tribal governments, public and state-controlled institutions of higher education, private institutions of higher education, independent school districts, public housing authorities/Indian housing authorities, and a wide range of nonprofit organizations (both 501(c)(3) and non-501(c)(3), excluding institutions of higher education where specified). For-profit organizations other than small businesses and small businesses are also eligible. The FOA explicitly highlights additional eligible applicant types such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), 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, and U.S. territories or possessions. At the same time, it clearly restricts non-U.S. organizations: non-domestic (non-U.S.) entities and non-domestic foreign institutions are not eligible to apply, and non-domestic components of U.S. organizations are not eligible to apply. However, foreign components are allowed as defined in the NIH Grants Policy Statement, meaning a U.S. applicant organization can include certain foreign elements of the project when justified and compliant with NIH policy, even though the applicant institution itself must be domestic.

In practical terms, this FOA is aimed at strengthening evidence on food insecurity as a modifiable social and nutritional determinant of health in people with HIV, with a specific spotlight on complications and comorbid conditions that match NIDDK priorities. Competitive applications would typically be expected to articulate clear hypotheses about mechanisms (nutritional, metabolic, behavioral, or healthcare access-related), define CCC outcomes with strong measurement plans, and, when proposing interventions, explain how reducing food insecurity is anticipated to translate into measurable improvements in HIV-related complications through identifiable causal pathways.

• The National Institutes of Health in the food and nutrition, health sector is offering a public funding opportunity titled "Food as Medicine: Food Insecurity and HIV-related Comorbidities, Coinfections, and Complications within the Mission of the NIDDK (R01 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.847.
• This funding opportunity was created on 2019-08-30.
• Applicants must submit their applications by 2020-03-09. (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.

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