Request for Proposals: CXR Software


South Africa has one of the highest burdens of TB in the world. Approximately 1% of the population develop active TB disease annually. This has informed a decision by the Global Fund Cluster within NDoH to procure computer-aided diagnosis (CAD) software through three sub recipients namely: TB HIV Care, AQUITY Innovations, and Isibani Development Partners.

NDoH through TB HIV Care is seeking a service provider to provide CAD software for chest X-ray TB screening across 16 community based X-Ray Containers to reach an estimated 620 000 clients by March 2022 in six TB priority districts (City of Cape Town, Ekurhuleni Health District, Johannesburg Health District, Ehlanzeni, eThekwini and OR Tambo).

The National Department of Health (NDOH) has appointed TB HIV Care NPO, to advertise the tender on behalf of the grant. All communication pertaining to the tender will be handled by TB HIV Care.

Tender Reference Description Closing Date

THC/NDOH 10/2020-05

Appointment of a service provider to provide:

§  CAD for TB

§ Real-time CXR management system

§ Cloud-based solutions to store and archive DICOM

§ Central radiologist reporting service

21 October 2020


The full Terms of Reference and additional detailed technical specifications can be downloaded here. All applicants are encouraged to review these to inform their applications as they are critical for application purposes. Interested parties are invited to submit enquiries to No response to queries will be actioned three days prior to the closure of the bid – 18 October 2020 (17:00pm). Responses to all enquiries will be posted on the TB HIV Care website ( on 19 October 2020 (11:00am) to promote equal provision of information.


For further enquiries, please contact TB HIV Care at 082 555 7341 by 18/10/2020.

Queries and Answers: 

  1. What will be the opening hours of the 16 containers (during which CXRs will be made and have to be reported on)?

The 16 containers will operate according to South African facility hours – some facilities deliver services for 8 hours (08:00 to 16:30) of the day while others deliver a 24 hour service.

2. How many weeks per year will the containers be operating making X-rays?

DCXR containers will be operational for 50 weeks of the year. We have a 2 weeks holiday break from the 16th of December to the 02nd of January.

3. How long will the project be running to screen the projected 620 000 people?

The Digital Chest X-ray programme will be operating until the end of our funding period which is March 2022.

4. How many CXRs will be made in the total of the 16 container per week? Please stipulate the minimum and maximum to be expected.

The minimum amount of CXRs – 400 with a maximum of 600 CXRs per week across the 16 containers.

5. Can you please share your protocol/SOPs? E.g. will sputum be collected on-site and will that be analysed by GeneXpert machines in the containers?

Draft SOP is currently with the National Department of Health of South Africa and will be shared once software tender has been concluded and a service provider appointed.

6. On page 3 of the tender document at 2. X-rays management system the requirement is: ‘Customize according to needs of SRs’. Can you elaborate on what is meant please? 

Each SR (Subrecipient) has specific needs under this grant. An SR might want to segregate daily data into age and gender whilst another would want to segregate in another way. The system thus needs to be adaptable when it comes to different M&E tools.

7. Can you please explain what the ‘Categories A, B and C’ mean at the financial capabilities page 7 of the tender document?

Point 7 refers to the financial feasibility of the bidder – according to bank rating / scoring.

8. On page 5 the tender document says at 5 Special conditions: all pages of the bid must be initialed. We assume that this does not apply to financial statements and other supporting documents, is that correct? It would create unnecessary huge files.

Yes, that is correct. Only the official tender documents can be initialed.

9. The closing date for submission is 21 October. Is that also at 17.00pm? 

Tender documents will only be opened the next day which is the 22nd, so no specific time for the closure.

10. We can submit enquiries to Do we also submit the bids to this address?

Yes, please send your bids to the same email address.

11. How many concurrent users for the central radiologist reporting service.

This will vary according to the usage across all sites.

12. Are the total number of studies 620K for two years? Please confirm.

Yes the total number of studies are 620 000 until grant period ends – which is end March 2022.

13. In the document, it is mentioned that they need storage for 7 years, who will provide the storage?

The storage needs to be part of the software package during the grant period – till March 2022 – thereafter it needs to be accessible for migration to another database hosting service.

14. What is the link bandwidth between the mobile clinics and the data center?

Bandwidth link of 20MB per second will be ideal for this project.

15. How many years are required for warranty?

The warranty has to be valid till at least March 2022 when the grant period ends.

16. Regarding the required AI, is it for the mobile clinics or the central radiologist reporting service?

AI has to be part of the software for the mobile clinics – Radiographers on site will use AI to determine whether a client is presumptive of TB or not. Presumptive clients have to be referred for sputum collection in order to be diagnosed. Radiologist will not be on site – images will have to be sent to the remote radiologist.

17. In the document, it is mentioned that there are a total of 16 X-Ray machines, Please confirm.

Yes, a total of 16 containers, thus 16 X-ray units.