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**Job Description**

In Northeast Syria (NES), availability of health services remains a major challenge, where out of 16 hospitals, only one is fully functioning, eight are partially functioning, and seven are not functioning at all, according to the consolidated Health Resources Availability Monitoring System (HeRAMS). None of the districts in NES meet the emergency threshold of at least ten hospital beds per 10,000 people and internally displaced people centers and camps are putting an additional burden on the already weak health system.

Medical needs remain huge, especially for pediatrics, surgery, and mental health (as the population has been exposed to repeated trauma and extreme stress), and for all of those fields, medical equipment and supplies are crucial for the successful delivery of the intervention.

Ensuring quality and timely delivery of pharmaceutical supplies is critical, however, ECHO and generally health partners are struggling with multiple challenges in the... procurement and importation of medical supplies (medicines, consumables, and equipment) into Northeast Syria (NES). These include:

· Long delays and lead times for procured supplies’ arrival.

· Ordering from Humanitarian Procurement Center (HPC) is time consuming and requires difficult coordination with HPC to obtain the needed items as well as the required documentation for custom clearances in KRI, where items are imported to be shipped into NES.

· Market shortages and increased bottlenecks and delays in the global medical supply chain during the ongoing pandemic worsened the issue, resulting in longer timing to process orders through HPC.

· Furthermore, importing from KRI remains a challenging process, as it involves several layers of authorization from different bodies. As a result, obtaining custom clearances to import takes a minimum of 3-4 months from the request submission date.

· There is chronic lack of coordination of health partners on the ground to pursue joint procurement procedures, leading to differences in lead time delivery of the supplies.

· Some of the partners resorted to local procurement from unapproved suppliers thus risking compromised quality of pharmaceuticals and disallowed costs.

The combination of the above challenges and possibly other elements, such as lack of clarity or changing levels of authorization and clarifications required for each shipment, resulted in delayed or no delivery of the needed medical supplies to the field in an adequate timing for implementing health life-saving activities in Northeast Syria (NES).
• *Scope of work:**

The prolonged conflict in the Syrian Arab Republic seriously affected the local manufacturing capacity of medicines. Prior to the crisis in 2011, the Syrian Arab Republic was producing 90% of its medical commodities within the country. Currently, the in-country production is very low, manufacturing lacks compliance with GMP prerequisites and facilities are not easily accessible to conduct a prequalification assessment and authorization. Consequently, the pharma sourcing is through HPC’s in Iraq, Turkey, and Europe. Northeast Syria (NES) health actors face challenges in terms of lead-time for procurement, Kurdistan Region of Iraq (KRI) transit process approvals, and securing importing approvals.

This ToR aims at selecting a qualified consultant and/or internal technical IRC staff (most likely from regional or global teams) to identify opportunities to reduce transaction costs, increase efficiencies, decrease procurement costs, and reduce procurement timeframes by identifying bottlenecks and opportunities especially for ECHO-compliant regional health procurements focusing on the safety and quality of delivered equipment and supplies.

This analysis will focus on scoping the pharmaceutical/medical sector in the region to identify possible efficiencies in procurement of pharmaceutical supplies and medical equipment for health projects implemented in NES, through better understanding of faced challenges and successes building on IRC and other health actor’s expertise and presence in the field.

This will include scoping the quality of medical equipment and supplies available in the regional and national markets and frontline states including Iraq, Turkey and other countries in the region that could be strategically positioned to reduce transaction and other costs.

The identified lead for this exercise will be tasked with conducting a comprehensive suppliers and health providers’ mapping as well as supply chain assessment, with clear identification of bottlenecks and possible solutions. This will include consultations with all ECHO and non-ECHO health actors in NES. The main objective is to advice on improved procurement processes that lead to delivering quality medical equipment and supplies faster and cheaper for all health actors operating in NES, while adhering to ECHO’s procurement guidelines and quality standards.

The following tasks are expected to be concluded under this ToR:

\- Mapping of health actors and pharmaceuticals suppliers operating or importing into NES with the support of IRC programs and operations team in NES.

\- Designing a set of comprehensive quantitative and qualitative tools and utilize them for data collection from key stakeholders involved in medical equipment and supplies importation process, including but not limited to, health actors, health cluster leads, local authorities, supply chain coordinators, procurement managers, customs’ authorities, permit grantees, etc. This will be supported by IRC MEAL team in NES

\- Analyzing the current supply chain approaches used by IRC and other health actors in NES and related bottlenecks in coordination with the NES health working group, the NES Operations and Support Working Group and Logistics Sectoral Working Group in Iraq and the direct engagement of major health partners.

\- With support from IRC Regional SC team and other IRC Country programs in the region, conduct a Regional Market Assessment to identify and gauge the capacity of vendors and suppliers in the region, and the viability of importation from different countries of origin such as Iraq, Egypt, Turkey, etc. that could expedite and improve the procurement process.

\- Provide a comparative cost analysis among different procurements routes (international, regional, etc) in terms of monetary value and other parameters involved.

\- Producing concrete recommendations and related action plan that would guide rehabilitation and improvement of current health procurement and supply chain guidelines, practices, and process for all health actors in NES.
• *Deliverables:**

A final report showcasing:

· Mapping of existing health actors and medical equipment and pharmaceuticals suppliers in NES, highlighting those who adhere to ECHO’s/WHO procurement guidelines.

· A review of current health actors’ supply chain practices in medical equipment and pharmaceuticals procurement according to ECHO’s/WHO guidelines. This will include identification of gaps, bottlenecks, successes in current health procurement processes in NES.

· Identified possible local, regional, and international suppliers who are able and willing to export and deliver supplies in NES based on DAP Incoterms 2020 and who are optimally compliant with Good Manufacturing Practices (GMP) and Good Distribution Practices (GMP).

· A review of required authorizations and importation approvals’ processes for NES.

· A set of recommendations that would ensure a more efficient, faster and cheaper system for health supplies procurement in NES including advising on ways to expedite and ensure acquiring of needed approvals for importation.

· Action plan to move to the identified system including timelines and roles and responsibilities for implementing the final report’s recommendations

· A presentation and debriefing for management / other partners at the end of the consultancy and report submission to present findings.
• *Qualifications**
• *The successful candidate will be identified within IRC existing technical staff or as external consultant and will ideally possess the following skills and characteristics:**

· University and/or master’s degree in pharmacy, Business Administration, Procurement/Purchase Management, Medical Engineering, or related fields.

· Consulting experience of at least 5-7 years within the international health sectors, preferably in pharmaceutical quality assurance and management, drug procurement and supply chain, or social marketing of reproductive health commodities, while working with international NGO’s, preferably working in the Syrian Context.

· Experience in writing and editing technical documents and proposals.

· Excellent English language skills (Writing and reading).

· Team player and ability to work in multi-cultural teams.

· Good working knowledge of Arabic and Kurdish would be a distinctive advantage.

· The ability to work to tight deadlines.

· Strong computer skills.

· Work under pressure and resolve any sudden problems with practical solutions.

· Previous experience in creating quality strategies for importation and distribution of products/medicines.

· Experience in market analysis related to pharmaceutical supply chain management.

Organisation & Methodology
• *International Rescue Committee**
• *Scoping out options and Harnessing Ideas to strengthen supply chains for greater Resilience and improved Access to medicines**

1\. Rationale
============

In the Terms of Reference of the assignment, the **Overall Objective** (Impact) to which this action contributes is *to increased pharmaceutical supply security, quality and cost efficiency in the NES*.

Successful development of actionable, concrete, context-adapted and time-sequenced recommendations guiding the procurement of essential medicines in the NES will require not only the project rationale to follow from results, to outputs, to objectives, but also to ensure that external factors do not negatively impact efforts. As well as this, the strategic assessment of needs, challenges, priorities and lessons learned must provide meaningful analysis of the context and complex factors in pharmaceutical supply chains —providing value to health actors in NES. Not only must this scoping exercise provide valuable recommendations, but these must be communicated effectively in order to achieve the desired impact.

The objectives will be achieved if the following **outputs** are produced:

i) A review and comparative analysis of the supply chain management practices and capacities of different health actors, including local health authorities, implementing partners, health facilities and private pharmacies, outlining experiences, challenges and failures along with areas that may warrant further research;

ii) A mapping and assessment of needed authorisation and import approval processes in terms of their variability, co-dependencies and interrelationships outlining a set of practical recommendations to streamline some of these processes where possible;

iii) A list of local, regional and international suppliers and vendors who would be optimally compliant with ECHO procurement guidelines and standards and a comparative analysis of alternative courses of action in terms of their transaction costs, predictability and efficiency gains; and

iv) A review of best practices to shorten procurement cycles, lower transaction costs and —where possible— leverage economies of scale informing a set of practical, context-adapted and time-sequenced recommendations to increase efficiencies in the procurement of essential medicines in the NES and a multi-pronged capacity building strategy for local health actors

The overall objective will be successful if the following **objectives** are achieved:

i) To review and analyse the supply chain management practices and capacities of different health actors, including local health authorities, implementing partners, health facilities and private pharmacies with a view to inform a comparative analysis of respective experiences, challenges and failures, outlining —where necessary— areas that may warrant further research

ii) To map and analyse needed authorisation and import approval processes in terms of their variability, co-dependencies and interrelationships with a view to inform a set of practical recommendations to streamline some of these processes where possible

iii) To identify and list local, regional and international suppliers and vendors who would be optimally compliant with ECHO procurement guidelines and standards informing a comparative analysis of alternative courses of action in terms of their transaction costs, predictability and efficiency gains

iv) To identify best practices to shorten procurement cycles, lower transaction costs and —where possible— leverage economies of scale with a view to inform a set of practical, context-adapted and time-sequenced recommendations to increase efficiencies in the procurement of essential medicines in the NES and a multi-pronged capacity building strategy for local health actors

These outputs and objectives depend on the review of the supply chain management practices and capacities; mapping of authorisation and approvals; and list of local, regional and international suppliers and vendors being of value to health actors, so that they act upon best practice recommendations. An accurate mapping exercise must be conducted, to provide useful and practical recommendations for health actors. A comprehensive and authoritative list of vendors provided, as well as a detailed review of NES pharmaceutical supply chains. In order to improve supply chains these health actors must not only recognise the importance of these recommendations, but they must have time, resources and commitments to implement them. As such, the communication and dissemination of recommendations is equally important.

The report must be easy to read and digest and summarised effectively. The report needs the endorsement of key figures within the health cluster and networks among NGOs, local health authority figures and donors in order to maximise the potentially relevant audience. Furthermore, the report must focus on positive processes of change for even the most low-capacity supply chains, in order to foster an attitude of best practice within the bounds of varying organisational capacities.

In the Terms of Reference of the assignment (Annex II) the risks and assumptions are outlined as follows:
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The action is premised on the following assumptions:

— Stakeholders share a common understanding of the value added of lower transaction costs and greater predictability and efficiency gains in procurement cycles in NES

— Political feasibility of emerging recommendations —including the sensitivity of neighbouring frontline states— is duly taken into account

— Operational space for implementation can be sustained

— Momentum generated by the assignment can be sustained

— Blueprint approaches are avoided

— Plans and proposals are realistic and feasible and the ‘politics of implementation’ is duly taken into account

— Broader political and security developments do not hinder support to health service delivery

The risks identified are:
• Inside Syria*

— A military solution to the conflict prevails in the short-term resulting in an uptake of violent conflict directly impacting operational space and cross-border operations

— Activities aimed at promoting efficiency gains in procurement bear too many risks or costs or returns are not self-evident for the stakeholders involved

— Remote management increases risks of aid diversion and renders channelling of funds difficult

— Local suppliers and vendors have limited capacity or high costs, benefit from a situation of de facto monopoly, are affiliated with proscribed entities, or not interested in expanding their market share

— Regulatory barriers are insurmountable and other factors curtail alternatives

— Fragmentation or competition amongst suppliers and vendors, implementing partners or donors impedes the identification and later on the uptake of alternatives

— Low appetite for support to localisation efforts amongst donors and implementing partners

— Uptake of local production capacity in Syria and reduced barriers to crossline circulation of goods and services (positive risk)
• In the region*

— The further deterioration of the security situation in the region as a whole has detrimental impact on the identification and later on the uptake of alternatives

— Antagonistic narratives and/or other geopolitical factors curtail the identification and later on the uptake of alternatives

— Engagement of neighbouring frontline states is hampered by internal dynamics and/or limitations in terms of quality standards, capacities and resources

— Operational space of key implementing partners is further curtailed

2\. Strategy
===========

The IRC proposes to conduct a comprehensive research engaging a qualified consultant for the assignment —most likely an IRC technical staff member from the regional or global teams.

A lead-researcher will be deployed for three months to produce a fact-finding research paper with realistic, contextual and suitable recommendations. The lead researcher will have academic and/or professional credentials in supply chain management, pharmacy, health, management, or related fields, and at least 8 years professional experience in public health supply chain management. He/she is expected to have proven experience in health supply chain management in fragile state country contexts and prior substantive and sustained work experience in roles related to strengthening supply chain management in more than one fragile state country contexts or in Syria. He/she is expected to have strong analytical skills and show proof of his/her ability to communicate complex health supply chain related issues to a diverse audience.

He/she will deliver the following outcomes:

1\. A mapping of existing health actors and pharmaceutical and medical supply producers and vendors, within NES, Syria more broadly and in the region including practices of private pharmacies and hospitals —specifically identifying those who adhere to ECHO/WHO procurement guidelines;

2\. A review of current health actors supply chain practices and their alignment or misalignment to ECHO/WHO guidelines, including an identification of gaps, bottlenecks, successes and failures in health procurement processes;

3\. The identification and listing of local, regional and international suppliers who are able and willing to export and deliver supplies in NES based on “Delivered at Place (DAP) incoterms 2020” (standard sets of trading terms and conditions designed to assist traders when goods are sold and transported) and a specification of those who are optimally compliant with Good Manufacturing Practices (GMP) and Good Distribution Practices (GDP)

4\. A review of capacity gaps and expertise amongst local partners to better understand the challenges faced by humanitarian actors and adopt best practices;

5\. An analysis of the draft Essential Drug List established for NES in terms of logistical and procurement challenges the established list may pose;

6\. A mapping and review of required authorisation and importation approvals processes for NES;

7\. A comparative assessment of efficiencies in purchasing from international versus local (regional) suppliers;

8\. A set of recommendations to ensure a more efficient and faster system of procurement of essential medicines in NES including practical ways to ensure and expedite needed approvals for imports;

9\. An action plan outlining concrete steps to move to the identified system, including timelines, budget, roles and responsibilities;

10\. The identification of areas for further operational research of relevance to the area scoped by this assignment;

11\. A set of actionable recommendations on ways to include local health authorities and the private health sector in the action plan, and a list of capacity building measures addressing capacity gaps identified;

12\. Two workshops (a kick of meeting and a debriefing seminar presenting report submission findings) to brief and debrief key stakeholders at the beginning and at the end of the consultancy

This analysis will focus on scoping the pharmaceutical sector in NES with a view to identify efficiencies, best practices and experiences, bottlenecks, transaction costs, procurement and logistical challenges and delays, as well as effective coordination mechanisms among humanitarian and local authority actors. The assignment is expected to contribute to a better understanding of the challenges faced by humanitarian actors and the expertise and capacities of local partners in the field of procurement and supply chain management. This assignment will include scoping and analysing the capacities of suppliers and vendors in Turkey, Iraq, Jordan, Egypt and other countries in the region which could been major suppliers for NES. The study will also include consultations with EU, ECHO and other donor-funded partners and health actors in NES.

The assignment will generate outputs in support to the achievement of the above-mentioned overall objective and, overall, it is expected to enable the EU Delegation to Syria and ECHO to take informed decisions to increase pharmaceutical supply security, quality and cost efficiency in the NES. The consultancy will take stock of lessons learned from past and ongoing procurement cycles. The HWG will facilitate access to key stakeholders and information. The exercise will include a mapping of experiences and capacities of local partners, suppliers and vendors.

Specific Objective(s)
\---------------------

The specific objectives of this consultancy are as follows:

i) To review and analyse the supply chain management practices and capacities of different health actors, including local health authorities, implementing partners, health facilities and private pharmacies with a view to inform a comparative analysis of respective experiences, challenges and failures, outlining —where necessary— areas that may warrant further research

ii) To map and analyse needed authorisation and import approval processes in terms of their variability, co-dependencies and interrelationships with a view to inform a set of practical recommendations to streamline some of these processes where possible

iii) To identify and list local, regional and international suppliers and vendors who would be optimally compliant with ECHO procurement guidelines and standards informing a comparative analysis of alternative courses of action in terms of their transaction costs, predictability and efficiency gains

iv) To identify best practices to shorten procurement cycles, lower transaction costs and —where possible— leverage economies of scale with a view to inform a set of practical, context-adapted and time-sequenced recommendations to increase efficiencies in the procurement of essential medicines in the NES and a multi-pronged capacity building strategy for local health actors

The assignment will also take into account to the following programmatic priorities:

— Complementarities with a EU-funded scoping of local manufacturing production capacity, challenges and potential in GoS-controlled areas and the design and costing of the Essential Primary Health Services Package (EPHSP) for NES which includes a standard Essential Medicines List (EML)

3\. Backstopping, Subcontracting and Capacity Providing Entities
===============================================================

The IRC is one of the leading INGOs working in the health sector and has been present in NES for more than 7 years, running more than 25 health facilities in addition to many Mobile Medical Units (MMUs) both in camp and out of camp areas. The IRC has strong technical and management capacity and well experienced health team members including staff conversant with supply chain management, procurement and quality assurance. The IRC has sector leading Standard Operating Procedures (SoPs) including SoPs for procurement, management and warehousing, which are fully compliant with IRC policies and procedures as well as international supply chain standards. IRC country teams also receive programmatic and operational support from health technical advisors including quality assurance staff and supply chain teams at regional and global level.

IRC will provide backstopping in the form of facilitation of needed information, background documentation, security briefing and regular updates (where needed), risk analysis and risks assessment, facilitation of travel, office space, security and visa arrangements. IRC will assist data collection, avail contacts of key informants and support the consultant in the organisation of bilateral meetings, briefing and debriefing sessions working in close cooperation with the NES Health Working Group. IRC may avail translation and/or interpretation services if required and will also assist with data visualisation, mapping, editing, quality assurance, and proof reading of the final report.

IRC will also avail office space in Erbil, Iraq.

No subcontracting arrangements are foreseen in this assignment.

4\. Involvement of All Members of the Consortium and of Capacity providing Entities
==================================================================================

The assignment will be exclusively carried out by IRC.

5\. Timetable of Work
====================

The assignment will be carried out over six months and foresees the following activities alongside the inception/desk phase, field and synthesis phases outlined in the Terms of Reference:

Activity

2022

2023

Sep

Oct

Nov

Dec

Jan

Feb

Implementing body

Preparation Activity 1 (Advertisement & Recruitment)

IRC

Execution Activity 1 (Scoping Exercise)

IRC

Preparation Activity 2 (Dissemination Event)

IRC

The Inception Report/Work Plan due at the end of the inception/desk phase will provide further details regarding the methodological design of the assessment, the research questions, the methods of data collection and analysis, and the Field Phase more broadly, including the travel plan. The Inception Report/Work Plan will be discussed in a virtual kick-off meeting with the EUD Syria, ECHO and —if and where relevant— other services
Syria

salary-criteria

Apply - Consultant - Scoping Study on Pharmaceutical Supply Chain Syria