Consultant - Scoping Study on Pharmaceutical Supply Chain
syria - derek
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).
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.
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.