Introduction

The Fleming Fund (FF) is a U.K. Department of Health and Social Care programme to help low- and middle-income countries fight Antimicrobial Resistance (AMR). AMR poses a severe global threat, expected to cause 10 million deaths annually by 2050. With potential costs reaching $100 trillion, its impact on the global economy is significant. Fleming Fund Grants aim to tackle the AMR challenge in developing countries including Pakistan. The grants are funded by the UK Department of Health and Social Care and managed by Mott MacDonald for the country, regional and fellowship grants. Pakistan has received Fleming Fund support since 2019 in the form of two Country Grants, 9 Fellowships, and central and local procurement of equipment, reagents, and consumables. Between 2017 and the end of phase-1 of the program in March 2023, the program has provided financial support to grantees to establish and support local development of national AMR surveillance systems.

In partnership with the Fleming Fund, DAI's programme in Pakistan collaborates with the Pakistani government to strengthen systems using a “One Health” approach – a multisectoral approach to complex health problems that reaches across human health, animal health, and environment sectors. As global leaders in One Health, the DAI team helps incorporate One Health across programme interventions. DAI is helping Pakistan become a leader in combating antimicrobial resistance, and a model for better management of antimicrobials in human and animal populations. DAI and its consortium partnershave successfully secured an additional round, Phase 2, of the Fleming Fund Country Grant in Pakistan which spans from January 2024 to December 2025. The Phase 2 of the FFCG programme focuses on achieving four intermediate outcomes: 1) Production of quality AMR/U/C and burden of disease data; 2) Conducting quality data analysis; 3) Sharing quality data analysis with decision-makers; and 4) Contributing to sustainable investments at both the country and global levels to counter AMR.

Position Summary

Fleming Fund CG requires an AMR Surveillance Consultant expert for Pakistan to implement the activities about the human health sector under the work area 1.01 of the Fleming Fund country grant Pakistan Phase 2 work plan whereby the consultant will provide technical assistance to the Government of Pakistan for the implementation of Antimicrobial Resistance (AMR) strategies of Human Health, Aquaculture, Animal Health, and Environment at national as well as provincial levels through different means (In-person & Virtual), and whereas possible arranging workshops for concerned colleagues.

Key Objectives:

The consultant will review the developed AMR surveillance strategy of Human Health, Environment, and Aquaculture to develop the SWOT (Strengths-Weakness-Opportunities-Threats) analysis of the One-Health approach for integration and the multi-stakeholder’s approach. Moreover, they will support the revision of ToRs of Antimicrobial Stewardship (AMS) to Antimicrobial, Infection Prevention and Diagnostics (AID) at the national as well as provincial level through the National Multi stakeholders Surveillance Coordination Committee (NMSCC), which will respond to the Apex Committees of provinces usually chaired by Chief Minister/Governor/Minister Health/Chief Secretary for implementation of action plans which will be finalised through AID under the umbrella of secretariats.

Such committees will help in the early phases of the National Action Plan and later, in true spirit, implement it at the national and provincial levels.

After the revised National Action Plan is finalised, the consultant will provide technical assistance to Technical Advisory Groups regarding the One-Health approach and provincial suggestions.

Consultancy Deliverables

Deliverable 01: Develop a Gantt Chart regarding activities planning

Deliverable 02: TEXT: Review AMR Strategies of Human Health, Environment, and Animal Health, conduct a detailed SWOT analysis

Deliverable 03: Review international strategies and incorporate their good practices in the document

Deliverable 04: Incorporate the Global Health Security Agenda (GHSA) and International Health Regulations (IHR) guidelines with proper citations using standard tools.

Deliverable 05: Incorporate  points for implementation of all activities in the context of Pakistan

Deliverable 06: For Each meeting with national and provincial concerned quarters, generate meeting minutes (MoM) duly signed by the meeting chair along with an attendance sheet

Deliverable 07: Develop the working framework for Provincial and National AMRCC (Antimicrobial Resistance Coordination Committee) secretariats and their ToRs and committee members (with mutual consent from concerned government officials). This AMRCC (Antimicrobial Resistance Coordination Committee)

Deliverable 08: Ensure AMRCC covers the AMR/AMS/AID components.

Deliverable 09: Develop the organogram of responsibility of each committee member and data and official communication flow.

Deliverable 10: Develop data confidentiality Standard Operating Procedures (SOPs) and their incorporation within AMRCC ToRs

Deliverable 11:  Ensure AMRCC ToRs are also fulfilling the Sustainable Development Goals (SDGs) supported by evidence and research at the national and international levels, and cite the SDGs wherever possible using a standard citation tool.

Deliverable 12: Identify the key indicators/variables with benchmarks. This should determine the success of AMRCC and justify each indicator based on either evidence-based research or policy documents.

Deliverable 13: Develop a Power BI tool to incorporate the results for the generation of results easily

Deliverable 14: Conduct a risk assessment to identify challenges and mitigation strategies while implementing the AMRCC at national and provincial levels.

Deliverable 15: Identify resources needed to implement AMRCC

Deliverable 16: Identify the government departments and national and international organisations/firms/alliances for resource management

Deliverable 16: If requested by the government, assist in developing the Planning Commission document

Additional Responsibilities: Complete additional tasks related to integrating AMR Surveillance aspects within the NAP as assigned by the supervisor.

Payment’s modalities

First Trench (25% Payment): Payment requisites

• Submission of Gantt Chart
• SWOT Analysis of national and international HH, AH, Environment, and Aquaculture strategies
• Incorporate points of action within the Pakistan Context
• Submit MoM and attendance sheet if any meeting was organised if budget
• In case of non-budget meeting, submit MoM
• In case of a virtual meeting (Zoom OR MS Teams), submit the recording and screenshots

Second Trench (25% Payment) Payment Requisites

• Submit ToRs and Committee formation for AMRCC for National and Provinces
• Submission should cover deliverables 7,8,9,10

Third Trench (20% Payment) Payment Requisites

• Submit deliverables 11 in an Excel sheet with calculations incorporated.
• Deliverable 12 will be in Power-Bi with linkages with deliverable 11
• Submit deliverable 13 in Excel format

Final Trench (30% Payment) Payment Requisites

• Submit the deliverables 14, and 15 in Word format
• Submit the deliverable 16 if requested by concerned government
• Ensure all formats are without grammatical errors
• Develop PowerPoint before consultancy closure to cover all aspects

Requirements (Education, Experience, Skills, Languages etc)

• Bachelor’s degree in medical/veterinary/biological science/allied health sciences with a master’s in public health, epidemiology, environmental health
• Post-graduation in health policy public policy will be an asset
• Minimum of seven years of experience in coordination, planning, design, follow-up, and report writing in a relevant field, with at least two years of experience in surveillance-related activities.
• Proven expertise in designing and conducting interactive training sessions.
• Excellent verbal and written communication skills in English and Urdu.
• Advanced skills in Microsoft Word, PowerPoint, and Excel
• Expertise in citation tools like Endnote / Zotero
• Ability to work effectively under pressure in a fast-paced environment.
• Familiarity with AMR, Global Health Security Agenda (GHSA), International Health Regulations (IHR), and multi-sector health initiatives.
• Demonstrated commitment to achieving results with a creative and innovative approach.