National Consultant to Develop a National ARVs Security Plan

Local Health System Sustainability (LHSS) Vietnam

National consultant to develop a National ARVs security plan

I. Background

The global USAID LHSS project helps low- and middle-income countries transition to sustainable, self-funded health finance systems that support high-performing overall health systems. The LHSS activity in Vietnam will work with the Government of Vietnam (GVN) to advance greater local ownership of HIV and TB prevention and control processes and functions. Led by Abt Associates, the four-year activity will support Vietnam in increasing its domestic financing for HIV and TB services in the context of declining donor funding, in using government resources more efficiently, and in assuming local ownership of HIV and TB prevention and control activities. Specific objectives are: (1) Support the GVN to strengthen its public financial management systems for public sector health and find greater efficiencies in social health insurance (SHI), (2) Increase and improve the efficiency of domestic financing for HIV prevention and treatment services; (3) Strengthen the capacity of Vietnam’s supply chain management system; and (4) Integrate TB services into SHI.

A decrease in donor funding for HIV and TB services is expected to impact Vietnam’s HIV and TB services in the coming years. Currently, the Government of Vietnam (GOV) provides ARVs and associated services through the Vietnam Social Health Insurance Fund (SHI) as a strategy to sustain the supply of HIV/AIDS commodities. This was initiated in 2019 with adequate coverage of ~42% of patients on two priority first-line ART regimens and was expanded in 2021 to include coverage for an additional  7 ARVs drugs included in five additional ART regimens which  85% of patients. Under this new scheme, ongoing procurement of ARVs with domestic funding sources has been facing challenges such as low-demand products (pediatric drugs at majority), lengthy procurement processes, procurement failure, limited drug registration numbers, for example, drugs with one or two Mas resulting non-competitiveness in procurement. As a result, the Global Fund remains the current“ backup source” of ART commodity inputs in order to avoid interrupting ARV supply to patients on or commencing ART. In this context, it is expected that Global Fund financing of ART inputs for the national HIV strategy will decrease significantly from 2022. Of deep concern to VAAC, there is as yet no commitment from Global Fund or other international donors to continue ARV financing after 2023. From 2024 onward, it is expected,  there will only be State budget and Social Health Insurance financing available for ARVs procurement. Thus, it is an immediate and high priority need that the GOV and VAAC collaborate with partners to develop a National ARV Security Plan that defines potential risks and barriers to sustained national ARV  supply,  proposes preventive actions and solutions to cope with both immediate and forecasted incidents expected to disrupt production and supply of ART inputs, and strengthens procurement and transportation process that will avoid interruptions in  ARV supply to patients in care. Such a national plan is needed to assist the GVN in planning now to avoid risks to ARV supply now and in the future.

II. Objectives and tasks of the assignment

a.     Objective

The national ARV drug security plan will support Viet Nam to develop a plan to ensure continuous ARV drug supply in the context of transition from donor to domestic program financing. The drug security plan will:

• recommend preventive actions and solutions on policies, mechanisms, and implementation best practices to ensure sufficient and high-quality ARV drugs for HIV/AIDS treatment.
• Support the Viet Nam Authority of HIV/AIDS control, the provincial center of disease control, pharmaceutical enterprise, and the relating units to access  global advanced treatment guidelines and best practices on ARV drug production and supply
• Assis the VAAC to   update the treatment optimization plan, support TLD regimens, and orient health providers on the use of  ARV drugs introduced to the national program (drug in subcutaneous form, DTG 10mg, ..)

b.     Tasks

The development of Drug security plan will be developed in two phases:

Phase 1:

• Review drug security plans of other domestically financed national programs and/or selected countries with similar context to Vietnam for reference and recommend appropriate approaches which are applicable in Vietnam;
• Work with VAAC, ARV suppliers, and related stakeholders to collect relevant information relevant to the following contents for analyzing and evaluating the ARVs supply in Vietnam:
  
  • List of valid Marketing Authorization numbers for ARVs and associated medicines
  • Estimated population need and forecasted consumption needs of each drug/ regimen in the short and long term
  • Collect information of suppliers’ interests for domestic production or importation and approaches to the Vietnamese ARV  market for the period of 2022-2026
  • Characteristics of ARV drugs supply in Vietnam in the transition of ARV procurement from donated source to local sources (patient transition among funding sources,  methods of drug procurement and management, reallocation mechanism, settlement method, patients and doctors’ accessibility to the drugs, especially for new active ingredient drug in new route of administration)
• Identify all difficulties and barriers which occurred during the quantification, procurement, distribution, reallocation mechanism, report, and information sharing that leads to or causes risk of interrupted ARV supply to HIV patients;
• Identify and analyze potential causes and solutions that were taken to solve these incidents for the lesson learned in phase 2.
• From the information collected and analyzed above,  forecast and list incidents that likely happen and cause ARV supply interruption in the future and propose preventive actions and measures in priority order to deal with the incidents.
• Develop the outline of the Drug security plan including proposed solutions and share with relevant partners to get inputs and consensus

Phase 2:

• Develop the detailed drug security plan including the preventive actions and solutions for potential incidents causing an interruption of the ARV supply chain 
• Support VAAC to present the ARV security plan at conferences/meetings to get feedback/ comments from relevant stakeholders
• Revise the Drug security plan according to the feedback and comments of the relevant stakeholders and submit it to VAAC for approval.

III. Deliverables

IV. Management of this assignment

All deliverables must be reviewed and approved by the LHSS Supply Chain Lead. The consultant will work closely with the Viet Nam Authority of HIV/AIDS Control, National Centralized Drug Procurement Center of MOH, and relevant stakeholders, pharmaceutical enterprises to collect data, information and conduct the analysis.

V. Location and Timing

5.1. Location 

The work will be carried out in Hanoi.

5.2. Timing 

The assignment is planned for the period from February through August 2022, with a total of up to 70 working days

VI. Requirements

• A master's degree in public health, pharmacy, or relevant disciplines, or a higher degree is preferable.
• More than seven years working with the National HIV/AIDS program.
• Strong knowledge of HIV/AIDS treatment
• Good understanding of drug supply management, and procurement through the domestic fund.
• Good understanding of the Vietnamese pharmaceutical market.
• Demonstrate ability to work effectively with government agencies, including the MOH/VAAC.
• Language requirement: Vietnamese. The ability to speak and write English would be an advantage.

To apply, please send your application documents to the following email : [email protected]

Deadline: 06 February 2022

Only short-listed candidates will be contacted for interviews.