Analysis of the NTD situation in 17 countries in sub-Saharan Africa At ANESVAD Foundation

INTRODUCTION This document contains the Terms of Reference (hereinafter ToR) for an analysis of the work currently being done regarding skin NTDs in eight (8) countries (starting point, extendable to 17) in sub-Saharan Africa.

Anesvad is a Non-Governmental Development Organisation (NGDO) with more than 50 years of experience in the field of cooperation. It is currently present in four countries in sub-Saharan Africa.

Purpose

Our purpose as an organisation, our raison d’être and our ongoing quest is to improve the health of the most neglected people and communities.

Mission

Our mission is to fight Neglected Tropical Diseases in sub-Saharan Africa by strengthening public health systems from a human rights perspective.

Anesvad’s interventions will focus on contributing to the control, elimination and, where feasible, eradication of certain NTDs that have a decisive impact on the living conditions of people in vulnerable situations in sub-Saharan Africa. The deployment of the intervention strategy shall contribute to the improvement of the general health level of the prioritised populations.

Anesvad will promote, assist, support and, where appropriate, lead transformation processes that contribute to the effective fight against NTDs in sub-Saharan Africa and, in general, to the effective exercise of the right to health of vulnerable populations, facilitating the necessary involvement and coordination of multiple actors, especially states, and helping to ensure that people and communities are the central figures in these processes.

Anesvad is committed to making it easier for people in vulnerable situations to exercise their right to health through their own means, both public and community-based.

Anesvad’s priority area of action is international development cooperation, including education for social transformation as a complementary area of work.

Vision Our vision is of a world in which tropical diseases are not neglected and people are able to enjoy good health, and with it, more opportunities to live a dignified life.

BACKGROUND OF THE ToR
In December 2018, the Anesvad Foundation approved its current Strategic Plan (SP) for a period of four years, from 2019 to 2022. This SP was preceded by a two-year Transitional Strategic Plan that required an extension of one year, that is, it ran from 2016 to 2018. It was “transitional” since it was the Foundation’s first plan once a new Foundational Model and a New Intervention Strategy were outlined, with both documents based on focusing our work on Neglected Tropical Diseases (NTDs) in sub-Saharan Africa.

Since the end of 2019, the merging and updating of these two documents establishes Anesvad’s Identity Document, a document that reflects the “essence and meaning” of our Foundation.

Earlier in 2021, the World Health Organisation (WHO) published its Roadmap for Neglected Tropical Diseases 2021-2030 which sets out a series of global targets for 2030 and milestones to prevent, control, eliminate and eradicate this heterogeneous group of 20 diseases and groups of conditions.

Importantly, this Roadmap also outlines the integrated approaches needed to achieve the proposed targets through a series of cross-cutting activities. Of particular relevance here is the integrated approach to tackling the set of skin NTDs, a priority focus of Anesvad’s work.

We are currently in a process of reflection that will enable us to define priorities in the fight against skin NTDs in the context of sub-Saharan Africa with a view to the Foundation’s next Strategic Plan for the period 2023-2026. In this regard, this work represents a vital part of the analysis that will allow us to advance in our work with governments/ministries of health.
To this end, we are issuing these terms of reference, identifying the main needs, priorities, weaknesses and gaps in the fight against these diseases in sub-Saharan Africa.

OBJECTIVES OF THE ToR

The general objective is to provide us with a review of the situation concerning skin NTDs in eight (8) countries (extendable to 17) in sub-Saharan Africa, allowing us to identify the geographical priorities to work on for the next Strategic Plan 2023-2026. The countries identified are:

• Block 1: Benin, Ivory Coast, Ghana and Togo (countries where the Foundation is currently managing different interventions).
• Block 2: Ethiopia, Kenya, Senegal and Tanzania (countries where the Foundation plans to manage interventions in the short term).
• Block 3: Maximum of nine countries after the delivery of the report regarding the first two blocks. Initially, the following countries: Niger, Mali, Burkina Faso, Guinea Conakry, Sierra Leone, Liberia, South Sudan, Mozambique and Madagascar.

The following are proposed as specific objectives:

Objective 1: Analyse the general situation of the countries in the following terms:

• Socio-demographic indicators (general geographical, demographic, economic and political-administrative information)
• Health indicators
• Development indicators (HDI and SDGs)

Objective 2: Describe the general context as regards international cooperation in the country:

• Main actors present in the country
• Prioritised topics and supported strategies and initiatives
• Financial contribution (by type of cooperation): multilateral (UN, WB, AfDB); bilateral (main state agencies present in the countries); civil society (main local/international NGOs or foundations)

Objective 3: Describe the health system and in particular that related to NTDs:
(a) Analysis of the health system:

• Structure of the health system
  • Annual budget
  • National priorities, timeframes and strategies of the health sector
  • Main challenges, weaknesses, strengths (taking as a guideline the building blocks and the criteria of the Right to Health)

(b) Health and NTDs

• General health situation: epidemiological data (incidence, prevalence, morbidity, DALYs); plans; priorities; donors and actors
• Situation as regards skin NTDs (BU, leprosy, yaws, filariasis): epidemiological data (incidence, prevalence, morbidity, DALYs); fit with the system; priorities; challenges; weaknesses; strengths; key donors and partners; annual budgets
• Description of the current situation regarding Master Plans for tackling NTDs (diagnostic/drafting phase and operationalisation plans).

Objective 4: Preliminary identification of the main weaknesses as regards skin NTDs in the countries analysed

• Based on the analysis carried out in the first three objectives, specify the main gaps identified between the current situation as regards skin NTDs and the target status (taking as a reference the WHO Roadmap).
• Take into account, if relevant, criteria relating to countries’ interest and/or motivation when it comes to understanding their weaknesses/strengths.

METHODOLOGY AND WORK PLAN
Methodology
In their technical proposal, the consultancy team shall describe, in a manner as detailed as possible, the research methodology with which the targets are to be achieved.

Work plan
In their proposal, the consultancy team shall provide a clear outline of the work plan to be followed during their work, how they plan to liaise with the person responsible for following up this work on behalf of Anesvad, the methodology to be used, the tasks/actions to be carried out, the deliverables and their deadlines. They will also draw up a timetable detailing the duration of each of the phases.

STRUCTURE AND SUBMISSION OF THE CONSULTANCY DELIVERABLES
The consultancy process will result in a document, a report containing the following points:

1. Introduction
2. Methodology used to carry out the consultancy process
3. Constraints and limitations of the study carried out
4. Actions carried out. Compliance with the Work Plan
5. Narrative response to the questions under each of the objectives
6. Conclusions and recommendations

There is no limit as regards length, although it will limit itself to answering the questions set.

This report will contain the information for the analysis of the eight countries included in Blocks 1 and 2, outlined in section 3 of these ToR. Subsequently, after the approval of this report, the possibility of extending this study to a maximum of 17 countries (nine more) will be considered.

CONSULTANCY TEAM
The number of members of the consultancy team will be proposed by the consultancy entity (attach CVs of the proposed team). The consultant/consultancy team must meet the following requirements:

• Experience in consultancy in the sector of NGDOs, international cooperation and human development in general.
• Experience in carrying out country diagnostics and identifying intervention strategies.

Other factors that will be considered are whether they have:

• Training in public health.
• Consulting experience in sub-Saharan Africa.

The consultancy team, if applicable, will appoint a coordinator (Team Leader) who will be ultimately responsible for the work and for liaising with the contact person with Anesvad.
The consultancy team must guarantee its independence from the Anesvad Foundation.

PREMISES OF THE CONSULTANCY, AUTHORSHIP AND PUBLICATION
Anesvad considers it essential that the consultancy team conducts itself in a professional and ethical manner, respecting the following premises:

• Anonymity and confidentiality. Respect the right of individuals to provide information while ensuring their anonymity and confidentiality during the consultancy.
• Responsibility. Mention in the report any disagreements or differences of opinion regarding the findings and/or recommendations.
• Comprehensiveness. Highlight necessary questions for a more complete analysis of the consultancy even if they are not specifically mentioned in the ToR.
• Independence. The team must have no links with Anesvad Foundation.
• Validation of the information (veracity). The consultancy team guarantees the veracity of the information collected and will be responsible for the information contained in the final report.
• Issues. Any problems that arise during the consultancy must be reported immediately to Anesvad. Otherwise, such problems may not be used to explain the failure to achieve the results set out in these ToR.
• Copyright and dissemination. All copyrights remain with the entity contracting the consultancy. The dissemination of the final report and the information collected is the prerogative of Anesvad. In case of publication of the report, the consultancy team will be named as the author of same.

DEADLINES AND PAYMENTS FOR THE CONSULTANCY SERVICE
The rough timeline for the complete consultancy process is as follows:

• The signing of the contract and of the consultancy service between Anesvad and the consulting team will take place on the 17th of September, 2021.
• The contract will have an estimated duration of five months from the signing of the contract to the approval of the final report.
• The preliminary version of the report is due by the 21st of January, 2022. The final version of the report, reviewed by Anesvad, is due to be submitted by the 21st of February, 2022.

These deadlines may be modified to a small extent, depending on what was negotiated with the contracted consultancy team, and shall be stipulated in the contract.

Payments will be made upon signing the contract and against delivery and approval by Anesvad of the deliverable.