Request for Proposal: HIV Response Sustainability Development Thailand

Organization: EpiC Thailand Project, Family Health International (FHI 360)

Issue Date: 7 August 2024

Response Deadline: 13 August 2024

1. Background:

Meeting Targets and Maintaining Epidemic Control (EpiC) project, implemented by FHI 360, funded by the U.S. Agency for International Development (USAID), is dedicated to achieving and maintaining HIV epidemic control. EpiC is led by FHI 360 and draws upon local, regional, and international resource partners to provide technical assistance, as well as global resource partners who bring unique capacities.

Several countries have made substantial strides towards eliminating AIDS as a public health threat by reducing new HIV infections and AIDS-related deaths. Millions of people living with HIV are now accessing life-saving treatments and are expected to lead healthy, productive lives well beyond 2030. While progress varies among countries and regions, there is clear evidence that achieving these targets is feasible.

However, the advances in the HIV response are fragile and must be protected and sustained beyond 2030. Maintaining momentum is crucial, as lifelong HIV treatment for those in need represents a significant multigenerational commitment. Moreover, unaddressed new infections could significantly increase the long-term fiscal burden for countries, exacerbating the sustainability challenge and negatively impacting the health and economic prospects of many nations.

In Thailand, notable progress has been made in meeting HIV treatment targets, with 91-91-98 rates achieved by the end of 2023. Despite these advances, substantial challenges remain, particularly in prevention and early diagnosis of HIV among young key populations and other vulnerable groups. The country faces an urgent need to reduce new infections. Additionally, criminalizing policies impacting sex workers and drug users, as well as policy and legal barriers that hinder community-led responses, continue to obstruct efforts in prevention and treatment, compounded further by discrimination.

Thai stakeholders are calling for urgent action to accelerate and sustain efforts to end the AIDS pandemic. As the country aims for Universal Health Coverage (UHC), with 91% funded by domestic resources and 74% of total AIDS spending supporting UHC, it is crucial to prioritize the development of a country-specific HIV sustainability roadmap. This strategic plan will guide and support nations and partners in meeting the 2030 targets and achieving long-term sustainable outcomes.

The development of an HIV sustainability roadmap in Thailand is crucial. It will ensure the ongoing delivery of proven HIV prevention, treatment, and care services. Achieving lasting impact requires transformative changes in systems, programs, policies, and financing mechanisms, necessitating a reevaluation of how HIV responses are integrated within broader health systems and strategies. Some program activities may need to be discontinued, while others could require adaptation or innovation to provide effective, equitable, and person-centered services, supported by adequate and sustainable financing.

Implementing this roadmap will optimize resource allocation and enhance the impact of existing investments. It will also facilitate the integration of HIV/AIDS programs into broader health system strengthening initiatives, enhancing the system’s capacity to respond to HIV/AIDS and other public health challenges. Additionally, the roadmap will foster intersectoral collaboration, involving health, education, social welfare, and economic development sectors.

Sustainability roadmaps are essential for ensuring that ongoing and future Global Fund and PEPFAR investments are strategically aligned with national long-term goals. They help optimize resource allocation by identifying opportunities for efficiency gains and cost-effectiveness. These roadmaps should be utilized to prioritize interventions that enhance the sustainability of the response, particularly in relation to Global Fund and PEPFAR processes.

Below is the outline for the call for proposals to develop the HIV Response Sustainability Roadmap under the new framework.

2. Objective:

To develop a country-tailored HIV Response Sustainability Roadmap for Thailand that will galvanize national efforts and drive sustainable transformation in HIV response. This roadmap aims to achieve and maintain epidemic control by 2030, uphold the right to health for all, and ensure the quality of life for individuals infected with and affected by HIV.

3. Scope of Work

1. Develop the HIV Sustainability Roadmap Framework: Design a methodology and approach tailored specifically to Thailand’s context, detailing key areas, processes, timelines, and workflows. Review and incorporate relevant elements from the PEPFAR and Global Fund Sustainability Frameworks as appropriate. This framework will guide the activities of the National Technical Working Group.

2. Refine Sustainability Assessment Tool: Update and translate the assessment tool to ensure its relevance and usability in Thailand.

3. Conduct Technical Working Group Orientation Workshop: Facilitate a workshop to educate members on technical aspects, key areas/domains/sub-domains, and the implementation plan for the roadmap development.

4. Initiate National Sustainability Dialogue: Engage stakeholders in crafting an initial outline of the Sustainability Roadmap for the HIV response. Discuss the necessary political, structural, and programmatic transformations for a more sustainable HIV response that integrates well into domestic systems (health, social, financial, etc.) and establish goals and a vision for sustainability.

5. Conduct the Sustainability Assessment:

1. Engage a diverse range of stakeholders in a sustainability consultation to ensure comprehensive input and collaboration.
2. Summarize the analytical resource package, including the PEPFAR Sustainability Index and the Global Fund co-financing requirements, along with any additional information. Ensure that the data are comprehensive and accurate.
3. Assess the current status of the country’s HIV response across five domains and begin assessing the sustainability of various program elements.
4. Identify barriers, risks, and opportunities related to the sustainability of the HIV response. Utilize the four snapshot assessments of the status of the HIV response, which include 1) contextual or development factors, 2) major blockages and barriers, 3) interventions that the government is currently unwilling to implement or fund, and 4) intervention-level assessments. These should serve as guidance but not be limiting factors.

6. Validation Workshop or consultations:

1. Collaborate with the National AIDS Management Center and the Division of AIDS and STIs to conduct validation workshop/consultations to review the findings from the Sustainability Assessment. Outline high-level outcomes, pathways of change, and prioritize sustainability initiatives.
2. The country secured policy and political endorsement of the finalized assessment.

7. Develop the Transformation Plan: Create implementation guidelines, monitoring, and evaluation measures, and outline resource needs to achieve the desired changes, impact targets and progress towards high-level outcomes.

8. National Multi-stakeholder Consultations: Collaborate with the National AIDS Management Center and the Division of AIDS and STIs to facilitate national consultations, reaching agreement on strategies and transformative actions.

9.Finalize the HIV Response Sustainability Roadmap: Complete the roadmap in both English and Thai to ensure accessibility and implementation.

10. Provide coordination support: to the Division of AIDS and STI within the Department of Disease Control, civil society organizations, communities, CCM, The Global Fund and key stakeholders including FHI360, UNAIDS, and PEPFAR.

4. Reporting and collaboration

Under the supervision of EpiC Thailand team (FHI 360) and UNAIDS, the selected individual consultant(s) and consultancy firm will collaborate closely with the Sustainability Roadmap Technical Working Group. This group, appointed by the Department of Disease Control, Ministry of Public Health, and including PEPFAR, will guide the development of the HIV Response Sustainability Roadmap.

By incorporating above steps, ensure that the process is inclusive, participatory, and driven by the priorities and perspectives of the country stakeholders, thus fostering true “country-ownership” of the process and outcomes; and ensuring the centrality of the engagement of key and vulnerable populations.

5. Key reference documents include:

• Sustainability Primer – provides an overview of the initiative including 5 main domains for the sustainability framework.
• Companion Guide Part A – provides specific guidance for all in country stakeholders in developing an HIV response sustainability roadmap Part A
• Assessment tool – is a tool to assess sustainability and set out the pathways of change through a set of high-level outcomes. The tool comes with a user guide.
• Country analytical resource package – a 3-pager with analytics providing a concise overview of an array of critical measures and indicators that are related to the country’s HIV response.
• Any existing assessment of sustainability or transition preparedness or other analyses that highlight challenges to strengthening sustainability of the national disease responses.
• National Strategic Plans, investments cases, and other country reports on HIV, TB, and the health sector. NSP Reviews, programme evaluations, Gender/Social protection/Community-led response assessment, stigma index, etc.
• Key Global Fund documents, including concept notes or funding requests (including funding landscape and gap tables), grant budgets, performance frameworks, progress reports, evaluations, etc.
• Materials from other sources or institutions including WHO, UNAIDS, World Bank, other UN agencies, bilateral donors (including PEPFAR, AFD, GIZ, DFID, JICA), the Bill and Melinda Gates Foundation, and others.

6. Key Deliverables:

1. Inception Report by 7 September 2024: This report will outline the methodology and provide a comprehensive work plan detailing the sequence of activities, responsible parties, and estimated timelines.
2. The Sustainability Assessment by 31 December 2024

2.1 Completed the assessment results formatted in Microsoft Excel.

2.2 Final Sustainability Assessment Report (in both English and Thai):

– Executive Summary

– HIV Sustainability Roadmap Development and Approach: Describes the methodology and strategies used.

– Current HIV Response: Includes current-state assessment, future-state summary, and sustainability priorities.

– HIV Sustainability Roadmap and Change Framework: Outlines high-level outcomes, pathways for change, and key inputs for the transformation plan.

2.3 Slide Set: A presentation highlighting the key findings from the assessment.

3. HIV Response Sustainability Roadmap by 30 June 2024

3.1Final HIV Response Sustainability Roadmap Report:

– Executive Summary

– HIV Sustainability Roadmap Methodology and Approach

– National Context: Overview of the local context influencing the roadmap’s development.

– Sustainability Assessment Findings

– Sustainability Roadmap: Detailed plan including strategic actions and objectives.

3.2 Slide Set: A presentation highlighting key elements of the roadmap.

3.3 Policy Brief: A concise document summarizing the roadmap and its implications for policy.

7. Budget:

A detailed budget breakdown should be provided, covering expenses related to personnel, travel, accommodation, logistics, and other project-related costs.

8. Profile required:

Local consultants should be prioritized. investing in building national capacities fosters sustainability by empowering local experts to lead and sustain future initiatives independently.

The candidate (or team) for this TOR should:

1. possess a strong background in public health, with specific expertise in HIV/AIDS programming and sustainability assessments. A minimum of 3 years of experience in conducting similar assessments, preferably within the context of international development projects, is required.
2. demonstrate comprehensive knowledge of HIV/AIDS prevention, treatment, care, and support services, as well as familiarity with the socio-political and economic factors influencing HIV/AIDS sustainability in the country.
3. have strong analytical skills, including experience in qualitative and quantitative data analysis; and excellent communication and interpersonal skills for effectively liaising with diverse stakeholders and conveying complex findings in a clear and concise manner.
4. have proven experience in stakeholder engagement, facilitation of key informant interviews and focus group discussions, and preparation of high-quality reports and presentations.
5. Have experience in developing policy advocates and dialogues and changes
6. Having team member who is/are fluency in both Thai and English is desirable.