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Ref.
2022/SOAHEFTPOAPFSFAOC/7363

Job offer type
Experts

Type of contract
Service contract

Activity sectors
Business facilitation and regional integration ; Health systems ; Economic and financial governance

Sub-theme
Health 2020: the European policy for health and well-being ; Health systems governance ; Health systems response to NCDs

Deadline date
15/03/2022 14:52

Duration of the assignment
Short term

Contract
Freelancer

Duration
5 months

Mission description

This assignment aims at preparing a PPP feasibility study of a new oncology center in Addis Ababa for the Ministry of Health (MoH). The study will inform the PPP Board on the project’s technical, financial, economic, legal, and institutional viability. The feasibility study’s table of content is presented below in the section Deliverables.

 

 

 

 

Work approach and available information

The MoH avails a technical team that will support the short-term experts during the entire assignment’s duration. This technical team are tasked to support the experts and gather additional information as required. The resident Expertise France advisor acts as the team leader and is responsible for managing the consistency and quality of the experts’ deliverables. A pre-feasibility study was prepared in 2019 by PWC and will be shared with the selected experts. This prefeasibility study sheds light on the services to be provided, projected demand for oncology services, notional capital – and operating expenditures as well as an analysis of the payment options.

Safety conditions allowing, a combined field visit in Addis Ababa for all the experts of a maximum of 10 working days is required and its timing will be coordinated with the stakeholders involved.  Separately, Expertise France will cover all expenses related to the field visit (per diem and flight tickets). The 10 days ffield visit can be split into several mission and this will be coordinated with Expertise France.  

The oncology PPP project will be the first of its kind in the country and the MoH has no experience in managing a PPP contract of this magnitude and scope. These constraints indicate that the project structuring should be kept as simple as possible. The selected experts must have experience working in the region and be comfortable working in a similar high-uncertainty environment.

Project or context description

According to World Bank data (2019) non-communicable diseases account for 39% of total deaths in Ethiopia with cancer contributing to 7% of its national mortality rate. For people under the age of 75 years, the risk of being diagnosed with cancer is 11% and the risk of dying from the disease is 9%. Based on 2018 data from the Addis Ababa Cancer Registry, breast cancer accounted for 31%, cervical cancer for 14% and ovarian cancer for 6% of all cancer cases. According to the only oncology centre in the country (The Tikur Anbessa – Black Lion), about 80% of the reported cases of cancer are diagnosed at advanced stages, when very little can be done to treat the disease.

Cancer-treatment infrastructure in Ethiopia is inadequate and some cancer treatment services are not readily available leading people to travel outside country. The country has very few cancer specialists and paramedics to support cancer care. This renders it difficult for a great majority of the population to access cancer treatment services, which results in long waiting times.  The first Ethiopian National Cancer Control Plan is aligned with the priorities of the National Health Sector Transformation Plan (HSTP II) and availing cancer treatment services in the country is now marked as a national priority.

 

Given the existing challenge pertaining to availability of cancer care and operational efficiency for delivery of quality services to the people, a Public Private Partnership (PPP) is felt to be essential for cancer care services in country. The PPP initiative recognizes that the private sector is essential to support the country's economic growth and improve the quality of public services, particularly in infrastructure. The GOE approved the PPP Policy and PPP Proclamation in August 2017 and February 2018 respectively to establish the PPP Framework as a part of its actions to support its economic growth path

 

The PPP proclamation established the PPP Directorate General (PPP DG) within the Ministry of Finance (MOF) and was tasked with managing the national PPP framework. The PPP DG is mandated, among others to provide technical support to the PPP Board, the Ministry of Finance (MoF) and the Contracting Authorities (CA) in designing and implementing PPP projects. Figure 1 below illustrates how the appraisal - and preparation phase fits in the wider PPP project lifecycle and the feasibility study driving its decision making.

The PPP feasibility study involves a rigorous process of identifying and gathering qualitative and quantitative information regarding the proposed PPP project. This information must be synthesized and analyzed to determine if the proposed PPP project is technically, economically, financially, legally, and institutionally feasible and provides for Value for Money to the Contracting Authority.

 

 

Required profile

Health expert  

  • A minimum of 10 years professional experience in the health sector.
  • Minimum of one (1) project reference that is similar to the assignment.
  • Experience in the scoping and costing (both investing and operational costs) of required equipment for health-related services. Specific experience in oncology related services is a plus.
  • Excellent English report drafting skills.
  • Master’s degree in for instance health – or medical sciences, management, finance, or any other related field.

The health expert will work closely with  legal, financial and environmental team members  that are recruited separately by Expertise France separately.

 

 

Additional information

Deliverables

  1. PPP feasibility study

Each expert is responsible for the chapters of the PPP feasibility study as per table below but must input to other chapters as well as requested by the team leader. The resident advisor acts as the team leader and is responsible for the consistency and quality of the experts’ contributions. Both the draft and final version of the feasibility report will be presented virtually to MoH and other stakeholders. Any comments will be assessed and incorporated, if appropriate, in the report’s final version. A comprehensive Actions Taken Report including all the comments received must accompany the report’s final version.

 

 

#

Chapters PPP feasibility study

Experts’ responsibility 

0

Executive summary 

Resident advisor with input 4 experts

1

Introduction -objective and background

·         Background and history of the project

·         Cleary stated project objectives

·         Link with previous government plans, budgets and initiatives

Resident advisor with input 4 experts

2

Case studies and lessons learned

·         Description of African/regional case studies of PPPs in the health sector

·         Lessons learned in terms of project structuring, payment mechanism and risk allocation 

Financial expert with input 3 experts

3

Project rationale and demand

·         Identify services and capacities of the oncology services to be provided

·         Quantify the existing gap in oncology services in the country both qualitatively and quantitative

Financial expert with input health expert

4

Technical options and recommendation

·         Capacity and spectrum of services for oncologic services & clinical nuclear medicine or radiation therapy to be provided

·         Scoping and defining required equipment oncologic care  

·         Scoping and defining required equipment clinical nuclear medicine or radiation therapy

Health expert with input financial expert

5

CAPEX and OPEX

·         Capital expenditures related to required equipment for both oncology services and clinical medical therapy.

·         Capital expenditures related to the center’s inventory and supporting services.

·         Annual operating expenditures for the project’s duration including recurrent and major overhauls and replacements

Health expert with input financial expert

6

Environmental and social impact assessment.

·         Description of environmental/social institutional framework

·         Description of environmental and social impacts both in construction and operations phase

·         Impact analysis and mitigation measures

 

Environmental/social expert

7

Legal due diligence    

·         Description of relevant legal framework, rules, and regulations for PPPs in the health sector and land acquisition

·         Identification of legal impediments, if any, related to the service delivery by a private partner in the health sector.

·         Legal analysis of the payment options as they accrue to the private partner

·         Legal analysis of the local health insurances companies and how this can be framed in a PPP project and its payment mechanism

Legal expert with input 3 experts

8

Financial and economic appraisal

·         Economic analysis of the project resulting in an economic internal rate of return (IRR) and Net Present Value

·         Financial analysis resulting in project IRR, equity IRR, Net Present Value with a rigorous analysis of the cost of capital and discount factors

·         Both the financial and economic analysis must include a sensitive analysis and scenario analysis  

Financial expert with input 3 experts

9

PPP model recommendation, risk analysis and market sounding

·         Analysis of relevant PPP models and its recommendation

·         Analysis of the payment mechanism options and its link with national insurance companies

·         Comprehensive risk allocation and mitigation measures

·         A market sounding exercise and its bearing on the recommended PPP model

Financial expert with input 3 experts

10

Value for Money

·         Both a quantitative and qualitative VFM analysis is required

·         The VFM will compare the public procurement with the recommended PPP model

Financial expert with input 3 experts

11

Key commercial terms PPP agreement

·         Term sheet with the main terms regarding the parties’ responsibilities, conditions precedent, payment mechanism, events of default and compensations no termination 

Legal expert with input 3 experts

12

Fiscal impact of government contributions and affordability

·         Financial quantification of required contributions in terms of land, guarantees, payments

·         Affordability of the financial contributions vis-a-vis government commitments and budgets

Financial expert with input 3 experts

13

Institutional - & stakeholder management

·         Contract management capacity assessment and recommendations

·         Stakeholder mapping and management and communications plan

Financial expert with input legal expert

14

Procurement plan

·         Procurement strategy proposed and prequalification criteria

·         Listing of required approvals for tendering

·         Analysis and recommendation bidding variables both financial and technical

Legal expert

15

Conclusions and recommendations

·         Final conclusions and recommendations for the tendering phase 

Resident advisor with input 4 experts

 

 

  1. Draft tender documents (legal expert with input 3 experts) - After approving the final feasiblity study by both the EF and the contracting authority, draft versions of the tender documents will be prepared i.e. the prequalification document, Request for Proposal and the PPP agreement. The legal expert is responsible for this deliverable with input from the other experts as required.
  2. Presentations of the draft - and final version of the reports (all experts) - Both the draft and the final version of the experts’ deliverables will be presented to the client and comments will be discussed. A power point presentation must be prepared and approved by Expertise France prior to its delivery. The virtual sessions will be delivered through an interactive and participative approach.

 

Planning and input in man-days per expert

. 

Milestones

Indicative Time-planning

Draft version feasibility study  

10 weeks after letter of commencement

Inputs on the different parts of the studies for financial, legal and environmental experts

Regularly

Final version feasibility study

12 weeks after letter of commencement

 

 

Input man-days per expert

Man-days

Financial expert

35

Legal PPP expert

40

Environmental expert

15

Health expert

20

 

 

 

Content of tender and scoring

 

Candidates output  proposals and  all correspondence and documents related to the tender exchanged by the tenderer and Expertise France must be written in English.

Supporting documents furnished by the tenderer may be in another language, provided a translation into the language of the procedure is attached. For the purposes of interpreting the tender, the language of the procedure has precedence.

Failure to fulfill the requirements described in the current paragraph will constitute a formal error and may result in a rejection of the tender.

 

Proposals shall be submitted at the latest the march, 15th, 2022 at 11 am (Addis time) thought the Expertise France Platform.

 

 

  1. Technical proposal - Proposals should be presented following the structure below and not exceed ten (10) pages excluding the annexed expert’s CV. It is important to describe in the proposal the expert’s project references only and not the ones of the company. We do not score the company’s references and exclude these from the evaluation. The scoring mechanism for each chapter is presented below.

 

 

Proposal’s content  

Maximum scoring

Chapter 0

Indicate the position applied for, the expert’s name and contact details 

 

Chapter 1

International/regional experience with a minimum of 10 years professional experience

 

·         <10 years professional experience = 0

·         > 10 years professional experience = 10

·         >5 years Africa experience = 5 

 

15

Chapter 2

Experience working for multilaterals and donors and excellent English language and report drafting skills

 

·         < 2 project references = 0

·         >= 2 project references for multilaterals and donors = 10

·         >= 2 project references in English speaking countries = 5 

 

 

15

Chapter 3

 

For the health expert, this chapter must explain the experience obtained in scoping and costing of health services, scoping and costing of  health sector services both in costing and oncology services and clinical nuclear medicine and/or radiation therapy.

 

·         Non relevant assignments = 0

·         1 assignment in the scoping and costing of health equipment and services = 10

·         1 assignment in the scoping and costing of specific oncology related services and  equipment  = 10

 

20

Chapter 5

Technical proposal - Methodology and experts should only detail the methodology she is responsible for

 

·         Understanding of the risks and issues in the assignment’s execution = 10

·         Methodology and approach to execute pertinent deliverables = 10

·         Workplan with a Gantt chart and activities and interdependencies = 5

25

Price (fees per day)

25

Total

100

Annex 1. Expert’s CV

 

 

  1. Financial proposal - A document detailing the fees per working days (max 20 days/ max 18 000 EUR).

 

  1. Identification sheet - An expression of interest form dully completed and signed.

 

  1. The duly completed, dated and signed Contract agreement.

 

Evaluation of tenderers’ capacity

 

Every tenderer must provide Expertise France with a proof of its legal personality or at least demonstrate its legal capacity to run a commercial activity.

Legal persons are not entitled to participate in this tender procedure or be awarded a contract if they are in any of the conditions (mentioned in Article 45 and 48 of the French order n°2015-899 issued on July 23rd), and detailed in the Annex of the current document “Declaration of honour on exclusion criteria and absence of conflict of interest”.

Failure to meet the above-mentioned requirements or to provide the documents requested as candidatures material will result in the candidate’s tender being declared non-compliant and rejected without being analysed.

 

 

Additional information

  • Costs for preparing tenders

No costs incurred by the tenderer in preparing and submitting the tender are reimbursable. All such costs must be borne by the tenderer.

  • Amending or withdrawing tenders

Tenderers may amend or withdraw their tenders by written notification through the e-procurement platform prior to the deadline for submitting tenders. Tenders may not be amended after this deadline.

Any such notification of amendment or withdrawal must be prepared and submitted in accordance with the requirements described hereinabove.

  • Period during which tenders are binding

Tenderers are bound by their tenders for 90 days after the deadline for submitting tenders or until they have been notified of non-award.

 

Selection criteria for applications

The selection process for candidates will be based on the following criteria :

  • Candidate’s training/skills/experience

Deadline for application : 15/03/2022 14:52

File(s) attached : Health expert - ToR feasibility study Oncology Center V3.pdf - DAJ_F043ENG_v02 - Expression of interest form (6).docx - Health Expert - Individual expertise service contract.docx

Expertise France is the public agency of French international technical cooperation. The agency operates around four priorities:

  • democratic, economic and financial governance;
  • security and stability of countries in crisis/post-crisis situations;
  • sustainable development;
  • strengthening health systems, social protection and employment.

In these areas, Expertise France carries out engineering and implementation missions for capacity building projects, mobilizes technical expertise and acts as an aggregator of projects involving public expertise and private know-how.

With an activity volume of 233 million euros, more than 400 projects in portfolio in 80 countries, and 63,000 days of expertise, Expertise France focuses its action towards France’s solidarity policy, influence and economic diplomacy.

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