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” (OH) 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 partners have 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

Under the overall supervision of the Sr. Programme Manager Governance & Advocacy, the Public Health Specialist will provide support for the Costing of Provincial AMR Surveillance in Health Department Sindh. The purpose of this assignment is to support the Health Department, Government of Sindh in strengthening the AMR surveillance system as part of the programme. This involves providing technical assistance for detailed costing of all recurrent budgetary requirements related to AMR. The finalized revised budget will be submitted for input and approval to ensure sustainability and effective implementation of the Provincial AMR Surveillance Plan (PASP).

Key Objectives:
• Review relevant National Action Plans and Provincial Plans on AMR, existing AMR surveillance frameworks, and guidelines from international bodies (e.g., WHO, FAO, OIE).
• Organize initial consultations with the Health Department Sindh and other relevant organisations and institutions and other stakeholders to understand system goals and priorities.
• Map the current state of AMR surveillance, identifying gaps in infrastructure, workforce, data systems, and governance.
• Ensure regular communication with stakeholders to align expectations and receive feedback.
• Facilitate workshops and validation meetings to ensure ownership.
• Conduct stakeholder interviews, and discussions to gather cost-related data. Review relevant national databases, surveillance reports, budgets, and expenditure records to collect historical data.
• Use an Activity-Based Costing (ABC) approach to identify and estimate the resources required for each function of the AMR surveillance system (e.g., laboratory testing, data collection, analysis, and reporting, capacity building, M&E, etc.).

• Categorize costs into:
       o Capital Costs: Equipment, laboratory infrastructure, and technology.
       o Operational Costs: Salaries, consumables, training, and maintenance.
• Utilize internationally recognized costing tools such as:
       o WHO-CHOICE
       o One Health Tool
       o Excel-based costing models customized for the AMR context.
• Identify potential funding sources, including government allocations, international grants, and private sector contributions.
• Perform cost-benefit analysis to justify investments and recommend phased financial commitments.
• Organize meetings/ workshops to validate assumptions and preliminary findings.
• Capacity building of stakeholders on costing methodologies and tools for continuity and local capacity development.
• Identify potential risks (e.g., data gaps, funding limitations) and develop mitigation strategies.
• Include flexibility in the plan to adapt to unforeseen challenges.
• Develop user-friendly reports with detailed methodologies, assumptions, and recommendations.
• Create infographics and presentation materials for effective communication to policymakers and donors.

Requirements (Education, Experience, Skills, Languages etc.):
• The ideal candidate for this position must hold a Master or higher degree in public health, health statistics, health economics, epidemiology, or other relevant fields.
• A minimum of 10 years of experience in public health, including 3 years focused on AMR.
• He/she should demonstrate a robust track record of data collection, analysis and evidence use, particularly within the public health sector.
• A proven track record in designing and implementing public health surveillance systems, and familiarity with national and international AMR guidelines.
• The candidate is expected to possess a deep understanding of the One Health sector in Pakistan, including familiarity with challenges related to limited data availability and insufficient data and evidence use across key departments. The individual should showcase proven expertise in facilitating participatory approaches and effectively engaging diverse stakeholders within both public and private sectors.
• Excellent written, editing, and oral communication skills in English are imperative.