Agreement for Performance of Work - A multi-sectoral approach to tackle non-communicable disease in Malaysia

1. Background

   The Third UN High-level Meeting on Non-Communicable Diseases (NCDs) at the UN General Assembly on Sept 27, 2018, in New York was the milestone in the global response to NCDs. It was the first gathering of heads of state and governments to discuss these critical issues in the context of their commitment to the 2030 Agenda for Sustainable Development in 2015.

   Premature deaths from NCDs are a tragic and largely preventable catastrophe. Malaysia is experiencing an increasing burden of NCDs which accounts for 70% of premature deaths. The probability of dying between ages 30 and 70 years from the 3 main NCDs (diabetes, cardiovascular diseases and chronic respiratory diseases) is high (Box 1). NCDs are exerting a serious toll on Malaysia’s economy, a situation that is likely to worsen if the country does not act now. The risk factors which are overweight/ obesity, lack of physical exercise, high salt intake and smoking resulting in an increase of premature deaths caused by NCDs and inflating health care cost. As was the case with HIV/AIDS, national responses require a whole-of-government approach. The government, private sector, and civil society are to work together, and a multi-sectoral approach is therefore best led by heads of state and government.

   Box 1 NCD risk factors in Malaysia

   •     Overweight, obesity and stunting: Nearly half of adults are overweight or obese, and children are increasingly affected. In 2015, 17.7% of Malaysian adults were obese. Stunting and wasting for children under 5 reached 20.7% and 11.5% in 2016, respectively; while overweight in children less than 5 years old was 6% and among those aged 5-19 reached an alarming 26.5%.

   •     Blood glucose: The prevalence of diabetes increased from 11.6% in 2006 to 17.5% in 2015 for adult population aged 18 years and above; and from 14.9% in 2006 to 22.5% in 2015 for adult population aged 30 years and above respectively.

   •     Hypercholesterolemia: In 2015, nearly half (47.7%) of adult population aged 18 years had hypercholesterolemia.

   •     Blood pressure: Although the prevalence of high blood pressure has declined steadily from 32.2% in 2006 to 30.3% in 2015 it remains high.

   •     Smoking: Rates of tobacco use in population aged 15 years and older has levelled around 23.1% in 2011. Disproportionally more men (42.4%) smoke than women (1.2%) as of 2016.

   The World Health Assembly endorsed a set of evidence- based best buys and cost-effective interventions to tackle social and commercial determinants of NCDs. These provide global leaders with a clear template on what to do. What is most important now is how these interventions are implemented. Responsibility for implementation lies with every national government. Almost all these interventions require multi-sectoral action beyond the health sector.

   The Malaysia Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2016-2025 aims at achieving a set of seven ambitious targets by 2025. The Plan calls for multi-sectoral action. Moreover Malaysia has released a National Plan of Action for Nutrition of Malaysia III 2016-2025. Under the NSP-NCD, there is a cabinet-level committee named Cabinet Committee for a Health Promoting Environment chaired by the Deputy Prime Minister, with 11 Ministers as members which does not include academia nor NGOs and civil society.

2. Purpose/Specific Objective of the Activity

The Malaysian Government is facing challenges by other Ministries and private sector, notably the related industry for example (i) in steadily increasing taxes on tobacco and introducing tobacco plain packaging and the (ii) the introduction of tax on sugar sweetened beverages. The implementation of WHO’s new guidelines on saturated fatty acids and trans-fatty acids intake in adults and children will likely pose significant challenges in an economy heavily reliant on the palm oil industry. Strategies to counter industry lobby will be a key component of any strategy document as well as communication for development and social marketing to promote positive behavior change.

Lifestyle interventions coupled with enhanced primary health care will need to focus on increasing awareness on prevention of NCDs, screening and aim at changing behaviors in the community. 

There is an unprecedented opportunity for the UN agencies to work together with national experts to elevate the NCD response to a truly multi-sectoral approach under the Deputy Prime Minister’s Office across the whole government and including civil society.

1. Description of activities to be carried out

   The assessment and strategy paper will be based on a review of secondary data and stakeholder consultations/ interview.

   Expected contribution/output(s) vis-à-vis the 12th Malaysia Plan, United National Development Assistance Framework:

   •    To outline successful strategies and proven best practice from around the world to implement  immediate actions to be taken by the Malaysian government making the case for a whole-of-government approach to prevent and manage non-communicable diseases, and to illustrate this approach will help to achieve the Sustainable Development Goals;

   •    To outline the comparative advantage and role of each UN agency in supporting the respective government agencies, and notably in respect to countering the industry lobby for providing the terms of reference for an interagency task force on non-communicable diseases

   •    To inform the formulation of policy options for the 12th Malaysia Plan, UNDAF and individual agency Country Programmes

    

1. Time line

   The assessment report and strategy paper have a short timeframe. The inception report for the assessment will be due on the 17 May, 2019, while the final draft is expected on the 14 June 2019 and the strategy paper shortly after. This report will both be an independent, public report as well as be formulated as a Strategy Paper for establishing the UN task force on NCDs and the 12th Malaysia Plan. WHO in Malaysia will work in close partnership with the UNICEF,  UNDP, and UNU in Malaysia as well as with technical assistance from WHO’s Pacific Regional Office in Manila, the UNDP Regional Office and HQ, World Bank in Bangkok and Washington,  UNICEF East Asia and Pacific Regional Office.

    

2. Fee and schedule of payment

    

   In the financial quote, interested consultants should include: the total consultancy fee (broken down into daily rate in US Dollars or Malaysian Ringit and number of consultancy days), travel costs (with details of in-country travel to Putrajaya) and administrative fees (if applicable, broken down into the separate categories of costs like internet, phone etc.).

   Payments will be done upon completion of the deliverables, certified by the supervisor, and as per below percentages:

   •           25% of total contract amount upon the submission of the first draft of the

               inception report

   •           50% upon delivery of final draft and acceptance by the steering committee

   •           25% upon delivery of the strategy paper and financial invoice

    

3. Working arrangements

The consultant will work remotely for the duration of the assignment with one travel to Malaysia for 5 days. 

•           The consultant will work under the supervision of the WHO Representative for Malaysia under the guidance of the technical steering committee of the UN Country Team.

•           The UN country team working group on health and well-being will provide the consultant with all relevant documentation and available data. 

•           The consultant will be expected to make his/her own arrangements for accommodation if travelling from abroad and transportation to and from the office, although the office will provide recommendations for both and costs will be fully covered within the contract. 

7.Education and work experience

The consultants must meet the following qualifications requirements:

•           Advanced university degree in medicine or health sciences

•           Master's Degree or higher in public health, epidemiology, health policy, health economics, health financing or related field

•           7-10 years relevant policy and research experience in public health analysis focusing on non-communicable diseases and related risk factors to improve population health status

•           Familiarity with the literature, evidence, policy guidance and best practice related to non-communicable diseases and related risk factors

•           Solid record of producing high-quality deliverables

•           Effective English languish skills – both oral and written

•           Strong team skills and an ability to work under pressure and meet deadlines

WHO is an equal opportunity organization which welcomes applications from qualified professionals. As we are committed to achieving diversity in terms of gender, we wish to encourage qualified women, with skills relevant to the range of qualifications required for this assignment, to apply. Any person with any ties to the SSB industry (i.e. a conflict of interest) need not apply.

Please submit following documents to the Supply Officer through WP RO UNGM at wproungm@who.int by 02 May 2019

• Expression of interest (cover letter) that includes proposed consultancy fee (per day) and availability

• WHO personal history form or CV

ADDITIONAL INFORMATION

• Please note that the application may be closed before the indicated closing date if a sufficient number of applications are received
• Only the successful candidates will be contacted
• Duration of contract: 20 days to start in May 2019

Please use Tender Notice No. WPRO/2019-04/MYS_NCD/TN89479/mom as subject to all submission.