Senior National STTA - AMR and One Health Expert / Team Lead

E4H KP TA: Embedded Technical Assistance to Institutionalize AMR Functions within IHR Systems and Sustain Priority Activities Post–Fleming Fund

Programme Overview

Evidence for Health (E4H) is a Foreign, Commonwealth & Development Office (FCDO)-funded programme aimed at strengthening Pakistan's healthcare system, thereby decreasing the burden of illness and saving lives. E4H provides technical assistance (TA) to the Federal, Khyber Pakhtunkhwa (KP), and Punjab governments, and is being implemented by Palladium along with Oxford Policy Management (OPM).

Through its flexible, embedded, and demand-driven model, E4H supports the government to achieve a resilient health system that is prepared for health emergencies, responsive to the latest evidence, and delivers equitable, quality, and efficient healthcare services. Specifically, E4H delivers TA across three outputs:

Output 1: Strengthened integrated health security, with a focus on preparing and responding to health emergencies, including pandemics.

Output 2: Strengthened evidence-based decision-making to drive health sector performance and accountability.

Output 3: Improved implementation of Universal Health Coverage, with a focus on ending preventable deaths.

Background

Pakistan faces a substantial Antimicrobial Resistance (AMR) burden, threatening health security, patient safety and effective treatment. The National Action Plan on AMR (NAP-AMR) 2.0 (2025–2029), alongside the National Action Plan for Health Security (NAPHS) 2024–2028, provides the policy and health-security framework for strengthening AMR governance, surveillance, stewardship and sustainable investment.

Khyber Pakhtunkhwa (KP) has established foundation for AMR action, including a provincial AMR dashboard, seven sentinel sites, a Public Health Reference Laboratory, teaching hospitals and One Health coordination mechanisms. Evidence for Health (E4H) KP has also supported revision of the KP Public Health (Surveillance and Response) Act 2017, creating an opportunity to institutionalise AMR coordination through the IHR governance mechanisms provided for under the revised legislation.

Following the end of Fleming Fund support, the immediate priority in KP is to ensure that these existing AMR functions are not implemented as parallel or externally dependent activities but are embedded within routine government systems. E4H KP will therefore support the Department of Health (DOH) and Director General Health Services (DGHS) through a time-bound TA package focused on institutionalising AMR governance, strengthening surveillance and data use, laboratory quality and antimicrobial stewardship, and building government capacity and financing pathways to sustain these functions beyond the TA period.

E4H KP is supporting antimicrobial resistance (AMR) as a continuation of the foundational work initiated under the Fleming Fund, with FCDO support now channelled through E4H under an agreed concept note, to help the Government of Khyber Pakhtunkhwa institutionalise and sustain AMR action through the province’s legally mandated IHR governance mechanisms

Problem Statement

While the KP DOH has established AMR governance, surveillance, laboratory and stewardship functions, the closure of Fleming Fund support creates additional pressure on functions that are not yet consistently integrated and operationalised across provincial and district health systems. The key challenge is to strengthen institutional arrangements, government capacity, routine data use and sustainable financing so that priority AMR functions continue to be effectively implemented and sustained through existing government systems.

Goal and Objective(s)

The overall goal of this TA is to strengthen and institutionalise priority AMR functions within KP’s provincial and district health systems, so they are effectively governed, implemented and sustained through government systems, particularly as external support from the Fleming Fund comes to an end.

We will achieve this by pursuing four objectives:

Objective 1: Strengthen and institutionalise provincial AMR governance, coordination and accountability through existing DOH and IHR governance mechanisms.

Objective 2: Strengthen the quality and continuity of priority AMR surveillance and laboratory functions, including the capacity of provincial and facility-level systems to generate reliable AMR and antimicrobial use data.

Objective 3: Strengthen routine use of AMR evidence for decision-making and action, including antimicrobial stewardship, rational antibiotic use and infection prevention and control at provincial and facility levels.

Objective 4: Strengthen government ownership and sustainability of priority AMR functions through capacity transfer, clear institutional responsibilities and integration of priority financing needs into provincial planning and budgeting processes.

Scope of Work and Methodology

The TA will be delivered through a flexible, government-led technical assistance model centred on capacity strengthening, institutionalisation and sustainability. A single multidisciplinary team of experts will work across the AMR agenda in KP from September 2026 to March 2027, with the DGHS serving as the designated government focal point for AMR priorities. Rather than dividing the package into separate thematic assignments, the team will bring complementary expertise together so that priorities and resources can be adjusted during implementation in response to evolving government needs, priorities and levels of ownership.

The TA will use the IHR governance mechanisms under the revised KP Public Health (Surveillance and Response) Act 2017 as its principal institutional entry point for advancing the AMR agenda. Building on E4H’s support to revision of the Act, the team will work with DGHS and the Department of Health to support the operationalisation of these governance mechanisms and strengthen their application to AMR coordination and action. The provincial AMR and sentinel-site committee, chaired by the Secretary Health, will provide an important platform for coordination, including alignment with UKHSA and other relevant partners to agree complementarity and minimise duplication.

A central feature of the methodology will be counterpart pairing and learning through implementation. Each TA position will be paired with a named counterpart in DGHS or the DOH and relevant government institutions. AMR interventions and technical products will be developed and implemented jointly with these counterparts rather than delivered on their behalf. Capacity strengthening will therefore be embedded throughout the assignment through joint working, coaching, mentoring and practical problem-solving, with responsibility for each area of work assigned to a government counterpart from the outset. This approach is intended to ensure that knowledge, capability and ownership remain within government beyond the period of TA support.

The team will operate at two mutually reinforcing levels. At provincial level, it will work with DGHS, the Directorate of Public Health, the Public Health Reference Laboratory, teaching hospitals, DG Drug Control and Pharmacy Services and other relevant institutions on AMR governance and coordination, surveillance and reporting, laboratory standards, data use, antimicrobial stewardship and related provincial functions. The team will work with existing and emerging financing opportunities, including public-sector and pandemic-related funding, and align these with government resources and priorities to maximise synergies, avoid duplication and support the sustainability of AMR interventions. The mix and sequencing of technical support will remain flexible, allowing the team to respond to government priorities while remaining focused on the critical AMR areas identified in the approved concept note and aligned with the National Action Plan on AMR.

At district and facility level, the TA will use work with E4H priority districts[1] Peshawar, Swat, Abbottabad and Kohat to connect provincial arrangements with the facilities where surveillance, reporting, prescribing and stewardship are implemented in practice. The team will also provide the implementation bridge between provincial technical work and district/facility action, avoiding the cost and fragmentation of establishing a parallel delivery structure. This will extend E4H KP’s existing district health-system strengthening demonstration model to AMR and enable implementation experience from facilities to inform provincial decision-making and system improvement.

Implementation will be adaptive rather than based on a fixed set of standalone technical assignments. Priorities, sequencing and the allocation of effort will be periodically reviewed with DGHS and relevant government counterparts, allowing the package to respond to changes in government demand, readiness and ownership without redesigning the overall TA. Through implementation, the emphasis will remain on strengthening government capacity, embedding AMR responsibilities within existing institutional arrangements, and progressively positioning government counterparts to manage priority functions themselves.

The final period of the TA will consolidate institutionalisation and sustainability, including documenting capacity transferred to government counterparts, clarifying continuing ownership of supported functions and identifying priorities requiring recurrent government financing or further action. In this way, transition will not be treated as a stand-alone end-of-project exercise; it will be built into the implementation model from the outset, with named counterparts, existing government structures and routine provincial and district systems providing the basis for continuity beyond March 2027.

Timeline and Days

The proposed LOE is 120 days from September 2026 to March 2027, subject to final confirmation from client.

Requirement

Technical Expertise

• MSc / MPH or postgraduate qualification in public health, epidemiology, health sciences, health systems or a related discipline.
• Professional/academic background in health, public health or a closely related field.
• Relevant professional experience, with demonstrated experience in AMR within the last five years.
• Experience supporting AMR, One Health, health security or related government-led programmes.
• Advanced expertise in AMR, One Health and health security.
• Strong understanding of IHR governance and institutional arrangements.
• Experience supporting government-led AMR strategies and action plans.
• Knowledge of provincial health governance, coordination mechanisms and public-sector planning.

Competencies

• Strong team leadership and coordination skills.
• Strategic thinking and problem-solving ability.
• Excellent government and stakeholder-engagement skills.
• Ability to facilitate high-level technical and policy discussions.
• Strong analytical, report-writing, mentoring and institutional capacity-strengthening skills.