Consultancy Service_ Continuity of Essential NCD Care (PEN-D)

Terms of Reference (ToR)

Consultancy Service for Continuity of Essential NCD Care (PEN-D) In A Disaster Setting, Including Anticipated Costing for Implementation

(14.10.2026)

1. BACKGROUND

Non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, represent a significant global health challenge, contributing to nearly 41 million deaths annually. A staggering 86% of these premature NCD-related deaths occur in low-and middle-income countries (LMICs) In Nepal, NCDs have emerged as the leading cause of premature mortality and Disability Adjusted Life Years. In 2019, NCDs were responsible for 71.1% of deaths and are projected to contribute to 78.6% of total deaths by 2040. The economic burden of NCDs is also substantial; between 2011 and 2030, NCDs were projected to result in approximately US$21.3 trillion in economic losses across low- and middle-income countries due to healthcare costs and lost productive capacity.  

Managing NCDs during humanitarian emergencies presents unique challenges. Disasters and emergencies can disrupt access to health services, medicines, and continuity of care, thereby increasing the risk of disease exacerbation and complications among people living with NCDs. Despite the growing burden, NCD care remains insufficiently integrated into disaster preparedness and response mechanisms both globally and in Nepal.

The Nepal Red Cross Society (NRCS), in partnership with the Danish Red Cross (DRC), Canadian Red Cross (CRC), and Aarhus University, and with funding support from the Novo Nordisk Foundation, is implementing the project: "Resilience NCD: Strengthening NCD Care Resilience in Disaster-Prone Municipalities of Western Nepal."

The project is being implemented in Bhajani Municipality and Laljhadi Rural Municipality of Kailali and Kanchanpur districts from 1 April 2024 to 31 December 2026.

The three major components of the project are:

• Designing a Package of Essential NCD Interventions for Disaster Preparedness and Response (PEN-D).
• Integrating PEN-D with existing Early Warning-Early Action (EWEA) and Anticipatory Action (AA) approaches.
• Testing the feasibility and effectiveness of PEN-D through simulations and real disaster response events.

As the PEN-D package moves toward implementation and scale-up, there is a need to generate evidence on its anticipated costs. This information will support decision-making by the Government of Nepal, humanitarian agencies, and development partners regarding resource mobilization, budgeting, and sustainability.

Under the Resilience NCDs Project, substantial progress has been made in strengthening preparedness and continuity of care for people living with non-communicable diseases during emergencies and disasters. The project generated valuable ground-level evidence through qualitative and quantitative studies, awareness-raising activities, and advocacy initiatives focused on ensuring continuity of NCD care services.

In close coordination with Epidemiology and Disease Control Division, National Disaster Risk Reduction and Management Authority and other relevant stakeholders, the project supported the development of the PEN-D (Package of Essential Noncommunicable Disease Interventions for Disaster Settings) package. The PEN-D package is currently undergoing the government endorsement process led by EDCD.

In addition, a national roundtable discussion was organized, bringing together key stakeholders from the health and disaster risk reduction sectors to discuss strategies for strengthening NCD care services in disaster contexts. The discussion focused on identifying entry points and recommendations for building a resilient health system capable of providing uninterrupted services to PLWNCDs before, during, and after disasters. Evidence generated by the project, operational learnings, and government priorities were presented to assess the current status of NCD care services and opportunities for strengthening service continuity.

A key recommendation emerging from the roundtable discussion was the need for a clear understanding of the costs associated with operationalizing and scaling up the PEN-D package before its formal endorsement. Stakeholders emphasized that evidence on implementation costs, financing requirements, and resource implications is critical for informed decision-making and sustainable integration of PEN-D into government systems.

Therefore, these Terms of Reference (ToR) aim to undertake a costing study to estimate the anticipated and actual costs of implementing the PEN-D package in different settings. The findings will provide evidence on the financial implications of PEN-D rollout, support government planning and budgeting processes, and facilitate informed decision-making regarding the endorsement and scale-up of the PEN-D package nationwide.

2. OBJECTIVES

The purpose of this assignment is to:

• To estimate the anticipated cost of PEN-D implementation to support the Government of Nepal and humanitarian stakeholders in understanding financial resource requirements and facilitating effective planning, budgeting, and resource allocation.

Click on the links below for the detailed TOR and Annexes:

1. F696-ToR Anticipated Cost Analysis
2. F696-Annex I - Terms and Conditions for Service Contracts
3. F696-Annex II- Declaration of Undertaking
4. F696-Annex III- IFRC Supplier Registration Form

APPLICATION AND SUBMISSION REQUIREMENTS

Interested individuals and company should submit the following documents to Ms Aliza Baidya at Aliza.Baidya@ifrc.org by 02nd Nov 2026. Please be informed that the Technical and financial proposals must be submitted as separate documents/file. Incomplete proposals in all respects and proposals submitted after the deadline will not be considered. Offers received after the specified deadline will not be considered.