Technical Assistance for the Conduct of a Population-Based Survival Study for Pediatric Cancer in the Philippines

BACKGROUND

Worldwide, an estimated 400,000 children will develop cancer each year with 80 % of them living in countries with limited resources (Ward et al, 2019). The average global survival rate is only 37 %, ranging from   90 % in High-Income Countries (HICs) to less than 30 % in low-middle-income countries (LMICs), (Rodriguez-Galindo, 2015; Atun, et al, 2020). In the Philippines, the political and economic environment has begun to prioritize cancer care delivery. Initiatives to improve service delivery included the provision of Philhealth case rates for 13 cancers, establishment of the acute lymphoblastic leukemia (ALL) medical access program (ALLMAP) and Philhealth Z package for ALL in 2012. In 2019, the National Integrated Cancer Control Act (NICCA) was passed, and the government partnered with the WHO for the Global Initiative for Childhood Cancer (GICC). 

The NICCA and WHO GICC are focused on health systems strengthening programs to improve cancer care delivery (WHO CureALL Framework, 2021). One of these is the use of robust information systems for evaluation and monitoring such as population-based cancer registries (PBCRs) and hospital-based cancer registries (HBCRs). Population-based cancer registries collect, analyze, and disseminate cancer incidence and survival data in a geographically- defined community. Data from PBCRs can give government and stakeholders information on the burden of cancer in the community over time as well as information on planning, monitoring, and evaluation of cancer control activities in the community. With PBCRs, the government will be able to craft evidence-based cancer control policies and programs (WHO IARC, n.d.; WHO CureALL, 2021). In the Philippines, there are two PBCRs- the Philippine Cancer Society–Manila Cancer Registry (PCS–MCR) and the Department of Health –Rizal Cancer Registry (DOH–RCR) which gather data on children who develop cancer in the covered 16 cities and 14 municipalities.  Both are recognized by the International Agency for Cancer Research (IARC) and produce incidence data, published internationally in the International Incidence for Childhood Cancer Volumes 2 and 3.

The value of population-based cancer survival data is it reflects the access to hospitals, public cancer programs, and the quality of medical care delivered for a population within a defined region. These statistics measure the effectiveness and impact of the national cancer control plans and policies. Since the last pediatric population-based survival data (2001-2005) which showed low survival for leukemia and lymphoma of only  30-40%, respectively, there has been much progress in cancer care in terms of policies, infrastructure, medicine access, and healthcare financing (Redaniel, 2010).  Determining the population-based survival statistics in this new era will help guide the NICCA program and investments. Furthermore, recent data will help in benchmarking with other ASEAN countries. Currently, the reported 5-year population-based survival for lymphoid leukemias in Malaysia is 68.3%, and 54 % in Thailand (Ssenyonga, 2022). The main barriers to creating Rizal-Manila population-based survival data are the perceived conflict with the Data Privacy Law and the lack of linkages with the Philippine Statistics Authority.

The Philippine 2019-2021 CureAll Progress Monitor developed during the WHO GICC launch in 2019, prioritizes the linkages of national databases for population-based statistics. This action plan is also included in the proposed 2021-2025 Pediatric Cancer Control Program of the WHO GICC report on “Rapid Baseline Assessment of the Cancer Health System and Development of Action Plan for Childhood Cancer Control in the Philippines”. Likewise, NICCA also explicitly states in Section 28 data sharing between the Philippine Statistics Authority and the PBCRs. Unfortunately, these targets have not yet been achieved due to competing interests, the COVID-19 pandemic, and lack of linkages. especially with the pandemic. The goal of this project is to determine the population-based survival for pediatric cancer patients, resolve the issues with the Data Privacy Law for data sharing and establish the policies and procedures for linking the population registry with the national vital statistics databases. This aims to formalize and develop linkages between the stakeholders in order to come up with regular outcome data for pediatric cancer as a pilot, and which can later on be scaled up to include reporting for outcomes of all cancer cases adult and pediatric in the Philippines.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

This work is for an institutional contractual partner for the determination of population-based cancer survival for childhood cancer and the development of operating procedures and policies for linking databases of cancer registries with national registries such as the death registry in alignment with the Data Privacy Law under an Agreement of Performance of Work (APW) contract.

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

The overall goal of the technical assistance is the determination of population-based cancer survival for childhood cancer and the development of operating procedures and policies for linking databases of cancer registries with national registries such as the death registry in alignment with the Data Privacy Law.

In partnership with the Department of Health and WHO Philippines, the expected outputs for this APW are:

Output/s and Deliverable/s:

Output 1: Approved Inception Report

Deliverable 1.1: A detailed plan of action on how to conduct the project. The report should include the following, but not limited to, objectives, significance of the project, implementing framework, methodology, target participants, data collection tools, processes for data collection, analysis, validation, consultation, and presentation of findings. The inception report should also include a project management plan.

Deliverable 1.2: GANTT Chart with expected outputs and deliverables

Output 2: Determine the population-based survival for pediatric cancer in the Philippines from 2006 to 2017, such as leukemias, lymphomas (Hodgkin lymphoma, non hodgkin lymphoma), brain tumors (low-grade gliomas, medulloblastomas), retinoblastoma, Wilms tumor

Deliverable 2.1: IRB-approved study protocol, with detailed workplan, output, objectives, and timeline of implementation

Deliverable 2.2: Analysis on population-based survival data for childhood cancer from 2006 to 2017 (specifically, but not limited to:  ALL, AML, NHL (Burkitt Lymphoma), Hodgkin Lymphoma, Wilms Tumor, Low-grade glioma, Medulloblastoma, Retinoblastoma) and the specific timepoints

Deliverable 2.3: Comparative analysis of population-based survival before and after the implementation of the medicine access program for pediatric cancer.

Deliverable 2.4: Comparative analysis of population-based survival before and after the rollout of the PhilHealth ALL Z-package

Output 3: Identify the barriers to linking databases (specifically the existing cancer registry database and the national death registry) and proposed solutions

Deliverable 3.1: Conduct meetings and interviews with Data Privacy Commission, DOH KMITS, PCC, Rizal-Manila Population-based Cancer Registries, and other stakeholders to determine best practices of linking population-based registries with national vital statistics in compliance with the data privacy law

Output 4: Develop national policies and operating procedures for linking databases of cancer registries with the national death registry that are aligned with the Data Privacy Law

Deliverable 4.1: Signed Memorandum of agreement between the Philippine Statistics Authority, DOH Rizal PBCR, and PCS Manila PBCR

Deliverable 4.2: Memorandum of Agreement between DOH-CCD and access sites for participation in the patient navigation program

Deliverable 4.3: Evidence-based, sustainable operating procedures and policies for linking the pediatric cancer registry database with the national death registry (end of the project)

Output 5: Technical narrative reports and financial statements.

Deliverable 5.1: Store all project materials (raw data, recordings, minutes of meetings, photos, references, etc.) on a cloud folder. All raw data and source documents shall be submitted to DOH and WHO Philippines

Deliverable 5.2: Submission of final technical narrative report that includes project implementation and financial report.

QUALIFICATIONS & EXPERIENCE

EDUCATION

Education of staff involved:

• • With a degree in medicine, clinical epidemiology, public health, or related fields.
• • With training on cancer registration from the International Agency for Research on Cancer (IARC)

EXPERIENCE

Experience required for key staff involved:

• • With previous or current experience as member of the DOH-Rizal or Philippine Cancer Society Manila Cancer Registry
• • With previous experience in developing and writing research proposals, papers, program policies, and operating procedures.
• • Previous collaboration and good working relations with DOH will be an added advantage
• • Previous collaboration with the Philippine Society of Pediatric Oncology will be an added advantage
• • Previous experience in linking population-based cancer registry and information system

TECHNICAL SKILLS AND KNOWLEDGE

• • With excellent research skills; dedication to research integrity, and can work collaboratively

LANGUAGE

• • With excellent verbal and written communication skills in English and Filipino.

ADDITIONAL INFORMATION

The contractor shall have no direct or indirect involvement or interest, in any form, in arms dealing, drugs, alcohol industry, tobacco industry or human trafficking.  The contractor and personnel involved in this work shall have no conflicts of interest in relation to the work being undertaken

Completion of work. The work to be done under this Agreement for Performance of Work (APW) shall be completed as set out in the Terms of Reference, supported by the approved Inception Report. The contract will be completed in not more than nine months from the commencement of the Work, or otherwise as agreed in writing among the Owner and the Contractor. The work shall be done in strict compliance with the Contract, Specifications, Schedules, and all other Contract documents and all Instructions. Failure to do so shall be at the Contractor’s risk and account. Submission of Bid by the Contractor shall constitute an acknowledgment by the Contractor that it is aware of and concurs with all of the requirements or conditions incorporated in the Call for Proposal and the other documents.

As time is an essential element of this Contract, for failure to complete all work within the stipulated as set out in the Terms of Reference, the Owner shall charge the Contractor liquidated damages. This shall be in the amount of the sum of 0.5% of the total contract amount per day (Saturdays, Sundays, and holidays are included) but not to exceed the total of 10% (ten percent) of the contract amount. These liquidated damages shall be for the added cost incurred by the Owner for such delay and also for the inconvenience caused to the users of the Work. It is understood that this is not a penalty but a fixed sum representing the liquidated damages for each calendar day of the delay. Delay shall be counted from the agreed completion date, considering further time extensions approved by the Owner, to the date of completion of work.

Confidentiality. The results, products, and reports of this APW are to be treated as confidential and must not be handed over to third parties. The DOH and WHO have exclusive ownership of the reports and reserve the right to further disseminate relevant information. Documents, other information, and/or statistics that are not publicly available and have been provided to the contractor for the purposes of undertaking this work may not be published, further analysed, disclosed to third parties, or used for any other purpose even after the end of the contract.

The contractual partner will also provide a disclaimer on the reports: This document has been produced with the assistance of the World Health Organization. The contents of this publication are the sole responsibility of the author and do not necessarily reflect the opinions, recommendations, or advice of the World Health Organization.

Management of Conflict of Interest. Any interest by an entity (organization/company), expert, or member of the project team that may affect or reasonably be perceived to (1) affect the expert’s objectivity and independence in providing advice to WHO related to the conduct of a project, and/or (2) create an unfair competitive advantage for the expert or persons or institutions with whom the expert has financial or interests (such as adult children or siblings, close professional colleagues, administrative unit or department).

WHO's conflict of interest Rules are designed to identify and avoid potentially compromising situations from arising thereby protecting the credibility of the Organization and of its normative work. If not identified and appropriately managed such situations could undermine or discount the value of the expert’s contribution, and as a consequence, the work in which the expert is involved. Robust management of conflicts of interest not only protects the integrity of WHO and its technical/normative standard-setting processes but also protects the concerned expert and the public interest in general.

Ethical and Professional Standards

• • WHO prides itself on a workforce that adheres to the highest ethical and professional standards and that is committed to put the WHO Values Charter into practice.
• • WHO has zero tolerance towards sexual exploitation and abuse (SEA), sexual harassment and other types of abusive conduct (i.e., discrimination, abuse of authority and harassment). All members of the WHO workforce have a role to play in promoting a safe and respectful workplace and should report to WHO any actual or suspected cases of SEA, sexual harassment, and other types of abusive conduct. To ensure that individuals with a substantiated history of SEA, sexual harassment or other types of abusive conduct are not hired by the Organization, WHO will conduct a background verification of final candidates

SUBMISSIONS

Qualified and interested specialists should submit the following documents to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 18 February 2023

• • Company Profile {for institutional applications} and/or Curriculum Vitae of project team members
• • Cover letter. The cover letter should outline how their experience and qualifications make them a suitable candidate for this bid.
• • Proposal indicating solution/methodology, timelines and cost

Please use Tender Notice No. WPRO/2023-02/PHL/191688 as subject to all submission. Only successful candidates will be contacted.

Last day of receiving queries for this tender is on 15 February 2023