Justification and Approval for Technical Support Services Contract No. 72067419C00001.pdf

JUSTIFICATION AND APPROVAL FOR EXPEDITED PROCEDURES PACKAGE

TO: Mei Mei Peng, Contracting Officer, Regional Office of Acquisition and Assistance, USAID/Southern Africa

CC: Deborah Broderick – Agency Competition Advocate

FROM: Ashley Frost, Health Office Director, USAID/Southern Africa

DATE: September 27, 2022

RE: Task Order number AID-674-TO–16-00003 Issued under Indefinite Delivery Indefinite Quantity Contact No. AID-OAA-I-15-00032 (“Guidehouse” formerly “Pricewaterhouse Coopers LLP”) for the South Africa Supply Chain Technical Assistance (SASC-TA) Activity

SUBJECT: Justification for Other than Full and Open Competition under the Expedited Procurement Procedures (EPP) for Programs Managed by the U.S. Agency for International Development (USAID) for the Prevention, Care, and Treatment of HIV/AIDS under the President's Emergency Plan for AIDS Relief (PEPFAR)

1. This document sets forth the facts and rationale justifying the use of other than full and open competition.

It is recommended that you approve this justification for use of other than full and open competition pursuant to the authorities under the Expedited Acquisition and Assistance Procedures (EPP) for Programs Managed by the USAID for the Prevention, Care, and Treatment of HIV/AIDS under PEPFAR, approved on December 31, 2019. Your approval of this J&A constitutes the justification for other than full and open competition as required by Tab 1 (D&F for the Authorization of Less than Full and Open Competitive Procedures in the Modification or Award of Contracts) of the EPP.

RECOMMENDATION

It is recommended that you approve this justification for use of other than full and open competition pursuant to the Action Memorandum Expedited Procurement Procedures for Prevention, Care, and Treatment of HIV/AIDS, approved on December 31, 2019. Your approval of this J&A constitutes the justification for other than full and open competition as required by Tab 1 (D&F for the Authorization of Less than Full and Open Competitive Procedures in the Modification or Award of Contracts) of the EPP.

2. The nature and/or description of the action being approved:

This is a request to approve an extension of the referenced Task Order (TO)’s end date from February 28, 2023 through February 27, 2024; and increase the level of effort by 13,087 days from 62,722 to 75,809. The additional 13,087 days is budgeted at an estimated $4,831,619. The projected mortgage at the end of the TO (February 28, 2023) is $8,598,672. It is anticipated that the technical assistance (TA) services needed under the requested extension will cost $7,115,242.

Therefore, the current scope of work and current TO ceiling of $52,543,344 remains unchanged.

3. Description of the supplies or services required, including an estimated value:

As stated above, the estimated value of technical assistance services under the proposed TO extension is $7,115,242 including an estimated $1,000,000 for Global Vax and COVID19 activities.

USAID/SA purchases roughly $6,000,000 annually in supply chain technical assistance services which ensures that roughly $500 million1 annually of GoSA procured HIV/AIDS Medicines, and over 7 million donated US COVID vaccines are distributed effectively and timely to the people that need them. These resources also underpin and safeguard PEPFAR’s annual investment in South Africa of over $400 million by ensuring that people who PEPFAR puts on life saving treatment continue to have access to the medicines they need in order to stay on life-saving treatment. With the transition to more effective HIV/AIDS medications and the global fight against COVID19, the GoSA needs USAID support in ensuring continuous commodities availability at all levels of the supply chain (from Medical Stores Department to health facilities).

The South Africa Supply Chain - Technical Assistance (SASC-TA) Activity under the USAID/SA referenced Task Order provides technical assistance to the GoSA to improve the country’s supply chain systems. Sustainable health supply chains which are agile, robust and resilient, contribute towards improving commodity security and the livelihood of South Africans.

The support from SASC-TA includes supply chain replenishment planning; technical assistance around data management, information systems and visibility; technical assistance in quantification, planning and forecasting; technical assistance to support adoption of new medicines, methods, and technologies into the supply chain. These efforts help to ensure the delivery of essential commodities to the people that need them and supports strategic planning and implementation to the GoSA. Additionally, SASC-TA assists the GoSA to broaden stakeholders’ engagement with the supply chain system and create an enabling environment to improve supply chain systems.

Since several programs under PEPFAR countries are transitioning to the NextGen suite of awards and the schedules for these transitions will experience delays and modifications, USAID/SA needs the flexibility to fill this gap and allow continuation of provision of technical assistance to ensure the sustainability of investments under PEPFAR. To support these mentioned activities, a longer period of performance and increase to the level of effort is required.

4. Statutory authority permitting other than full and open competition:

17.5 B Rand in 2019/2020- NASA Nov, 2021 Presentation.exchange rate used $14.7 ZAR/USD

AIDAR 706.302-70(b)(3) and 40 U.S.C. §113; see Action Memorandum entitled “Expedited Procedures Package for Programs Managed by the U.S. Agency for International Development for the Prevention, Care, and Treatment of HIV/AIDS under the President's Emergency Plan for AIDS Relief” signed by the USAID Administrator on December 31, 2019 and will expire on December 31, 2024. It is expected that 90% of the funding for the contract will come from the PEPFAR program and, therefore, the EPP may be applied to this action.

5. A discussion of the proposed contractor’s unique qualifications or the nature of the acquisition that requires use of the authority cited.

The EPP states that “decisions and authorities within the EPPs procedures have been essential to USAID’s ability to respond quickly and effectively in meeting the critical needs of all HIV/AIDS activities and response to outbreak of contagious infection diseases.” In addition, “the flexibility provided by these expedited procedures is necessary to avoid impairment of USAID’s foreign assistance objectives and goals.”

USAID Southern Africa partners with the GoSA to ensure life-saving medicines are provided to over 5 million people living with HIV/AIDS (PLHIV) in South Africa. In FY23, PEPFAR and the GOSA intend to put an additional 500,000 people on life-saving treatment. USAID technical assistance to the National Department of Health (NDOH) in supply chain management underpins PEPFARs broader efforts to reach 95-95-95 and ensure PLHIV have access to best-value medicines.

The SASC-TA project plays a critical support role to the Affordable Medicines Department (AMD) which is the NDOH’s procurement and supply chain unit. Guidehouse, the TO Contractor, has become a trusted partner within NDOH circles especially for the AMD directorate. This is evidenced by several events, including, for example, the NDOH appointing the project’s chief of party as the supply chain lead for an NDOH-led taskforce to manage the roll out and management of South Africa’s COVID-19 vaccine campaign in 2021.

There are potentially catastrophic implications, immediate and longer-term, if there were a sudden cessation of TA by the SASC-TA project (and/or a qualified successor). The following activities highlight some of the key areas of SASC-TA’s work and the potential adverse consequences that are likely to result in the absence of SASC-TA.

USAID Technical Priorities and implications: TLD, Multi Month Dispensing, Information Systems, Governance

The USG has several key priorities in FY23-24 which include the following: expansion of multi month dispensing (MMD); the expansion of the dolutegravir-based HIV/AIDS medicine (TLD), a clinically superior regimen; further development of the national supply chain information systems, and improving supply chain governance and contract management. Expansion of these interventions will reduce costs to the national program, reduce the spread of HIV/AIDS and safeguard the lives of millions of PLHIV in South Africa. While the SASC-TA project was an integral part of the successful roll out and uptake of TLD, further supply chain technical assistance is needed to support the continued scale up and roll out of these life-saving interventions in FY2023-24.

Guidehouse is a deeply trusted technical assistance partner and has developed a strong relationship of trust with the NDOH and GoSA. Guidehouse employs over 30 highly qualified technical staff that partner with the government at various levels of the supply chain; house uniquely technical qualifications in forecasting, supply planning and pharmaceutical management, and have institutional memory of the national HIV/AIDS supply chain program.

The SASC-TA TO is the only mechanism with the unique qualifications that can continue providing an immediate complex array of tailored supply chain technical assistance to the South African Public Health Supply Chain and has the deep relationship of established trust with government partners in South Africa needed to carry out these life-saving interventions in FY 23-24.

Procurement timelines and constraints

Given SC-TA’s current contract end date of February 28, 2023, there is a significant risk that the task order will expire prior to a new follow-on contract being awarded. In December 2021, USAID/SA opted to buy into the centrally managed multiple award NextGen Comprehensive Technical Assistance for Health Supply Chain and Pharmaceutical Management (CompTA) IDIQ. At that time, the anticipated award and launch for the CompTA IDIQ was June 2022.

This timeline would enable USAID/SA sufficient time to award a task order and secure some overlap between the new activity and the incumbent SASC-TA project.

For reasons outside of the control of USAID/SA, the award of the CompTA IDIQ has been delayed and is now estimated to be awarded towards the end of 2022. USAID/SA cannot issue a task order by the February 28th, 2023 deadline, putting the USAID and PEPFAR Programs in South Africa at risk of not achieving treatment targets. USAID/SA would also risk potentially damaging its own relationship with the NDOH and with PLHIV civil society groups who depend on these medicines for survival. Lastly, USAID faces the risk of losing funding and territory in the supply chain space during the PEPFAR interagency budget negotiations if there is no viable follow-on supply chain mechanism in place.

USAID/SA anticipates that a task order under CompTA could be awarded by May 2023, which would then require additional months for startup, handover and close out. Based on this, USAID/SA estimates a 12-month extension is needed for SASC-TA to ensure a seamless transition between the existing SASC-TA task order and the new task order issued under Comp

TA.

Under a 12 month extension, SC-TA would continue to support its existing scope of work which include activities such as: quantification methods, planning and stock monitoring to avert stockouts or stock shortages, national roll-out of an improved approach to replenishment management with facility level minimum-maximum (min-max) stock levels, technical assistance and planning for TLD and MMD expansion and other interventions; technical assistance to improve supply chain Management Information Systems and responsiveness; Provide technical assistance to strengthen governance and contract management for medicines tenders and management processes; technical assistance in supply chain management and stock data management to advance COVID 19 vaccination rollout. These activities target strategic points in the supply chain and in medicines delivery to avert medicines stockouts and wastage and ensure that PLHIV and patients seeking COVID vaccines can access their treatment and/or vaccines in an efficient manner.

Based on the above, it has been determined that Guidehouse, through the provision of its supply chain technical assistance, has the unique qualification and is the only organization capable to immediately assist USAID and the GoSA in meeting HIV/AIDS treatment targets, scaling up new life-saving interventions such as TLD and MMD, and scaling up COVID vaccination during

FY 23-24.

6. A description of efforts made to ensure that offers are solicited from as many potential sources as is practicable.

The EPPs allows for an exception to competition consideration; therefore, no offers were solicited.

7. A determination by the Contracting Officer that the anticipated cost to the Government will be fair and reasonable.

Based on the initial Independent Government Cost Estimate (IGCE) prepared by the COR and the costs incurred under the current Task order, the Contracting Officer, in approving this J&A, has determined that the anticipated cost to the government will be fair and reasonable. There is no change in the scope of work. Historical and actual costs of the ongoing SASC TA Activity were used in establishing the IGCE for this proposed ceiling increase; thus, the projected costs have been determined to be fair and reasonable. No other types of costs are anticipated.

8. A description of the market research conducted (see FAR Part 10) and the results or a statement of the reason(s) market research was not conducted.

Efforts by the Bilateral Health Office began in earnest in FY21 Q4 with the formation of a technical design team, predicated on a contract end date of February 2023. The team engaged in a lengthy deliberation process to determine the best course of action regarding the subsequent supply chain project taking into account myriad factors including basic instrument options;

potential management burden; technical skills/human resources; contracting office constraints;

potential procurement timelines; NextGen developments; and competing procurement priorities across the USAID/SA Health Office.

USAID/Washington’s Global Health Supply Chain Team establishes worldwide mechanisms for procuring commodities and providing supply chain technical assistance to host country government counterparts. These global mechanisms provide high quality supply chain technical assistance, are on the cutting edge of new technology, supply chain models and evidence-based approaches. They are able to take best practices and lessons learned in one region, tailor them and apply them to other regions to advance public health objectives. This high level of quality and cutting-edge TA services are only accessible via USAID/W Global Health Supply Chain awards. In close consultation with USAID/SA’s Regional Office of Acquisition and Assistance and the USAID/Washington NextGen design teams, USAID/SA determined that the Comp TA IDIQ would provide the best value and highest quality supply chain technical assistance needed to advance USAID/SA’s mission objectives. USAID/SA then opted to buy into the centrally managed Comp TA IDIQ contract through a mission issued RFTOP. At that time, FY22 Q1, the anticipated award and launch for the CompTA IDIQ was June 2022. This timeline would enable USAID/SA to make an award and secure some overlap between the new activity and the incumbent SASC-TA project. This timeline has now been delayed and is now estimated to be awarded in Q1 FY23. USAID/SA cannot issue a RFTOP and make a successful award by the February 2023 deadline.

After additional consultation with USAID/W, the Nextgen design teams, and USAID/Tanzania who has also extended their similar TO task order, USAID/SA determined that the only viable option to prevent a gap in supply chain technical assistance services would be to seek an extension for the existing task order.

9. Other facts supporting the use of other than full and open competition.

All facts are provided above.

10. Sources, if any, that expressed, in writing, an interest in the acquisition.

Publication of a notice is not required per the determination at AIDAR §705.202(b) and no sources submitted a written expression of interest in this acquisition.

11. The actions the Agency may take to remove or overcome any barriers to competition before any subsequent acquisition for the supplies or services required:

USAID/GH is competing the follow-on to the GHSC-TA contract and all the other NextGen contracts for the same or similar services of the GHSC Program. As stated above, USAID/SA is planning to issue the follow-on SASC-TA TO under the new GHSC-TA NextGen IDIQ follow-on.

12. Technical Certification:

In accordance with FAR 6.303, I hereby certify that the technical statements included above, and which form a basis for the justification are complement and accurate in accordance with EPP entitled “Expedited Procedures Package (EPP) for Programs Managed by the U.S. Agency for International Development (USAID) for the prevention, care, and treatment of people living with HIV/AIDS under the President's Emergency Plan for AIDS Relief (PEPFAR)”, approved December 31, 2019.”

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