UNOPS hosts the Stop Tuberculosis Partnership Secretariat (STBP) as of 1 January 2015, in Geneva, Switzerland. The vision of the Stop TB Partnership is to realize the goal of elimination of Tuberculosis (TB) as a public health problem and, ultimately, to obtain a world free of TB by ensuring that every TB patient has access to effective diagnosis, treatment and cure; stopping transmission of TB; reducing the inequitable social and economic toll of TB; and developing and implementing new preventive, diagnostic and therapeutic tools and strategies. The Stop Partnership is uniquely positioned to support the development and further implementation by partners of the current and future Global Plan, acting as a coordinator and catalyst for the range of partners engaged in the fight against TB.
Founded in 2001, the Stop TB Partnership’s mission is to serve every person who is vulnerable to TB and ensure that high-quality treatment is available to all who need it. Stop TB partners include international and technical organizations, government programmes, research and funding agencies, foundations, NGOs, civil society and community groups and the private sector.
Under the overall guidance of UNOPS / Stop TB Partnership’s Deputy Director, The MDR TB Consultants’ scope is focused on ensuring required Programmatic Management of Drug-resistant TB (PMDT) policy is met and clinical protocol and guidelines are updated to reflect not only the WHO’s latest recommendation but also the most recent best practices. Additionally, consultants are expected to support the NTP to develop clear clinical eligibility for a patient’s enrollment on Short Treatment Regimen (STR) New Regimen (NR), provide hands-on clinical training, mentor health care providers, and implement active Drug Safety Monitoring (aDSM).
The approach (model) for the MDR TB consultant has the following key elements: 1) Supportive partnership with NTP/Ministry of Health (MOH), (i.e. to help not to evaluate) with shared goals; 2) Working with the NTP/MOH to increase the number of patients who will be enrolled/initiated on MDR TB treatment through the implementation of new guidelines for MDR TB; 3) Focus on clinic-based mentoring; 4) Coordination with WHO, USAID partners (Bilateral, Challenge TB (CTB), Regional Green Light Committees (rGLC) and other technical partners and 5) Ongoing remote support and communication with NTP. Additionally, the MDR TB Consultants will ensure all supported countries have comprehensive STR/NR implementation plans in place (Planning).
The purpose of this Scope of Work is to engage MDR TB Clinical Consultants to provide technical support, both clinical and programmatic for the expansion of STR and NR for the treatment of MDR TB in all priority countries NTPs. The goal is to scale up STR/NR through provision of specific clinical expertise to translate WHO guidelines into implementation at the country level, hence the need for engagement of high level consultants with strong clinical MDR TB management experiences.
Overall expectations for the consultant:
To work with priority countries NTPs and build their capacity to successfully scale up STR/NR and support the rolling out of the new guideline for the management of MDR TB. It is expected that the Consultants would contribute to different areas of MDR care such as updated/revised guideline and clinical protocol, training materials for STR/NR etc. the key functions of the consultant will be:
1: Expand and strengthen national MDR-TB care and treatment capacity to optimize the use of current and novel regimens
- In view of expected changes in policies from WHO, work with NTPs and in-country partners to ensure that the review/update of policy/guidelines is not dragged on for long to impact on implementation and slow the momentum gained in STR/NR implementation.
- Work with NTP and other stakeholders to develop/review/update clinical protocols for implementation and scale up of STR and NR.
- Support regimens selection/design for use in healthcare facilities for treatment of drug resistant TB cases in line with WHO recommendations and based on country TB drug resistance profile. Incorporate recent development and discussion on the effectiveness and safety of injectable agents (IA) into the national discussion.
- Review and assess the processes and capacity of NTP in all aspects of STR/NR implementation and identify partners providing technical assistance.
2: Strengthen active TB drug safety monitoring (aDSM)
- Ensure all NTP implement activities developed in their aDSM roadmaps to establish/strengthen aDSM system to be used for all patients receiving new drugs or shorter regimen
- Assess if the system for routine recording and reporting of adverse events/severe adverse events (AEs/SAEs) for patient’s safety exists, if not, work with NTP and stakeholders to develop a systems for AEs/SAEs reporting based on aDSM guidelines.
- In collaboration with MDR Clinician and NTP, assess/determine the proportional of various drugs toxicity profile among the current MDR cohort and provide this information to be used to expand/adjust eligibility criteria for STR and NR inclusion.
- Provide support to strengthen the collaboration between NTP and National PV centers and provide support for continuous collaboration of the two entities.
- Ensure that all MDR TB treatment sites have Audiometry, ECG monitoring machine at the sites and all have access to diagnostic facilities for clinical biochemistry tests critical for patients monitoring and aDSM.
3: Improve overall Drug Resistant TB (DR-TB) case finding
- Assess lab/diagnostic capacity on GeneXpert network, culture, DST, Second Line Probe Assay (2nd LPA), completeness of patient outcomes and overall availability of lab results to guide patient management and provide recommendation to lab/diagnostic to address any identified gap.
- Support in the review of the diagnostic algorithm and optimization of the available lab/diagnostic capacity to increase DR TB case finding.
- Work with NTP and partners to expand the number of treatment sites that enroll patients on STR/New regimen (scale up). Support in the development of DR-TB decentralization plan for DR-TB services to ensure national wide access to DR TB treatment.
- Support with the increase in number of patients enrolled on STR and NR. Based on eligibility criteria, support NTP and partners to periodically revise estimated number of patients eligible for enrollment into STR/NR.
- Coordinate with GDF and in-country procurement and supply chain (PSM) partners to ensure quantification and forecasting figures for second line drugs, specially drugs included in the new treatment regimen and companion drugs match the needs and patient scale up plan. This is critical given the uncertainties about quantities of drugs included in the STR and NR as programs work to design effective and safe regimen, the needed to maintain stock levels, avoid stock outs, and avoid over-ordering of drugs that will be needed.
4: Provide training and mentoring in all areas to enhance the capacity to scale up STR/NR and strengthen aDSM
- Develop/review/update training material for service providers (doctors, nurses, consilium members, supervisors and national PV center staff) to ensure they reflect current recommendations and practices.
- Provide hands on clinical training during workshops or one-on-one mentoring to healthcare providers and NTP staff on optimal introduction and use of STR and NR as part of the MDR TB treatment.
- In collaboration with MDR TB clinicians, review and discuss MDR TB patient’s clinical profile and determine those that would be eligible for STR and NR. Ensure all eligible patients are enrolled and plan for scale up.
- Provide ongoing remote support and communication with NTP and MDR TB Clinicians to ensure timely clinical decisions are reached and patient management proceed smoothly.
- Enhance capacity of Consilium or Clinical Review Panels/Committees to systematic documentation of clinical case decisions (both meeting minutes and in clinical files) and support clinician managing patients at treatment sites. Ensure that Consilium or Clinical Review Panels/Committee have formal Terms of References (ToR) that clearly defined functions, responsibilities and meeting schedules.
5: Support the improvement of quality of MDR TB treatment
- Support the development and implementation of patient-centered TB and MDR-TB quality service delivery sites and a system for monitoring these sites.
- Work with countries to develop, implement and scale up ancillary care packages to improve MDR-TB patient treatment outcomes.
- Support the development of TB adherence assessment tool and assist with its implementation.
Briefing and coordination
- At the end of each mission, consultant will brief the Stop TB Partnership, the NTP, key stakeholders and Ministry of Health officials on key findings and discuss mission main recommendations.
- Discuss the specific need for further technical assistance on STR/NR implementation and potential partners to provide needed consultancy.
- In countries where USAID has seconded In-country GF Advisor, consultant is required to work with them for activity implementation including discussions with MoH, NTP officials and partners.
- Prepare a brief narrative maximum 2-pages (Trip Report) with highlights from the short term technical assistance visit (STTA) with immediate action items to be submitted within 2-weeks of the TDY
- If training was conducted, prepare a training report with: total number of national TB program staff and health workers (by gender) trained, training materials used during the workshop and pre and post-training improvement in knowledge
- Technical Report- with the recommendations to address the identified gaps in conjunction with Stop TB Partnership, the NTP and any in country partners. The technical report should include: number of patients (if any) that consultant has provided clinical review, patient profile reviews, discussion with clinicians about adverse event management on these patients and treatment option for patients who are newly initiated on or continuing NR). Also finalized or reviewed or developed clinical protocols and guidelines for STR/NR and adverse event management can be annexed to the technical report. The report should also provide concrete and feasible recommendations with a responsible person and a timeline. These recommendations will be monitored for their level of implementation and achievement.
The MDR TB Clinical Consultants will support ALL USAID priority countries around the world. Therefore, travel should be expected for over 30% of the time.
- Preferably, advanced university (Master) degree in public health, international development, or similar subjects. Medical Doctors are also encouraged to apply.
- A University degree (Buchelor) in one of the subjects above in addition to 2 extra years of relevant experience, may be accepted in lieu of an advanced university degree.
- A minimum of 5 years of progressive experience in one of the following areas: clinical care; public health; or TB programs. Ideally with extensive clinical experience in treatment of patients with drug-resistant TB.
- Experience with the introduction of new TB medicines and regimens for Multidrug-Resistant TB care.
- Experience in establishing clinical monitoring of medicines use and reporting adverse events.
- Knowledge of key WHO and StopTB partners’ guidelines on Multidrug-Resistant TB, PMDT, patient safety (pharmacovigilance) for TB, and on the introduction of short course Multidrug-Resistant TB regimen and new TB medicines and regimens.
Excellent knowledge of English with proven ability to communicate in English (spoken and written) in a clear and concise manner. Knowledge of another UN official language is an asset.
Contract type, level and duration
Contract type: International Individual Contractor Agreement (IICA)
Contract level: IICA-2 (ICS10 - P3 equivalent)
Contract duration: On a retainer basis (150-200 days within 12 months, renewable based on available budget and satisfactory performance)
For more details about the ICA contractual modality, please follow this link:https://www.unops.org/english/Opportunities/job-opportunities/what-we-offer/Pages/Individual-Contractor-Agreements.aspx
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