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Consultant – Technical expertise on key populations and harm reduction activities

WHO - World Health Organization

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Purpose of consultancy

This contract consists of two related but distinct components:
  1. To provide technical expertise to Madagascar on HIV and viral hepatitis programming for people who inject drugs
  2. To develop an update of the WHO implementation tool to start and scale up needle and syringe programmes

Background

Activity 1: To provide technical expertise on Harm reduction in Madagascar
The HIV epidemic in Madagascar (overall HIV prevalence of 0.3%) can be characterized as a concentrated epidemic among key populations including sex workers, men who have sex with men, people who inject drugs and their partners.
Spectrum 2023 estimates reveal that there are 70,000 people living with HIV (PLHIV) in Madagascar. However, only 17,073 PLHIV know their HIV status in 2023. Also, the estimated proportion of PLHIV on antiretroviral treatment is 24. 1% and the proportion of PLHIV under treatment with suppressed viral load is 6.1%. These figures are far from the global HIV targets of 95%, 95%, 95% by 2030. On average 1,500 people are estimated to have died from AIDS every year over the past 5 years.
According to the 2022 integrated bio-behavioural survey (IBBS), the HIV prevalence particularly high among key populations, notably 20.5% among men who have sex with men (MSM), 11.2% among Sex Workers (SW) and 13.1% among people who inject drugs (PWID).
The Coalition for Global Hepatitis Elimination reported that in 2022 the prevalence of chronic HBV (HBsAg ) was estimated at 6.41% with a modeled HBV related mortality of 3.6 per 100.000. In 2022, the chronic HCV (RNA /cAg) was 0.39% and HCV related mortality was 6.38 per 100.000 in 2019. Further data are mostly unavailable including on people who use drugs and on overall rates of diagnosis and treatment of both conditions.
Madagascar will implement a harm reduction program for PWID and will develop a formal action plan. Some small-scale NGO-run needle and syringes programmes have started, but there is a need to also initiate the implementation of opioid agonist therapy (OAT). The reference frameworks for its implementation are currently documented, including treatment protocols, the process for the registration, importation and introduction of methadone, supply chain, as well as various regulatory requirements. Technical assistance is required to help start an OAT pilot and increase the NSP coverage.
Activity 2: To develop an update of the WHO implementation guidance to initiate and scale up needle and syringe programs (NSP)
In 2007, WHO published a guide to starting and managing needle and syringe programmes (NSP) . Since then, more information and evidence and good practice examples have become available, and more countries are requesting technical expertise to implement and scale up evidence-based harm reduction.
While more countries have initiated NSP, the quality of these NSPs could be much improved. In addition, their coverage is too low in most settings in order to have a public health impact on epidemics of HIV, viral hepatitis as well as other health problems including overdose-related mortality. WHO continues to support Member States in defining and implementing evidence-based harm reduction programs and the update of this implementation guidance with most recent content and evidence is essential for this.

Deliverables

  • Deliverables/time frame activity 1: To provide technical expertise on Harm reduction in Madagascar
    • Task 1.1: To conduct a rapid assessment and response exercise in country with focus on people who use drugs and on developing an appropriate harm reduction response.
      • Deliverable 1.1.1. Short report on findings and recommendations from assessment
        Expected by: 15 December 2024
      • Deliverable 1.1.2. Report on planning for registration and procurement and introduction of OAT medications
        Expected by: 30 April 2025
    • Task 1.2: To facilitate the organization of a harm reduction training for relevant stakeholders and development of training materials
      • Deliverable 1. 2.1. Training materials for in-country training
        Expected by: 31 January 2025
      • Deliverable 1. 2.2. Training report (including evaluations forms) and slide deck or other training materials used.
        Expected by: 15 March 2025
    • Task 1. 3: To contribute to the development of relevant national guidance on evidence-based harm reduction and SoP for implementers in French
      • Deliverable 1. 3.1. Draft national guidelines (in French)
        Expected by: 31 July 2025

Activity 1 overall timeframe: 75 days in period November 2024 – July 2025 with a minimum of two visits to the country in collaboration with WHO Country Office.

  • Deliverables/time frame activity 2: To develop an update of the WHO implementation guidance for introducing and scaling up needle and syringe programs
    • Task 2.1: Set up a technical working group with expertise in NSP and low-and middle-income countries (LMIC)
      • Deliverable 2.1.1 Report of technical working group meeting
        Expected by: 15 December 2024
    • Task 2.2 Review latest evidence and implementation examples of good practice and develop draft and final document
      • Deliverable 2.2.1 Draft Document
        Expected by: 30 May 2025
      • Deliverable 2.2.2 Final document
        Expected by: 31 July 2025
Activity 2 overall timeframe: 75 days in period November 2024 – July 2025

Qualifications, experience, skills and languages

Educational Qualifications:

Essential:
  • Advanced university degree in public health and nursing, medicine or other related science

Experience

Essential:
  • Minimum of 7 years of international experience in public health response to improving drug user health – of which at least 3 years working in LMIC on implementing harm reduction
  • Specific experience in working on harm reduction in Sub-Saharan Africa
  • Experience in writing public health documents and guidance

Skills/Knowledge:

Essential:
  • Excellent analytical and technical writing skills
  • Good presentation and networking skills

Languages and level required (Basic/Intermediate/Expert):

Essential:
  • Expert knowledge of English
  • Expert knowledge of French

Location

Off-site: Home based.

Travel

The consultant is expected to travel.

Remuneration and budget (travel costs are excluded):

Remuneration:

Band level B: USD 7,000 – 9,980 per month

Living expenses (A living expense is payable to on-site consultants who are internationally recruited):

Not applicable

Expected duration of contract (Maximum contract duration is 11 months per calendar year):

9 months (150 working days during this period)

Additional Information:

  • This vacancy notice may be used to identify candidates for other similar consultancies at the same level.
  • Only candidates under serious consideration will be contacted.
  • A written test may be used as a form of screening.
  • If your candidature is retained for interview, you will be required to provide, in advance, a scanned copy of the degree(s)/diploma(s)/certificate(s) required for this position. WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.
  • For information on WHO’s operations please visit: http://www.who.int.
  • The WHO is committed to creating a diverse and inclusive environment of mutual respect. The WHO recruits workforce regardless of disability status, sex, gender identity, sexual orientation, language, race, marital status, religious, cultural, ethnic and socio-economic backgrounds, or any other personal characteristics.
    The WHO is committed to achieving gender parity and geographical diversity in its workforce. Women, persons with disabilities, and nationals of unrepresented and underrepresented Member States (https://www.who.int/careers/diversity-equity-and-inclusion) are strongly encouraged to apply for WHO jobs.
    Persons with disabilities can request reasonable accommodations to enable participation in the recruitment process. Requests for reasonable accommodation should be sent through an email to [email protected]
  • An impeccable record for integrity and professional ethical standards is essential. 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 (https://www.who.int/about/who-we-are/our-values) 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 short-listed candidates.
  • WHO has a smoke-free environment and does not recruit smokers or users of any form of tobacco.
  • Consultants shall perform the work as independent contractors in a personal capacity, and not as a representative of any entity or authority.
  • WHO shall have no responsibility for any taxes, duties, social security contributions or other contributions payable by the Consultant. The Consultant shall be solely responsible for withholding and paying any taxes, duties, social security contributions and any other contributions which are applicable to the Consultant in each location/jurisdiction in which the work hereunder is performed, and the Consultant shall not be entitled to any reimbursement thereof by WHO.
  • Please note that WHO’s contracts are conditional on members of the workforce confirming that they are vaccinated as required by WHO before undertaking a WHO assignment, except where a medical condition does not allow such vaccination, as certified by the WHO Staff Health and Wellbeing Services (SHW). The successful candidate will be asked to provide relevant evidence related to this condition. A copy of the updated vaccination card must be shared with WHO medical service in the medical clearance process. Please note that certain countries require proof of specific vaccinations for entry or exit. For example, official proof /certification of yellow fever vaccination is required to enter many countries. Country-specific vaccine recommendations can be found on the WHO international travel and Staff Health and Wellbeing website. For vaccination-related queries please directly contact SHW directly at [email protected].
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  • Consultants working in Switzerland must register with the applicable Swiss cantonal tax authorities and social security authorities, within the prescribed timeframes (Guidelines issued by the Swiss Mission are available at: https://www.eda.admin.ch/missions/mission-onu-geneve/en/home/manual-regime-privileges-and-immunities/introduction/Manuel-personnes-sans-privileges-et-immunites-carte-H/Non fonctionnaires et stagiaires.html

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