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Qualifications
Purpose of consultancy
This contract consists of two related but distinct components:
- To provide technical expertise to Madagascar on HIV and viral hepatitis programming for people who inject drugs
- 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 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 (PLHIin Madagascar. However, only 17,073 PLHIV know their HIV status in Also, the estimated proportion of PLHIV on antiretroviral treatment is 1% and the proportion of PLHIV under treatment with suppressed viral load is 1%. These figures are far from the global HIV targets of 95%, 95%, 95% by On average 1,500 people are estimated to have died from AIDS every year over the past 5 years.
According to the 2022 integrated biobehavioural survey (IBB, the HIV prevalence particularly high among key populations, notably 5% among men who have sex with men (MS, 2% among Sex Workers (Sand 1% among people who inject drugs (PWI.
The Coalition for Global Hepatitis Elimination reported that in 2022 the prevalence of chronic HBV (HBsAg ) was estimated at 41% with a modeled HBV related mortality of 6 per In 2022, the chronic HCV (RNA /cAwas 39% and HCV related mortality was 38 per 000 in 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 smallscale NGOrun needle and syringes programmes have started, but there is a need to also initiate the implementation of opioid agonist therapy (OA. 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 (NS
In 2007, WHO published a guide to starting and managing needle and syringe programmes (NS. 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 evidencebased 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 overdoserelated mortality. WHO continues to support Member States in defining and implementing evidencebased 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: 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 Short report on findings and recommendations from assessment
Expected by: 15 December 2024
- Deliverable Report on planning for registration and procurement and introduction of OAT medications
Expected by: 30 April 2025
- Task 2: To facilitate the organization of a harm reduction training for relevant stakeholders and development of training materials
- Deliverable Training materials for incountry training
Expected by: 31 January 2025
- Deliverable Training report (including evaluations formand slide deck or other training materials used.
Expected by: 15 March 2025
- Task 3: To contribute to the development of relevant national guidance on evidencebased harm reduction and SoP for implementers in French
- Deliverable Draft national guidelines (in Frenc
Expected by: 31 July 2025
Activity 1 overall timeframe: 75 days in period November 2024July 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 1: Set up a technical working group with expertise in NSP and lowand middleincome countries (LMI
- Deliverable 1 Report of technical working group meeting
Expected by: 15 December 2024
- Task 2 Review latest evidence and implementation examples of good practice and develop draft and final document
- Deliverable 1 Draft Document
Expected by: 30 May 2025
- Deliverable 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 SubSaharan 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/Exper:
Essential:
- Expert knowledge of English
- Expert knowledge of French
Location
Offsite: Home based.
Travel
The consultant is expected to travel.
Remuneration and budget (travel costs are exclude:
Remuneration:
Band level B: USD 7,0009,980 per month
Living expenses (A living expense is payable to onsite consultants who are internationally recruite:
Not applicable
Expected duration of contract (Maximum contract duration is 11 months per calendar yea:
9 months (150 working days during this perio
Additional Information:
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- A written test may be used as a form of screening.
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