HIV and STI Clinical Consultant

Location : Homebased

Application Deadline : 02-Jun-21 (Midnight New York, USA)

Time left : 13d 13h 53m

Type of Contract : Individual Contract

Post Level : International Consultant

Languages Required :
English

Starting Date :
(date when the selected candidate is expected to start) 01-Jul-2021

Duration of Initial Contract : 12 months

Expected Duration of Assignment : 01 July 2021 – 30 June 2022

UNDP is committed to achieving workforce diversity in terms of gender, nationality and culture. Individuals from minority groups, indigenous groups and persons with disabilities are equally encouraged to apply. All applications will be treated with the strictest confidence.

UNDP does not tolerate sexual exploitation and abuse, any kind of harassment, including sexual harassment, and discrimination. All selected candidates will, therefore, undergo rigorous reference and background checks.

Background

The United Nations Development Programme (UNDP) is the UN’s global development network, advocating for change and connecting countries to knowledge, experience and resources to help people build a better life. We are on the ground in 170 countries and territories, working with governments and people on their own solutions to global and ational development challenges to help empower lives and build resilient nations.

UNDP is a lead agency in UNAIDS for addressing the dimensions of HIV and AIDS relating to human rights, gender and sexual diversity. In addition, UNDP contributes to public health and development partnerships through collaborations with the Global Fund to Fight AIDS, Tuberculosis and Malaria (the ‘Global Fund’), Roll Back Malaria, Stop TB Partnerships, and special programmes on human reproduction and infectious diseases that disproportionately affect poor populations.

As part of its wider engagement with the United Nations, the Global Fund has partnered with UNDP since 2003 to ensure that grants are implemented, and services are delivered in countries facing complex challenges. The partnership focuses on three closely linked areas of work: implementation support, capacity development, and policy engagement. For implementation support UNDP serves as an interim Principal Recipient (PR) (currently in 25 countries) in a variety of settings including countries that face capacity constraints, complex emergencies, poor

governance environments, political upheaval, or donor sanctions. It does so upon request by the Global Fund and/or the Country Coordinating Mechanism (CCM) and when no national entity is able to assume the role at the time. UNDP’s role as PR is an interim arrangement until national entities can assume full responsibility for implementation and the capacity of national partners (Government and CSOs) is also strengthened to ensure long-term sustainability of health outcomes.

In December 2020, UNDP was once again nominated by the PIRMCCM for the role of PR for two grants in the Western Pacific region: 1) malaria, covering Vanuatu only; and 2) Multi- Country TB/HIV Programme covering 11 Pacific IslandCountries (PICS) namely Republic of Marshall Islands, Federal States of Micronesia, Kiribati, Vanuatu, Tuvalu, Samoa, Tonga, Cook Islands, Nauru, Niue, and Palau. The current funding cycle is for 1 January 2021 – 31 December 2023.

Under the overall supervision of the Programme Manager, the HIV/STIs Clinical Consultant will provide clinical mentorship, advice and capacity building to 11 Pacific Island countries in management of antiretroviral therapy for people living with HIV as well as in treatment of sexually transmitted diseases.

Project Description and consultancy rationale

HIV prevalence in the 11 Pacific Island Countries (Cook Islands, Federated States of Micronesia, Kiribati, Nauru, Niue, Marshall Islands, Palau, Samoa, Tonga, Tuvalu and Vanuatu) continues to be low with prevalence in the Western Pacific estimated at 0.1%. The cumulative number of persons ever diagnosed, with HIV up until December 2019 in the 11 supported countries is 251. Despite the low rates and numbers, HIV vulnerability is still high due to factors such as widespread migration and mobility, dense sexual networks, a large caseload of untreated STIs, low knowledge about HIV and STIs, high levels of transactional sex and significant levels of intimate partner violence.

The Project Goals are:

• To halt the spread of HIV among the population of the Western Pacific and maintain HIV incidence rates below 0.1 percent annually;
• To reduce AIDS-related mortality by strengthening HIV case finding and case management;
• To reduce the prevalence, incidence and mortality from all forms of TB in the 11 Pacific Island Countries, thereby contributing to the post-2015 global TB strategy; and
• To promote universal and equitable access to quality diagnosis and appropriate treatment of TB, MDR-TB, TB/DM and TB/HIV patients across 11 Pacific Island Countries.

Although the number of HIV cases is quite small, the number of people receiving antiretroviral treatment is small as well. Over the last decade, the majority of PLHIV either passed away or were lost to follow up by the health care providers. Due to the low case load as well as high turnover of medical staff, there is a capacity gap in management of ART. The Pacific PLHIV Forum conducted in October 2018 made the following recommendations:

ART guidelines

• Health care workers should reach out to their respective health ministries and bodies in charge of HIV to endorse national ART guidelines as soon as possible.
• Health care workers should consider establishing a guidelines committee that can readily update changes and ensure guidelines are up to date.
• Guidelines currently in draft form and those that have not been endorsed should include the addition of Dolutegravir (DTG) as the third agent in first-line ART as per the WHO recommendation.
• The WHO recommendation about the use of DTG in women of reproductive age should be included in all national ART guidelines.

Antiretroviral therapy:All doctors managing people living with HIV should:

• Undergo training in HIV medicine and ART.
• Link to the available clinical support and mentoring programme
• Educate nurses, peers and other clinical staff about ART and HIV.
• Provide required antiretroviral therapy treatment uptake data and reports to the UNDP ARV Procurement and Supply Chain Management System in a timely manner.

Clinical management:
All clinics managing people living with HIV should

• Provide education such as general factsheets and online resources on HIV, opportunistic infections, CIs, ART, PPCTC and living well with HIV.
• Implement algorithms outlining patient flow in the clinic, i.e. steps in ART initiation, monitoring and required blood tests, appointment schedules and confidentiality guidelines for clinical staff to follow. This is especially important for when a doctor is absent.
• Provide factsheets and online resources for people living with HIV outlining the basics of HIV including prevention, transmission, advantages and disadvantages of ART including side effects, PPCTC and breast-feeding advice, the importance of adherence, warning symptoms to look out for and report, and the need to adhere to ART and attend clinics for monitoring at regular intervals or as necessary.
• Provide factsheets and online resources about methods known to maintain the immune system in addition to ART (i.e. general health information about nutrition, exercise, sleep, alcohol and drug use).

Cascade of care:

• Implement patient recall systems to prevent people living with HIV being lost to follow-up. Consider delegating a team member (e.g. nurse or counsellor) to undertake follow-up and monitor non-attendance,
• Appoint a second clinician (e.g. nurse or counsellor) who is available for people living with HIV when the doctor is not available in order to maintain engagement in care. A multidisciplinary approach to patient care is best.
• Countries to liaise with UNDP for support increasing retention in care, e.g. supporting travel costs to clinics for people living with HIV.
• Provide accurate Global AIDS Monitoring (GAM) statistics to UNAIDS in a timely manner for country reports.

These data are essential in monitoring the success of the cascade of care in countries, as well as in identifying gaps and opportunities to build on patient care. Based on the above, there is a clear need to support countries in ensuring that all available patients are receiving ART

and adhering to it. Therefore, the HIV/STIs Clinical Consultant will support 11 Pacific island Countries in ensuring at least 90% of PLHIV are receiving ART treatment and that the side effects are managed appropriately and that the countries adhere to the international clinical protocols and relevant guiding documents.

Key stakeholders/partners:
The HIV/STIs Clinical Consultant will work closely with the national counterparts such as Ministries of Health and relevant national communicable diseases units and doctors, UNAIDS and WHO, community groups of people living with HIV and the UNDP Programme Management Team based in Suva, Vanuatu and Samoa

Duties and Responsibilities

Scope of Work

The consultancy will be demand driven and will include but not limited to expert support in the following areas:

• Telemedicine/ clinical management support for PLHIV to 11 Pacific Islands Countries:
• Provide clinical mentoring to HIV and STI treatment teams for both adult and pediatric care services and other relevant healthcare workers in 11 PICs.
• Provide clinical advice and assistance in initiating and improving ongoing clinical care for patients on OIs, ART and PMTCT.
• Develop necessary tools to conduct the clinical mentorship.
• Provide technical support to the HIV clinicians and HCWs on case management, ARV treatment, ART guidelines and clinical management.

Clinical monitoring of PLHIV treatment regimens, management (CD4 and viral load assessments) and care using the National HIV registers and recommend improvement:

• Support in establishment of ART administration at the site-level, set-up of patient flow patterns and creation of Standard Operating Procedures if required.
• Support ART sites to improve patient records: monthly, and quarterly reports.
• Support ART sites to improve the drugs and test kits consumption, requisition report, and the overall ART drug supply management system.
• Support sites in the optimal use of available resources including ARVs, diagnostics and treatments for

opportunistic infections, etc.

• Support the enhancement of routine data collection system in the HIV/STIs programme.
• Support laboratory setup and testing through analyzing the available testing gaps and equipment needs

Facilitate webinar sessions for one-hour didactic teaching, discussion & case presentations on HIV/ STI and any other

emergency preparedness to clinicians & HCWs:

• Provide One hour of didactic teaching, discussion & case presentations to the HIV clinicians & HCWs using Zoom or other communication methods to 11 PICs.
• Improve knowledge of all stages of HIV disease management including IRIS, opportunistic infections and non AIDS associated comorbidities
• Improve management of HIV in children & young people
• Improve skills around HIV testing and working with Key Population & PLHIV
• Improved knowledge and skills in dealing with the spectrum of HIV disease in children, young people.
• Improved knowledge and skills in dealing with STI.

Online HIV & STI in- country training on formal didactic, clinical mentorship and HIV/ STI management:

• Conduct Online HIV & STI in- country training on formal didactic, clinical mentorship and HIV/ STI management with HIV/ STI/ SRH clinical staff and HCW in 5 countries (FSM, RMI, Kiribati, Samoa and Vanuatu)
• Assist in the development of initial and continued medical education for all in- country clinical staff.
• Encourage community-based support to ensure proper adherence and psychosocial support to patients.
• To improve knowledge of all stages of HIV disease management including IRIS, opportunistic infections and

non-AIDS associated comorbidities

• Discussion of supply chain issues as appropriate for clinicians.
• If needed, review HIV clinical and M&E training tools, Guidelines and Strategic Plans for the National HIV/STIs Program

Institutional Arrangement

• The HIV/STIs Clinical Consultant will report to and work under the guidance of the UNDP Programme Manager.
• The HIV/STIs Clinical Consultant will work closely with the national counterparts such as Ministries of Health

and relevant national communicable diseases units and doctors, UNAIDS and WHO, community groups of

people living with HIV and the UNDP Programme Management Team based in Suva, Vanuatu and Samoa.

• The HIV/STIs Clinical Consultant will respond timely (within 24 hours, preferably) to technical requirements of

key national counterparts such as Ministries of Health and relevant national communicable diseases units and

doctors, UNAIDS and WHO, community groups of people living with HIV and the UNDP Programme

Management Team based in Suva, Vanuatu and Samoa. This input can be where applicable, by email, telephone

and as necessary, in person;

• The consultant is required to provide for his/her own computer

Duration of the Work

• The assignment duration is for 12 months and is expected for approximately 89.5 working days.

Duty Station

o The consultancy is primarily home based. The support to countries will be provided through email communications, skype and other online means.

o Travel may be anticipated based on country needs. If travel is agreed than dates will be agreed based

on consultant’s availability and travel restrictions due to Covid 19

Competencies

• Strong interpersonal and communication skills;
• Strong analytical, reporting and writing abilities skills;
• Openness to change and ability to receive/integrate feedback;
• Ability to plan, organize, implement and report on work;
• Ability to work under pressure and tight deadlines;
• Proficiency in the use of office IT applications and internet in conducting research;
• Outstanding communication, project management and organizational skills;
• Excellent presentation and facilitation skills.
• Demonstrates integrity and ethical standards;
• Positive, constructive attitude to work;
• Displays cultural, gender, religion, race, nationality and age sensitivity and adaptability.

Required Skills and Experience

Educational Qualifications:

• Minimum Master’s degree in medicine or medical science;
• Certified Medical Practitioner.

Experience

• At least 5 years’ experience of treating patients with HIV/AIDS including children
• Previous experience with treating sexually transmitted infections
• Previous experience in delivering capacity building trainings on ARV, STIs and OI treatment, barriers to adherence, counselling and care
• Previous experience of drafting guidelines, clinical SOPs
• Previous experience of working in the Pacific region and knowledge of the context is a strong asset
• Excellent report writing and editing skills.
• Excellent communicator and facilitator

Language requirements

• Excellent working knowledge of English.
• Proficiency in computer application and information technology

Evaluation Method and Criteria

Individual consultants will be evaluated based on the following methodology:

Cumulative analysis

The award of the contract shall be made to the individual consultant whose offer has been evaluated and determined

as a) responsive/compliant/acceptable; and b) having received the highest score out of set of weighted technical criteria

(70%). And financial criteria (30%). Financial score shall be computed as a ratio of the proposal being evaluated and the

lowest priced proposal received by UNDP for the assignment.

Only candidates obtaining a minimum of 49 points (70% of the total technical points) would be considered for the Financial Evaluation

Technical Criteria for Evaluation (Maximum 70 points)

• Criterial 1: Minimum Master’s degree in medicine or medical science. – 10 points
• Criteria 2: Certified Medical Practitioner with at least 5 years’ experience of treating patients with HIV/AIDS including children. – 10 points
• Criteria 3: Previous experience with treating sexually transmitted infections. – 10 Points
• Criteria 4: Previous experience in delivering capacity building trainings on ARV, STIs and OI treatment, barriers to adherence, counselling and care. – 15 Points
• Criteria 5: Previous experience of working in the Pacific region and knowledge of the context is a strong asset. – 15 Points
• Criteria 6: Previous experience of drafting guidelines, clinical SOPs– 10 Points

Interviews maybe conducted for the technically qualified consultants as part of the validation process.

Only candidates obtaining a minimum of 49 points (70% of the total technical points) would be considered for the Financial Evaluation.

Price Proposal

Consultant must send a financial proposal based on Lump Sum Amount. The total amount quoted shall be all-inclusive and include all costs components required to perform the deliverables identified in the TOR, including professional fee, travel costs, living allowance (if any work is to be done outside the IC´s duty station) and any other applicable cost to be incurred by the IC in completing the assignment. The contract price will fixed output-based price regardless of extension of the herein specified duration.

In the event of unforeseeable travel not anticipated in this TOR, payment of travel costs including tickets, lodging and terminal expenses should be agreed upon, between the respective business unit and the Individual Consultant, prior to travel and will be reimbursed.

Schedule of Payments

Payment shall be provided upon satisfactory completion of the deliverables outlined in Expected Deliverables and timelines section and upon submission and acceptance of a report mentioned above.

• Upon completion of deliverable 1 – 10.06% (upon acceptance of deliverables)
• Upon completion of deliverable 2 – 10.06% (upon acceptance of deliverables)
• Upon completion of deliverable 3 – 10.06% (upon acceptance of deliverables)
• Upon completion of deliverable 4 – 10.06% (upon acceptance of deliverables)
• Upon completion of deliverable 5 – 7.82% (upon acceptance of deliverables)
• Upon completion of deliverable 6 – 7.82% (upon acceptance of deliverables)
• Upon completion of deliverable 7 – 6.70% (upon acceptance of deliverables)
• Upon completion of deliverable 8 – 6.70% (upon acceptance of deliverables)
• Upon completion of deliverable 9 – 16.76% (upon acceptance of deliverables)
• Upon completion of deliverable 10 – 13.97% (upon acceptance of deliverables)

Payment request submitted by the consultant must be certified by the UNDP Programme Manager and UNDP Programme Analyst and, accompanying by payment invoice. Payment are to be made within 30 days from receipt of the invoice/Certificate of Payment.

Documentation required

Interested individual consultants must submit the following documents/information to demonstrate their qualifications.

• Cover letter, including a) a brief description of why the individual considers him/herself as the most suitable for the assignment;
• Letter of Confirmation of Interest and Availability and Financial Proposal using the template provided in Annex II. Financial Proposal to be submitted in United State Dollars (USD)
• Personal CV, indicating all past experience from similar projects, as well as the contact details (email and telephone number) of the Candidate and at least three (3) professional references.

Note: Successful individual will be required to provide proof of medical insurance coverage before commencement

of contract for the duration of the assignment.

Incomplete and joint proposals may not be considered. Consultants with whom there is further interest will be contacted. The successful consultant shall opt to sign an Individual Contract or a Reimbursable Loan Agreement (RLA) through its company/employer with UNDP.

All required templates are available on the UNDP Procurement website: www.pacific.undp.org