BACKGROUND

Lao PDR has a high TB disease burden with an incidence rate of 162 per 100,000 (11,000 TB cases annually), a mortality rate of 34 per 100,000, and a treatment coverage rate of 57%. People living with HIV/AIDS (PLHIV) around 10,180 (85%) were aware of their status. Of these 8,638 (85%) PLHIV were started on ART but only 6,484 (64%) of those registered are currently retained on ART treatment. In 2018 there were an estimated 270 TB deaths among PLHIV, a decrease of 66% since 2010, moving close to the 75% reduction required by 2020. However, the TB and HIV treatment coverage among estimated total incident TB cases among all PLHIV is still at a low level, 23%. This estimate includes PLHIV and TB patients who have not been diagnosed, registered and started on treatment due to access barriers and limited availability of services.

The epidemics and co-epidemics of TB and HIV are an important public health issue. TB and HIV are leading causes of infectious disease morbidity and mortality in Lao PDR, especially among high risk, vulnerable and key populations. Around half of the estimated number of both TB and HIV patients were not diagnosed and commenced on treatment. It is very important to approach the TA support framework in an integrated and dynamic manner. These include, the inception of the HANSA and the cross-cutting nature of this mechanism; the importance of aligning with the national UHC policy; adapting the framework appropriately to support areas of technical overlap between the two programs. A consultant will provide comprehensive on Laboratory technical assistance for NTC and CHAS through an integrated, systems strengthening approach.

The MOH and Global Fund have requested this particular area of technical support from WHO, which is being 100% funded by Global Fund. The objectives and outputs of TA also aligns with the WHO CO flagship program (reaching the unreached) as well as the current country office support plan.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

The purpose of the post is to provide technical support to National TB Center (NTC), the National TB Reference Laboratory (NRL), and the Centre for HIV, AIDS, and STI (CHAS) in strengthening national laboratory capacity of testing and control of tuberculosis (TB) and HIV/STI, under the guidance and supervision of the HIV/TB/Malaria (HTM) Team Leader in WHO, in collaboration with the Ministry of Health (MOH), HTM team in the Country Office and in the Regional Office, the incumbent will perform the following

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

Output/s

Output 1: Support NTC to develop National Laboratory Strategic Plan and annual operational plan for Tuberculosis 2023-2025.

Deliverable 1.1: Support NTC to organize technical working group meeting to discuss contents and draft the NSP for TB Laboratory and update them based on the feedback from TWG members and partners.

Deliverable 1.2: Support NTC to develop a costed plan to implement the priority actives in the NSP for TB laboratory 2023-2025, considering a range of expected funding availability.

Deliverable 1.3: Finalize and get consensus on the framework of the NSP for TB laboratory including vision, goals, objectives, priority activities, indicators and targets, costing for TB laboratory for the next 3-years period 2023-2025.

Output 2: Technical support to ensure TB/HIV laboratory in quality assured microscopy (ZN), and capacity for TB culture and drug susceptibility testing (DST) in the NRL (BSL-3) and other culture laboratories.

Deliverable 2.1: Implement quality control for microscopy and assist NTC/NRL in EQA, ensure that regular feedbacks are released to provincial and district Level laboratory.

Deliverable 2.2: Training on laboratory working with TB culture when equipment is operational.

Deliverable 2.3: Supporting monitor and improve the drug containing media for DST and assist the NRL to implement first line DST as routine technique.

Output 3: Technical support on strengthening GeneXpert skills in the NRL and at the provincial level and GeneXpert usage for HIV viral load testing in close collaboration with NTC, NRL, CHAS, and National Center for Laboratory and Epidemiology.

Deliverable 3.1: Providing technical support to capacity laboratory staff on usage GeneXpert machines.

Deliverable 3.2: Set up GeneXpert machines and train laboratory staff on GeneXpert for HIV viral load testing.

Deliverable 3.3: Supporting on stock management to ensure that orders are placed on time and to avoid shortage and stockout of materials and reagents.

Deliverable 3.4: Support programmes in maintenance and troubleshooting the GeneXpert machine and all the equipment in the laboratory.

METHODS TO CARRY OUT THE ACTIVITY

The consultant will report to and be guided by the WHO Country Office HIV, TB and Malaria (HTM), Country Team Leader, in collaboration with the Ministry of Health (MOH) in the Lao People's Democratic Republic and the WHO Western Pacific Regional Office teams, the consultant is assigned to:

1. Assist the NTC to develop National Laboratory Strategic Plan and annual operational plan for Tuberculosis 2023-2025.
2. Assist the National Referral Laboratory (NRL) in quality assured microscopy (ZN)
   1. Implement quality control for microscopy staining solution following the national guidelines
   2. Assist NTC/NRL in EQA, ensure that regular feedbacks are released to provincial and district Level laboratory.
3. Develop capacity for TB culture and drug susceptibility testing (DST) in the NRL (BSL-3) and other culture laboratories
   1. Training of regional laboratory working with TB culture when equipment is operational
   2. Monitor and improve the drug containing media for DST
   3. Assist the NRL to implement first line DST as routine technique
   4. Supervision of media preparation and culture result
4. Strengthening GeneXpert skills in the NRL and at the provincial level
   1. Complete the training of lab technicians selected to work with GeneXpert
   2. Ensure a high level of performance in the NRL and in the other selected laboratories in their daily duties
   3. Assist the NRL and other selected laboratories in maintenance and troubleshooting of the GeneXpert machine
5. Support GeneXpert usage for HIV viral load testing in close collaboration with NTC, NRL, CHAS, and National Center for Laboratory and Epidemiology
   1. Set up GeneXpert machines and train laboratory staff on GeneXpert for HIV viral load testing
   2. Monitoring HIV viral load testing practices
   3. Assist the laboratories in maintenance and troubleshooting of the GeneXpert machine for HIV viral load testing
6. Assist NTC/NRL in maintenance of all the equipment in the laboratory (BSC, Autoclave, refrigerators, pipettes, etc)
7. Ensure training and supervision of NTC/NRL laboratory technicians,
8. Collaborate with partner laboratories and other organizations at national level in order to optimise the resources.
9. Assist NTC/NRL in stock management to ensure that orders are placed on time and to avoid shortage and stockout of materials and reagents
10. Participate in retooling of TB laboratory and use of new WHO recommended diagnostic tools
11. Maintain a high level of collaboration with Supra National Reference Laboratory (SRL)
    1. Inform the SRL when new procedures are introduced or changed
    2. Ensure that the SRL recommendation are followed and implemented
    3. Assist the SRL personnel during their visits
12. Assist NRL/NTC in data management
    1. Ensure standard recording and reporting (following the WHO recommendations)
    2. Ensure that data are accurate and reliable
    3. Assist NTC/NRL in improving data management: (updating the existing record forms, registers, etc)
13. Assist NTC/NRL in developing an electronic database

QUALIFICATIONS & EXPERIENCE

EDUCATION

Essential: University degree or equivalent background, in medical or microbiological sciences and postgraduate studies (masters’ level) in public health, or health related field

EXPERIENCE

Essential: 7 years or more of the experience in culture, identification and DST of M. tuberculosis and familiarity with mechanical and operational details, maintenance and standards of BSL-3 laboratory.

Desirable: Working experience in Lao PDR 

TECHNICAL SKILLS & KNOWLEDGE

• • Broad knowledge of principles, practices, methodology, and techniques in public health.
• • Ability to understand the principles of results-based management and develop plans, organize resources and take actions to ensure objectives are achieved within realistic time lines.
• • Ability to quickly acquire a thorough working knowledge of essential WHO procedures, policies and rules and regulations that support WHO's presence in countries.
• • Ability to work independently and take initiative.
• • Good interpersonal skills with the ability to work well with, and positively relate to, people at all levels and from diverse cultural and educational backgrounds and orientations and maintain a high standard of personal conduct.
• • Ability to establish and maintain harmonious relationships with national and international colleagues.

LANGUAGES

Proficient English (speaking, reading and writing) is essential.

COMPETENCIES

Technical Expertise

Communication in a credible and effective way

Producing results

ADDITIONAL INFORMATION:

• • Individual applicants only;
• • Applications are accepted only from applicants who are in Laos;
• • Work at the Lao National TB Centre, Vientiane Capital, Lao PDR
• • Duration of contract is for 16.5 months (2 Aug 2021 - 31 December 2022 with the contract break)

APPLICATIONS

Qualified and interested specialists should submit their CV and Expression of Interest {cover letter} to the Supply Officer through WP RO UNGM at < [email protected] > by 08 July 2021. 

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed daily consultancy fee and availability.

Please use Tender Notice No. 133434 as subject to all submission. Only successful candidates will be contacted.