National Consultant-Neglected Tropical Diseases and Leprosy Elimination

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Purpose of the Consultancy

In line with the targets set by Cambodia’s National NTD Strategic Plan (2020-2025) and the WHO’s Road Map for Neglected Tropical Diseases 2021-2030, the National Consultant will provide technical support to the relevant National Programs to contribute to the control and elimination of the following NTDs:

1. 1. Leprosy
   2. Soil-transmitted helminthiasis (STH)
   3. Food-Borne Trematodiases (FBT)
   4. Taeniasis/Cysticercosis
   5. Strongyloidiasis
   6. Rabies
   7. Scabies

The specific objectives are to:

1. Coordinate WHO’s support to institutions involved in control and elimination of NTDs in Cambodia, including Ministry of Health and partners at the Provincial, Operational District (OD), Health Centre, and village/community levels, and facilitate cross-sectoral collaboration among all relevant institutions;
2. Support strengthening the planning, implementation, monitoring and evaluation of interventions/activities implemented for control and elimination of NTDs in Cambodia, including MDAs, case finding and case management, epidemiological surveys and disease surveillance (including post-validation surveillance for LF);
3. Supervise the implementation of leprosy elimination activities, including contact tracing, PEP-SDR (Post Exposure Prophylaxis with Single-Dose Rifampicin), and implementation of active case finding in hotspots;
4. Facilitate the planning and implementation of community engagement approaches aimed at increasing adherence to planned NTD activities, fostering local governance, empowerment and ownership, and reducing stigma and discrimination; and
5. Support the ongoing process of transformation of primary health care and the shift from a “disease-based” to a “people-centered” approach; facilitate the inclusion of NTDs into such new model.

Background

Cambodia has made significant progress against Neglected Tropical Diseases (NTDs) in recent years, as exemplified by WHO’s validation for the elimination of Lymphatic Filariasis (LF, 2016) and Trachoma (2017) as a public health problem.

However, Cambodia continues to be endemic for other NTDs including Leprosy, Schistosomiasis, Soil Transmitted Helminthiasis (STH), Food-Borne Trematodiases (FBT), Taeniasis/cysticercosis, Strongyloidiasis, Rabies and Scabies.

Action is required to scale up activities aimed at further reducing the burden of NTDs across Cambodia, in line with the policies and targets included in WHO’s road map for neglected tropical diseases 2021-2030.

Leprosy

Cambodia has also made significant progress against Leprosy with hopes of leprosy elimination in sight. In 1998, Cambodia achieved the WHO-recommended goal of eliminating leprosy as a public health problem. This happened when the registered prevalence of leprosy cases fell below 1 case per 10,000 population. The goal had been set in 1991 by World Health Assembly resolution WHA44.9, with a call to all WHO Member States to reach that threshold by the year 2000.

In 2019, the last year before the COVID-19 pandemic, Cambodia reported 127 registered cases (i.e. people under treatment), and 92 new cases. In 2020, amidst the disruptions caused by the COVID-19 pandemic, these numbers had fallen to 39 (as reported to WHO; 55 based on more recent data from the NLEP database) and 38 (as reported to WHO; 55 based on the NLEP database), respectively.

Cambodia has been one of the first countries to adopt the WHO-recommended policy of administering post-exposure prophylaxis with single-dose rifampicin (PEP-SDR), contact tracing, and community awareness to accelerate the elimination of the Mycobacterium Leprae in the country.

In 2021 and 2022, WHO supported efforts to review both epidemiology of leprosy and programmatic activities implemented so far in Cambodia. WHO also promoted the development of a Roadmap and Action Plan 2022-2030 that would guide efforts toward elimination.

Schistosomiasis

The annual Mass Drug Administration (MDA) campaign for schistosomiasis started in 1995 and continues to date, with WHO-donated Praziquantel (PZQ) targeting both School Age Children (SAC) and adults in all endemic villages. Sentinel and spot-check surveys are implemented every year, supported by WHO. Out of the total population in Cambodia, 99,111 people required interventions against Schistosomiasis in 2020.

Since the end of 2016, WHO has been supporting a community-led initiative to eliminate schistosomiasis through WASH interventions (CL-SWASH) in Cambodia. As of now, 22 out of 114 endemic villages have implemented CL-SWASH. In addition, WHO supported efforts such as MDA, multi-sectoral collaboration, expansion of WASH to all endemic villages, and strengthening lab capacity for surveillance toward the elimination of schistosomiasis by 2025.

Soil-transmitted helminthiasis

Nearly 3.5 million people in Cambodia needed deworming coverage in 2020 for Soil-Transmitted Helminthiasis. Cambodia is one of the countries with the longest history of deworming. Semi-annual deworming has been ongoing in the last 2 decades, initially for School Age Children (SAC) but now also covering pre-SAC and Women of Child-Bearing Age (WCBA) in close collaboration with immunization, Maternal and Child Health (MCH) and plantation.

Other NTDs

Cambodia is known to be endemic for Taeniasis/cysticercosis, however, data is limited. Nevertheless, WHO supported the integration of Taeniasis diagnosis in trainings and STH survey since 2019.

For Strongyloidiasis, a nationwide endemicity map is available as well as a demonstration of the effectiveness of MDA using ivermectin for strongyloidiasis control. However, Ivermectin is not yet available for donation. However, WHO is making efforts to get donations to initiate the pilot MDA.

WHO also supported nationwide FBT mapping integrated with strongyloidiasis mapping several years ago. Hence a nationwide disease map is available. Other partners (Yamanashi University in Japan) have also been supporting a grass-root level FBT control project with stool/ultrasound diagnosis, MDA, and community engagement (similar to CL-SWASH) approach.

Information on rabies is scarce. in 2020, there were 57,1784 dog bites with a total of 115 cases of dog-mediated rabies. Post-exposure prophylaxis for rabies (human rabies immune globulin (HRIG) and rabies vaccine) is available throughout Cambodia, but public health control of rabies is limited.

Key priorities include increasing and sustaining the coverage of NTD interventions (mass drug administration (MDA), active and passive case-finding, etc.), strengthening cross-sectoral collaboration and integrated approaches such as One Health and WASH (especially for animal-mediated/zoonotic diseases), carry out review/analysis and ensure timely collection and reporting of prevalence and incidence data, strengthen disease surveillance (including post-validation surveillance for LF), etc. For leprosy, Post-Exposure Prophylaxis with Single Dose Rifampicin (SDR) following WHO guidelines needs to be scaled up. In addition, community engagement approaches aimed at increasing adherence to planned NTD activities, fostering local governance, empowerment and ownership, and reducing stigma and discrimination are equally important priorities in achieving targets set in Cambodia’s National Strategic Plan for NTDs (2020-2025) and full implementation of Cambodia’s National Leprosy Elimination Roadmap.

Work to be performed

Deliverables

In close collaboration with the Medical Officer for Malaria, Vector-borne and Other Parasitic Diseases (MTD) at WCO Cambodia, and partners/counterparts, the consultant is expected to provide the following outputs and deliverables.

Output/s:

Output 1: Coordination and program management to improve: (1) planning of high-priority NTD interventions for Leprosy, STH, FBT, Taeniasis/ Cysticercosis, Strongyloidiasis, Rabies and Scabies (MDA, deworming, Mapping/Surveillance, Cross-Sectoral Collaboration including WASH and Zoonotic NTDs, active and passive case-finding) in line with WHO’s and national policies; (2) program management and coordination at different levels of the health system (national, provincial, district, health center, village/community)

Deliverable 1.1: Coordinate, review activities planning, and build capacities;

Deliverable 1.2: Strengthen relationships among partners and ensure optimal coordination of activities;

Deliverable 1.3: In line with Cambodia’s policies and successful track record of health services integration, facilitate mainstreaming of NTDs with PHC, report to MoH and WHO the support provided, and identify any challenges and opportunities.

Related Outcomes: Improved planning of NTD interventions and surveillance, improved management of NTD Programs, strengthened integration and mainstreaming of NTDs, stronger collaboration with other sectors.

Output 2: Close monitoring of activities at the village level to ensure implementation of planned NTD activities (MDAs, case finding and case management, epidemiological surveys, disease surveillance; active case finding in hotspots, contact tracing, and PEP-SDR interventions for Leprosy) and timely data reporting from peripheral to central level (to WHO and MoH).

Deliverable 2.1: Assist provincial level, Operation District level, health center, and village levels in implementing priority NTD interventions according to the planning;

Deliverable 2.2: Assist provincial level, Operation District level, health center, and village levels in establishing a functioning data reporting system;

Related Outcomes: Planned NTD activities (e.g. Intensified Leprosy Contact Tracing, PEP-SDR; Implementation of Planned NTD activities) are on track; data related to epidemiology and programmatic outcomes are timely collected and reported.

Output 3: Support to community engagement approaches aimed at relieving burden of NTDs

Deliverable 3.1: In collaboration with relevant national and international stakeholders, facilitate the planning and implementation of community engagement approaches aimed at increasing adherence to and compliance with planned NTD activities

Deliverable 3.2: In collaboration with relevant national and international stakeholders, facilitate the planning and implementation of community engagement approaches aimed at fostering local governance, empowerment and ownership

Deliverable 3.3: In collaboration with relevant national and international stakeholders, facilitate the planning and implementation of community engagement approaches aimed at reducing stigma and discrimination among people affected by NTDs

Related Outcomes: Enhanced/stronger engagement of communities in governance, implementation of NTD activities, and reduction of stigma and discrimination affecting those afflicted by NTDs and other communicable and non-communicable diseases.

Specific requirements

Educational Qualifications

Qualifications required:

• Bachelor/University degree in science, public health, or epidemiology degrees.

Experience

Experience required:

• Minimum of 5 years of work experience in public health at the national and or international level
• Working knowledge of one or more countries in the Western Pacific Region would be an advantage
• Language requirements: Excellent knowledge of English is essential (Read-Write-Speak).

Desirable: Working at the health centre and community level in a low-middle-income country.

Competencies

• Technical Expertise
• Monitoring and Evaluation skills
• Communication
• Moving Forward in a Changing Environment
• Producing Results

Place of assignment (on-site)

The consultant is required to work closely with the National Centre for Tuberculosis and Leprosy Control (CENAT) and WHO country office in Phnom Penh, Cambodia.

Medical clearance

The selected consultant will be expected to provide a medical certificate of fitness for work.

Travel

The Consultant is continuing to work with counterpart and WHO country office in Cambodia, including extensive travel to the provincial level.

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.
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• Applications from women and from nationals of non and underrepresented Member States are particularly encouraged.
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• Consultants shall perform the work as independent contractors in a personal capacity, and not as a representative of any entity or authority. The execution of the work under a consultant contract does not create an employer/employee relationship between WHO and the Consultant.
• WHO shall have no responsibility whatsoever 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 in each location/jurisdiction in which the work hereunder is performed, and the Consultant shall not be entitled to any reimbursement thereof by WHO.
• The purpose of this vacancy is to develop a list of qualified candidates for inclusion in this advertised roster. All applicants will be notified in writing of the outcome of their application (whether successful or unsuccessful) upon conclusion of the selection process. Successful candidates will be placed on the roster and subsequently may be selected for consultancy assignments falling in this area of work or for similar requirements/tasks/deliverables. Inclusion in the Roster does not guarantee selection to a consultant contract. There is no commitment on either side.