Historique

Treatment regimens that include a combination of three or more ARV drugs can achieve suppression of the HIV viral load. Since 2016, WHO recommends that lifelong ART be available to all people living with HIV, including children, adolescents and adults, and pregnant and lactating women, regardless of their clinical status and CD4 count. By June 2020, the “treat all” recommendation was adopted by 185 countries collectively accounting for 99% of all people living with HIV in the world. In addition to “treat all,” WHO also recommends that all people living with HIV begin ART promptly, including offering those willing to receive treatment to start ART on the same day they are diagnosed with HIV. By mid 2020, 70 low- and middle-income countries reported having adopted the policy, and about half of them reported implementing it nationwide.
According to official statistics by the end of 2021, the total number of officially registered HIV cases in Tajikistan (since 1991) was 13,992, including 8,918 (63.78%) male and 5,074 (35.8%) female cases. UNAIDS estimates that the number of people living with HIV in Tajikistan is 14,000. Thus, the actual number of people living with HIV (10,077) is 72.0% of the estimated number of people living with HIV in the country.
Between 1991 to December 31, 2021, 3,915 or (28.0%) of the people registered with HIV died of various causes. 1,106 children were under the age of 18 living with HIV, or 11.0% of the cumulative number of all PLHIV in the country in 2021 922 HIV new cases of, of which 578 were males, 344 females, including 60 children, of whom 31 were infected through vertical transmission in 2021..
According to the National AIDS Prevention and Control Center, the overall coverage of people living with HIV under dispensary observation was 91.7% in the first half of 2021. A high level of prophylactic medical examination (dispensary) services is noted among children, where the coverage of dispensary observation reached 98.0%
As of December 31, 2021, 8,719 people (or 86.5%) out of the total number of people living with HIV (10,077) received antiretroviral therapy. Coverage of people living with HIV who are under dispensary observation (9,238) and receive antiretroviral therapy (8,719) is currently 94.3%.
1,073 (or 97.0%) of 1,106 children under 18 living with HIV who are under dispensary observation, continue to receive antiretroviral therapy.
In February 2021, the “National HIV/AIDS Program for 2021-2025” was endorsed bythe Decree of the Government of the Republic of Tajikistan which includes 6 main strategic areas, one of which is access and increase of the coverage of PLHIV with antirevoviral therapy.
In 2005, the “Clinical protocol for HIV treatment of in the Republic of Tajikistan” was developed and approved for the first time, which has been regularly reviewed in accordance with WHO recommendations.
In 2019, based on the new WHO recommendations on ART issued in 2018, the country revised and adapted the national protocol for the treatment of HIV patients. The protocol was approved by the order of the Ministry of Health and Social Protection of Tajikistan No. 342 dated May 14, 2019. The new protocol also provides clear guidelines for selecting and optimizing treatment regimens, while simultaneously strengthening patient adherence to treatment and ensuring the long-term effectiveness of antiretroviral drugs. As the main drug in the first-line treatment regimens, it is planned to introduce a combination drug based on fixed doses of three ARV drugs, which can be taken in the form of one tablet per day. According to WHO recommendations, the 3-component drug based on Tenofovir/Lamivudine/ Dolutegravir/ (TLD) was adopted as the primary drug of the main treatment regimen.
The first optimization plan was developed in late 2018 for treatment to the first cohort of patients comprising 1,000 people. Subsequently, a second optimization plan was adopted, which was later approved by the WHO and the GF (in 2020). According to this plan, 90% of patients should receive treatment based on TLD regimen. The number of treatment regimens has been reduced from 19 to 7 for adults and from 24 to 14 for paediatric patients.
UNDP conducted training with involvement of WHO consultants for specialists of dispensary departments from all regions. The trainings enabled clinicians to discuss the prescription of regimens that were included in the optimization plan based on WHO recommendations. At the beginning of 2020, this plan was revised based on new TLD regimen recommended by the WHO..
UNDP is hiring a consultant to assess implementation of the Optimization Plan and provide recommendations for the revision of treatment regimens.

Devoirs et responsabilités

Goal: To assess the implementation of Optimization Plan and provide technical recommendations on updating treatment regimens.This assessment will include the following activities: 1. Review and analysis of existing Treatment Protocols and regulatory documents in the country to determine their compliance with the latest WHO recommendations 2. Analysis of existing treatment regimens in the country, based on the data of the electronic system 3. Analysis of outpatient records at selected sites for compliance of the chosen regimens with clinical indications, based on the results of clinical tests. 4. Review of the implementation of the optimization plan by districts and regions 5. Development and presentation of the report with recommendations based on the assessment results The assessment results will serve as the basis for further revision or improvement of the Treatment Optimization plan. The methodology shall include (but not be limited to): 1. An introductory meeting at the National AIDS Center together with dispensary specialists from the National and City AIDS centers, UNDP, as well as dispensary specialists at the regional and district levels, online. 2. Site visits to the following AIDS centers to complete the assigned tasks: • DRS (Vahdat, Rudak ) - 2 days • Khatlon Region (Bohtar, Panj, Kulyab, Farkhor) - 4 days • Sughd Region (Khujand, Isfara, Istaravshan) – 3 days 3. Development and presentation of the assessment results at the Round Table, conclusions and discussions with key partners.

1. Review and analysis of existing Treatment Protocols and regulatory documents in the country to determine their compliance with the latest WHO recommendations 2. Analysis of existing treatment regimens in the country, based on the data of the electronic system 3. Analysis of outpatient records at selected sites for compliance of the chosen regimens with clinical indications, based on the results of clinical tests. 4. Review of the implementation of the optimization plan by districts and regions 5. Development and presentation of the report with recommendations based on the assessment results

Compétences

Corporate Competencies

  • Demonstrates integrity by modeling the UN’s values and ethical standards;
  • Promotes the vision, mission, and strategic goals of UN;
  • Displays cultural, gender, religion, race, nationality and age sensitivity and adaptability;
  • Treats all people fairly without favoritism;

Functional Competencies

  • Climate change adaptation in the context of natural resource management broadly;
  • Knowledge of integrated catchment management approaches to sectoral and community level land use and management solutions; ability to undertake or coordinate multi-hazard risk assessment and modelling work is an asset;
  • Research and analytical skills combined with good communication skills, including drafting skills and writing skills, in English and possibly another UN language (Russian, Persian);
  • Able to work independently and as part of team and deliver on time under pressure.

Qualifications et expériences requises

Education:
• At least a master's degree in public health or an MD degree with a specialization in infectious diseases
Experience:
• 10 years of experience in public health and medicine (infectious diseases) on HIV issues;
• Experience in conducting similar assessments in the light of modern approaches to the clinical management of PLHIV (knowledge of the latest WHO recommendations on ART regimens);
• Experience in developing countries, preferably in the region
Language Requirements:
• Excellent knowledge of English and Russian with proven oral and written skills

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Application Procedure:

Please follow the link to download Individual Consultant Procurement Notice and follow the application procedures indicated in the downloaded ICPN: 

http://www.undp.tj/va/upload/va/ICPN_ART%20rapid%20Assessment_International%20Consultant.pdf 

 

DOCUMENTS TO BE INCLUDED WHEN SUBMITTING THE PROPOSALS.

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

  • Letter of Confirmation of Interest and Availability using the template provided by UNDP.
  • Personal CV and/or resume.
  • Brief description of approach to work/technical proposal of why the individual considers him/herself as the most suitable for the assignment, and a proposed methodology on how they will approach and complete the assignment; (max 1 page)
  • Financial Proposal that indicates the all-inclusive fixed total contract price and all other travel related costs (such as flight ticket, per diem, etc.), supported by a breakdown of costs, as per template attached to the Letter of Confirmation of Interest template.  If an applicant is employed by an organization/company/institution, and he/she expects his/her employer to charge a management fee in the process of releasing him/her to UNDP under Reimbursable Loan Agreement (RLA), the applicant must indicate at this point, and ensure that all such costs are duly incorporated in the financial proposal submitted to UNDP.

All application materials should be submitted by email at the following address ONLY: (ic.tj@undp.org) by (01 June 2022). Incomplete applications will be excluded from further consideration. 

 

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.