Immunization Specialist (Measles and rubella elimination)

BACKGROUND

There have been remarkable achievements in vaccine-preventable diseases and immunization (VDI) programme in the Pacific Island Countries (PICs) over the past two decades. The countries and areas have made great efforts to protect their people from Vaccine-Preventable Diseases (VPDs) including attaining some landmark achievements such as sustained polio eradication, achieved maternal and neonatal tetanus elimination (MNTE) and controlling measles outbreaks.  Incredible contributions are also made to newborn survival, reduction of child and maternal mortality and hence supporting the achievement of Sustainable Development Goals (SDGs).

Routine immunization remains the backbone and main element of the primary health care programme in the PICs. A well-functioning routine immunization system and high vaccination coverage are critical to achieving/sustaining national and regional disease elimination and control goals. 2021 administrative immunization data shows that most countries and areas in the Pacific have less than 95% coverage for measles-containing vaccine (MCV) first and second doses. The immunization programme as a whole is also experiencing a range of challenges and difficulties including delivery of immunization services to remote and scarcely populated islands, reaching vulnerable populations, lack of utilization of services, and lack of human resource capacity. The number of targets to be vaccinated is inaccurate, especially at service delivery points and micro-planning is weak in a few countries. Data management, analysis and interpretation also needed to be improved in a few countries.

VPD surveillance systems in the Pacific are mainly Hospital-Based Active Surveillance (HBAS) and Pacific Syndromic Surveillance System (PSSS). The HBAS started in 1997, however, after 2014, the monthly reports became irregular. The PSSS comprising at least four core syndromes and accompanied by standardized case definitions was established in 2010. Acute fever and rash (AFR) are part of this PSSS, and PICs adopted it well. AFR case report through PSSS is available for 18 countries but no availability of subsequent information like case investigation, lab test, etc. The PICs also respond timely to vaccine-preventable disease outbreaks through adequate investigation, management and immunization response activities. Congenital Rubella Syndrome (CRS) is a notifiable disease in many PICs but the weak system.  A few national measles/rubella laboratories exist in the PICs. There is a significant improvement needed for the verification standard measles/rubella surveillance and strengthening laboratory capacity in the Pacific.

There have been periodic measles outbreaks in PICs in the last few decades. Most countries/areas in the PICs faced major measles outbreaks in 2018-2019 due to the global resurgence. Multiple efforts were taken including Supplementary Immunisation Activities (SIAs) to increase the population immunity. Few countries are conducting MCV catch-up vaccination annually to improve coverage. Following measles outbreaks, from 2020 onward the COVID-19 pandemic has affected routine immunization services and VPDs surveillance in PICs like in many other countries in the world, resulting in decreased vaccination coverage of the national immunization programmes, especially for the measles-containing vaccine.

Partners working in the PICs are strongly engaged and supportive of both immunization and surveillance system and programmes. WHO as convener has been coordinating and working together to strengthen the immunization and surveillance system. There is a continuing need for coordinated approaches and support in PICs to improve the systems as a part of the wider health system.

In 2005, the fifty-sixth session of the World Health Organization Regional Committee decided to aim to eliminate measles by 2012 (WPR/RC56.R8). At the sixty-third session in 2012, the Regional Committee urged Member States (WPR/RC63.R5) to establish National Verification Committees (NVCs) to prepare regular progress reports and submit to the Regional Verification Commission (RVC). For measles and rubella elimination, PICs will be verified as one epidemiological block, as was done for certification of polio-free status. Therefore, WHO established the Sub-regional Verification Committee (SRVC) for measles and rubella elimination in the Pacific. SRVC is responsible to collect, analyze and validate national data, also endorse and submit the necessary documentation to the RVC annually.

The SRVC in its 11th meeting held in May 2022 concluded that given the absence of endemic measles and rubella transmission in the sub-region in recent years, the PICs should aim to be verified for measles and rubella elimination by 2025. To support measles and rubella elimination verification and to respond to any future measles/rubella outbreaks needs political commitment; improvement of immunization system and coverage; and strengthening and improving quality of measles/rubella surveillance in the Pacific.

Therefore, WHO will continue to provide support in disease elimination and control especially for measles and rubella elimination to the National Immunization Programmes (NIPs); disease surveillance/epidemiological units and Ministries of Health (MOHs) in the Pacific. The main areas of support will be policy, strategic and technical support; strengthening measles/rubella epidemiology and laboratory surveillance; capacity building of health workforces; improving service delivery including the development of micro plan for reaching the last miles and unreached population toward increasing population immunity; strengthening laboratory surveillance; preparedness and response to measles outbreaks; conduct measles/rubella campaign; data management including improving data quality; sustainability of the national immunization programme and plans of action addressing critical issues to sustain measles and rubella elimination; etc.

 

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

The Director of Pacific Technical Support and WHO Representative Office to the South Pacific is seeking technical assistance to support the NIP, disease surveillance/epidemiological unit and MOH in the PICs with the following objectives:

• • To review the existing national measles/rubella preparedness and response plans and update them.
• • To strengthen the immunization systems and programmes by guiding and supporting to implement of identified immunization activities toward reducing inequities of immunization coverage with a special focus on reaching the unreached, especially for measles-containing vaccines;
• • To strengthen the VPD epidemiological and laboratory surveillance systems including improving detection and reporting of suspected measles/rubella; and
• • To support and conduct capacity-building activities.  

 

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

Output 1:

1. Reviewed existing national measles/rubella preparedness and response plans and update them and conduct EPI review/immunization programme assessment.  

Deliverables:

1. Conduct desk review of existing national preparedness and response plans in countries and areas in the Pacific;
2. Plan, prepare and develop/update national measles/rubella preparedness and response plans; and
3. Explore and conduct an EPI review/immunization assessment and develop action plans.

Output 2:

1. Strengthened routine immunization system toward reaching the unreached and increasing vaccination coverage of the national immunization schedule, especially for MCV.

Deliverables:

1. Conduct regular national and sub-national level data analysis by countries and areas in the Pacific and provide feedback;
2. Support in improving immunization data management;
3. Review and support the harmonization of MCV doses’ schedules among countries and areas in the Pacific;
4. Support in improving routine immunization coverages including MCV first and second dose in countries and areas in the Pacific with special focus on low-performing countries and areas; and
5. Support capacity-building activities.

Output 3:

1. Strengthened the VPD epidemiological and laboratory surveillance systems including improving detection and reporting of suspected measles/rubella.

Deliverables:

1. Plan, prepare and facilitate VPD surveillance activities including conducting training toward improving the detection and reporting of VPD cases especially suspected measles/rubella case;
2. Coordinate and engage with partners for supporting the strengthening of the VPD surveillance system;
3. Support laboratory surveillance activities toward expanding measles/rubella laboratory and establishing Rapid Diagnostic Test (RDT); and
4. Data management and monitor VPD surveillance performances at national and sub-national levels and providing feedback.

Output 4:

1. Facilitate and participate in VPD outbreaks, especially measles/rubella outbreaks preparedness and response activities.

Deliverables:

1. Support countries and areas for measles/rubella outbreaks preparedness and responses activities including conducting simulation exercises;
2. Participate in and facilitate measles/rubella case investigation and immunization responses activities;
3. Plan, prepare, implement and monitors the measles-rubella vaccination campaign; and
4. Conduct capacity-building on Infection Prevention and Control (IPC) along with other programmes.

Output 5:

1. Provided additional support needed for the office; and prepared and submitted the mission report.

Deliverables:

1. Provide additional support needed by the DPS office as needed.
2. Prepare mission report and submit it to WHO DPS office (by end of mission).

 

METHODS TO CARRY OUT THE ACTIVITY

A consultant will be based in Suva, Fiji work under the overall guidance of the Technical Officer-VDI. She/he will be working and in collaboration with the NIP, disease surveillance/epidemiological unit and MOH of countries and areas in the Pacific for planning, preparing, implementing and monitoring the above-mentioned activities including frequent visits to countries and areas.

 

QUALIFICATIONS & EXPERIENCE

EDUCATION

Essential:  Medical graduate with a postgraduate degree in public health from a recognized university or its equivalent

Desirable: Training in EPI and/or measles and rubella elimination

EXPERIENCE

Essential: At least 10 years of relevant experience and/or experiences in the field of immunization programmes at the country level.

Desirable: Working experiences in WHO or UNICEF country office

TECHNICAL SKILLS & KNOWLEDGE

Sound knowledge in policy and technical areas; and in the planning, preparation, implementation and monitoring of various activities in vaccine-preventable disease and immunization programme. Ability to work harmoniously as a member of a team, adapt to diverse cultural backgrounds and maintain a high standard of personal conduct. 

LANGUAGES

Excellent knowledge of spoken and written English. 

COMPETENCIES

1. Producing results.
2. Fostering integration and teamwork.
3. Communicating in a credible and effective way
4. Respecting and promoting individual and cultural difference

 

ADDITIONAL INFORMATION

Contract duration

11 months starting 1 November 2022

Duty station      

Suva, Fiji

Travel

Frequent visits to countries and areas in the Pacific.

 

APPLICATIONS

Qualified and interested specialists should submit their CV and Expression of Interest {cover letter} to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 5 October 2022. 

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

Please use Tender Notice No. 183102 as subject to all submission. Only successful candidates will be contacted.