CONTEXT

Within MSF the Operational Center Brussels (OCB), the Medical Department provides strategic direction and technical leadership, committing to keeping up to date on innovations in health care. We share the responsibility of the operational choices and the responsiveness, and we are involved in the support of our project teams co-developing context-adapted medical-operational strategies and defining levels of care. The department also does normative work (e.g., developing guidelines, tools), supporting their translation (e.g., trainings, quality improvement, information knowledge management) and enabling operational research and innovative ideas.
Composed of multiple specialists based across a network of units across the world, we work in close collaboration with operations, other OCB departments, other OC's. We also provide technical support to the newest operational entity in MSF, West Africa and Central Africa (WACA).
Resistance to acute bacterial infections is a rapidly growing problem. WHO and public health leaders now consider antimicrobial (antibacterial and antifungal) resistance (AMR) as one of the main matters of concern for global public health.
MSF is increasingly confronted with AMR in many of our projects, while realizing that we are only aware of a fraction of the extent of the issue. Our microbial laboratory and diagnostic capacity in the countries of intervention is still limited but progressing. MSF tackles AMR based on three pillars:
(1) Antibiotic stewardship and rational antibiotic prescription,
(2) Diagnostic tools (bacteriology etc...) and AMR surveillance,
(3) IPC (Infection/ Prevention/Control).

OCB is looking for an Infectious Disease/Antibiotic Resistance specialist to maintain and improve the Antibiotic stewardship and rational antibiotic prescription in MSF OCB projects. The objective is to further improve MSF's capacity to provide quality medical care by effectively diagnosing and treating bacterial infections, including addressing drug resistant bacterial infections.
As there is already expertise on certain infectious diseases in the medical department, such as HIV&TB, malaria, vaccine preventable diseases etc.... this position will focus on antibiotic resistance patterns we encounter in the field, where MSF doctors prescribe antibiotics for thousands of patients in OPD and IPD on a yearly basis.
The focus lays on optimal antibiotic use adapted to the context and the resistance pattern and on the detection of bacterial infections in the bloodstream, urine, bone and soft tissues (post-operative wounds, burn wounds) as well as infections in specific vulnerable populations such as severely malnourished, neonates and immunosuppressed, as well as setting up systems to continuously collect data, give feedback and improve antimicrobial use.

As the Infectious Disease/Antimicrobial Stewardship referent, you are part of the Middle East Medical Unit (MEMU) together with the other AMR referent, the microbiology referent, the IPC MIO (Mobile Implementing Officer), an operational research referent focusing on AMR and the regional epidemiologist, as well as an Analysis and advocacy expert, which is hosted by the MSF Lebanon branch office in Beirut.

By maintaining regular contact through calls, videoconference, and visits, you stay connected to and collaborate with the medical department and operational cells referents.

Due to the current volatile situation in Lebanon, the location of the MEMU will preferably be reoriented to Amman or Nairobi. The final location will be decided before the start of this position. Once the situation in Lebanon has stabilized, the medical unit will be moved back to Beirut.


RESPONSIBILITIES

1. Defines medical policy, strategies and technical norms related to Antibiotic Stewardship Programs
● Draft, review and follow the implementation of guidelines, protocols and tools
● Propose different strategies to projects in antibiotic stewardship and AMR surveillance system in the MSF facilities
● Review and develop facility-specific treatment recommendations, based on patient type (neonate, surgical, burn wound, etc.), national guidelines, local susceptibilities, and formulary options. Imbed facility-specific guidance in evidence-based clinical pathways and antibiotic protocols
● Evaluate the need of and requests for WHO Watch and Reserve category antibiotics given individual bacterial resistance pattern. Develop criteria for use or requiring prior approval for the use of certain antibiotics, for example those that are WHO Watch and Reserve category
● Contribute to the operational research agenda on antibiotic resistance and its treatment and prevention within MSF

2.Support the use of the Microbiological diagnostics
● Develop algorithms outlining indications for ordering various microbiological tests in collaboration with other medical referents (e.g. bone/tissue sampling for osteomyelitis)
● Work with the laboratory team to develop SOP's for ordering and obtaining cultures and other diagnostic tests (appropriate culturing practices, proper sampling of various specimen types (e.g. blood cultures, bone/tissue intra-operative specimens)
● Discuss with microbiologist and clinicians the documentation and interpretation of bacteriologic results

3. Provide support to MSF projects and the medical managers in the cells
● Give technical support to our projects through:
        o Responding to technical queries or case discussions. Providing clinical decision and patient management support to the field (prescribers,                     pharmacists, and laboratory technicians) for complex infections or clinical conditions, including interpretation of results and adaptation of                     treatment based on preliminary microbiology results and AST
        o Regular project visits
● Contribute to the strategy of projects through collaboration with the medical responsible in the concerned operational cell and Emergency Unit.
● Assure the technical briefing & debriefing of IMS (international Mobile Staff) that will be responsible for antibiotic stewardship programs in MSF projects
● Support the HR on the organization of project positions for infectious diseases specialist related to ABR.
● Develop and share expertise in antibiotic use, and collaborate with the Learning & Development Unit to establish training modules on antibiotic use and Stewardship

4. Monitoring and analysis of Microbiology and Antibiotic use activity
● Establish a surveillance data management system in collaboration with the microbiologist.
● Work with pharmacy team to monitor, give feedback, and make visible data regarding antibiotic utilization, cost and adherence to the MSF health facilities' recommended culturing and prescribing practices.
● Perform regular analysis of data and shares outcomes with medical teams.
● Produce an analytical medical annual report.

5. Collaborate in internal working groups and assure representation outside MSF
● Actively participate in the OCB antimicrobial resistance circle (some roles included in the circle: pharmacist referent, lab referent, IPC referent, environmental health referent, microbiologist, etc...).
● Collaborate as active member of other Med Dep circles (internal fixation, critical care, outbreak control...).
● Participate regularly in the Antibiotic Stewardship contact group
● Liaise with the Analysis Department to develop advocacy messages and strategies on AMR.
● Establish an external network of specialists in antibiotic resistance in high, low and middle-income countries.
● Participate to workshops, conferences, international expert groups or other validated initiatives.
● Participate to the medical department meetings, , and the coordination week.
● Collaborate with the Medical Academy regarding specific dossiers (Post Graduate Diploma on Infectious Diseases; OPD training, AMS and IPC diploma courses).

6. In relationship with MSF local branch offices
● Collaborate with the different departments in the MSF branch offices in the region (communications, field HR, MSF visibility in the region).
● Represent MSF at different conferences, meetings with academia and other NGOs, when relevant

REQUIREMENTS

Education & Experience
● Medical doctor with Clinical Academic Infectious Diseases specialty training
● At least 2 years of medical NGO experience in low resource settings, preferably with MSF
● Experience in working within a hospital's antimicrobial Stewardship program, preferably having experience in implementation, monitoring and evaluation of stewardship programs

Competencies
● Excellent communication skills
● Demonstrated ability to work on projects with a wide variety of participants, and to facilitate dialogue and share information among all concerned parties
● Ability to synthesize and analyze medical data so as to recommend improvements to field practice and draft implementation plans for adopting changes
● Ability to write reports, medical protocols, and scientific articles for internal and external audiences
● Ability to effectively present information

Languages
● Fluent in English and French (both spoken and written)
● Arabic is an asset (both spoken and written)

CONDITIONS

● Expected starting date: January 2025
● Location: Amman or Nairobi
● Mobility: at least 30% of the time in MSF projects worldwide
● Contract type: Fixed-term contract - Full-time
● Contract duration: 12 months (extendable)
● The contractual terms, conditions and salary will be established based on the station, on administrative / legal constraints and in respect of MSF function grids and salary policies
● Adhere to the MSF principles and to our managerial values: Respect, Transparency, Integrity, Accountability, Trust and Empowerment
● Adhere to the MSF Behavioral Commitments

Deadline for applications: 5th of December 2024