Infectious disease Antibiotic Resistance Referent

Médecins Sans Frontières (MSF) is an international humanitarian aid organization that provides assistance in more than 60 countries to populations in distress, to victims of natural or manmade disasters and to victims of armed conflicts, without discrimination and irrespective of origin, religion, creed or political affiliation. To develop this work from our headquarters in Brussels, the Medical Department of the Operational Centre Brussels (OCB) is looking for an:

 Infectious disease -Antibiotic Resistance Referent

Background

Resistance to acute bacterial infections is a rapidly growing problem. WHO and public health leaders now consider antibiotic resistance (ABR) as one of the main matters of concern for global public health.

MSF is increasingly confronted with ABR 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 field is still limited and in most projects the attention to ABR and what it entails is still narrow. In response to this and to coordinate MSF’s common commitment to this dossier, an intersectional taskforce was setup in 2016. This task-force was requested to develop a detailed roadmap to improve the capacity to prevent, detect and manage ABR in the MSF projects. The mandate of the MSF ABR task-force is to guide the implementation of the plan over a period of 4 years. Three main topics are identified as priorities in the roadmap:

(1) Antibiotic stewardship and rational antibiotic prescription,

(2) Diagnostic tools and ABR surveillance,

(3) IPC (Infection/ Prevention/Control).

OCB is looking for an Infectious Disease/Antibiotic Resistance specialist to lead the OCB roadmap. 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.

The Medical Department framework

The aim of the Medical Department is to improve the quality of MSF interventions in the field. This is done through the following activities: direct support to the field (field visits, technical advices etc.), training of MSF medical staff, definition of policies and protocols and support to operational research.

The Infectious Disease /Antibiotic Resistance (ABR) referent is based together with the microbiologist referent, the IPC MIO (Mobile Implementing Officer), an operational research referent focusing on ABR and the regional epidemiologist, in the MSF Lebanon branch office in Beirut. By regular contact through skype, videoconference, and visits to Brussels, he/she stays connected and works together with the referents in the medical department and the operational cells.

JOB DESCRIPTION

1. Defines medical policy, strategies and technical norms related to Antibiotic Stewardship Programs

• Drafts, reviews and follows the implementation of guidelines, protocols and tools.
• Propose different strategies for pilot projects in antibiotic stewardship and ABR 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 Bacteriology

• 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 the field and the medical managers in the cells

• Give technical support to field projects through:
  • 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.
  • Regular field visits.
• Contribute to the strategy of field projects through collaboration with the medical responsible in the concerned operational cell and Emergency Unit.
• Assure the technical briefing & debriefing of medical expatriate staff that will be responsible for antibiotic stewardship programs in the field.
• Support the HR on the organization of field positions for infectious diseases specialist related to ABR.
• Develop and make available expertise in antibiotic use. Together with the Learning & Development Unit contribute 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.
• Performs regular analysis of data and shares outcomes with medical teams.
• Produces an analytical medical annual report.

5. Collaborate in internal working groups and assure representation outside MSF

• Coordinate the OCB ABR 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 circle (internal fixation, critical care, outbreak control).
• Participate regularly in the Antibiotic Stewardship contact group and in the ABR intersectional task force meetings when required.
• Liaise with the Analysis Department to develop advocacy messages and strategies on ABR.
• 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, B&O exercises, and the coordination week.
• Collaborate with the Medical Academy regarding specific dossiers (Post Graduate Diploma on Infectious Diseases; OPD training).

6. In relationship with MSF Lebanon branch office • To collaborate with the different departments in the MSF Lebanon branch office (communications, field HR, MSF visibility in the region).

• To represent MSF at different conferences, meetings with academia and other NGOs, when relevant.
• Medical doctor with Clinical Academic Infectious Diseases specialty training
• Experience with implementation/monitoring/evaluation of a hospital antibiotic stewardship program
• Excellent communication skills in English (written and oral); French (written and oral) is an added value
• 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 and respond to questions from colleagues, including managers, as well as donors, and the general public
• Adherence to the MSF principles and to our managerial values: Respect, Transparency, Integrity, Accountability, Trust and Empowerment.

CANDIDATE PROFILE

• Medical doctor with Clinical Academic Infectious Diseases specialty training
• Experience with implementation/monitoring/evaluation of a hospital antibiotic stewardship program
• Medical field experience with MSF in low resource settings
• Excellent communication skills in English (written and oral); French (written and oral) is an added value
• 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 and respond to questions from colleagues, including managers, as well as donors, and the general public
• Adherence to the MSF principles and to our managerial values: Respect, Transparency, Integrity, Accountability, Trust and Empowerment.

CONDITIONS

• • Open-end contract – Full-time
  • Based in Beirut with travels to the field and Europe
  • Start date: ASAP