Support the establishment of Opioid Agonist Therapy (OAT) in a harm reduction approach to drug use tenders at Médecins Sans Frontières (MSF)

Background and context

For more than 40 years, Médecins du Monde, a campaigning medical organization committed to international solidarity, has been caring for the most vulnerable populations here and abroad. It has continued to bear witness to obstacles that exist in accessing healthcare and has secured sustainable improvements in health-for-all policies.

Those working for this independent organization do not solely dispense care and treatment but condemn violations of human dignity and rights and fight to improve matters for populations living in precarious situations.

MdM France currently works in 30 countries across all continents to facilitate access to healthcare through 6 political battles:

• Sexual and Reproductive Health Rights
• Migration, Exile, Human Rights and Health
• Harm Reduction
• Environment and Health
• Humanitarian Space
• Healthcare systems and rights

MdM has been present in Tanzania since 2010 and established the first comprehensive harm reduction project for people who use drogs (PWUD) in Dar es Salaam. In 2019, this project was transferred to the local NGO, Mukikute, as a successor to continue providing services while MdM remained as the technical assistance organization to continue providing technical support for local actors. MdM supported the government of Tanzania to scale up NSP (needle and syringe program) in other regions outside of Dar es Salaam.

Since 2022, MdM together with Burnet Institute, INPUD and University of Bristol engaged in CUTTS (Catalyze the Uptake of Underutilized tools for hepatitis C) research project to manage the study across 3 countries managed by MdM This research project has 3 main components ; model of care study to treat hepatitis C using Oraquick test, value and preferences for low dead space syringes among people who inject drugs, feasibility of long acting depot buprenorphine as the option for OAT.

In the meantime, since 2022, MdM supported Ministry of health and local actors in Burundi to develop OAT guideline and setting up of the very first OAT program in Bujumbura. Moreover, MdM joined the consortium with local actors (five CSO) from Rwanda in 2022 as to provide technical assistance to initiate the harm reduction services in Kigali which entails development of guidelines, training, mobilize and empower PWUD community.

Another technical assistance project to support Kigali Mental Health Referral Center (KMHRC), will be implemented in 2025. This technical assistance project requires to develop a series of guidelines, protocols, training materials, to organize consultation meetings/workshop with local stakeholders (MoH, KMHRC, CSO, PWUD community etc.) and also to organize training for relevant stakeholders to initiate OAT service in KMHRC which will be a center of excellence for substance use treatment, training and research in the long-term.

Scope of work and activities

The role of the consultant is to develop guidelines, protocols, standard operating procedures and training materials and also to deliver training mainly focused on OAT (Opioid agonist therapy).

The consultant will work closely with

• the team from KMHRC (Director, psychiatrists, nurses, social workers etc.), Rwanda Biomedical center (RBC), other mental health referral centers in Kigali, Rehabilitation centers, CSO and PWUD community representatives
• MdM team from head quarter (technical referents)
• MdM team in Tanzania to ensure smooth communication and coordination among all stakeholders.

The field harm reduction advisor under the directions of the harm reduction coordinator and general coordinator will be the main focal person for communication and coordination with KMHRC on behalf of MdM team in Tanzania.

Outputs / deliverables

• Meeting and consultation with KMHRC, RBC and other relevant stakeholders
• Review the existing methadone, drug treatment guidelines and other relevant guidelines from KMHRC, RBC and Rehabilitation centers
• Develop the OAT (opioid agonist therapy) guideline and associated training materials
• Deliver the training for the KMHRC team and other relevant health care workers as recommended by KMHRC
• Provide weekly online follow up supervision of the KMHRC team once the clients are enrolled
• Visit and assess the readiness of the KMHRC and other potential health centers for scale up in a later stage

Timeline

• March to October 2025, maximum 22 working days
• Working days will be defined and agreed upon selection of the candidate

Qualification and selection criteria

MdM is seeking a harm reduction expert with expertise in guideline development, program design and training.

The consultant /technical expert is expected to have the following qualifications, experience and competencies:

• Advanced academic degree (Master or PhD) in the field of medicine; substance use disorder / opioid dependency and treatment, HIV, HCV, TB and other communicable diseases common among people who use drugs
• Minimum of ten (10) years of professional experience in addiction medicine/ opioid dependency treatment, HIV, HCV, management of OAT centers and program implementation. Understanding of employment and social protection systems, including contributory and non-contributory approaches and economic inclusion initiatives and strategies
• Proven experience working on assignments related to social protection and employment
• Experience working in international contexts including in the Africa region is an asset
• Lived experience of the issues impacting the lives of people who use drugs would be an asset
• Familiarity and exposure to rights-based approaches to social protection
• Ability to work proactively while keeping ILO officials engaged and informed
• Excellent command written English

Remote work opportunities

How to apply

Individual consultants are invited to share the following documents by March the 2nd 2025., with email at: doi.applications@medecinsdumonde.net

• CV
• A cover letter outlining relevant for the assignment
• An example of previous work on a similar assignment (treatment guideline, training etc)
• Technical and financial proposal