Senior Childhood TB and Drug-Resistant TB Advisor, DOS LEAP Global - Nigeria

ZemiTek•Bethesda, MD

About The Position

The Senior Childhood TB and Drug-Resistant TB Advisor will support in carrying out life-saving humanitarian assistance (LHA) in full alignment with the new Presidential Executive Order (EO) directives. Tuberculosis (TB) remains a leading cause of morbidity and mortality in children and a persistent public-health threat due to drug-resistant TB (DR-TB). The WHO Global TB Report 2024 highlights that children continue to be under-diagnosed and under-reported globally. In Nigeria, only 10% of all TB notifications in 2023 were children, underscoring gaps in case detection, access, and diagnostic capacity. Common barriers include difficulty obtaining sputum, limited imaging access, and weak integration of TB screening into child-health platforms. Innovations such as Portable Digital X-ray with Computer-Aided Detection (PDX-CAD), stool GeneXpert testing, and household contact investigations offer proven opportunities to improve detection but remain under-utilized. Similarly, DR-TB continues to threaten national and global health security. In 2022, Nigeria detected only 3,867 DR-TB cases (≈40% of the estimated burden). Delays in resistance testing, weak linkage to treatment, and limited decentralized management constrain progress despite the availability of rapid molecular tools and all-oral regimens. To address these gaps, the U.S. Department of State (DOS) seeks a short-term consultant to provide strategic technical support for improving childhood TB and DR-TB diagnosis, treatment, and reporting, aligned with the National TB Strategic Plan (2021–2025). Overall Objective of Assignment: To strengthen national and subnational capacity for early diagnosis, prompt treatment initiation, and effective management of Childhood TB and DR-TB, through enhanced identification of presumptive cases among children and those with DR-TB, diagnostic network performance, clinical mentorship, and program coordination.

Requirements

Master’s degree or local equivalent from an accredited program in Public Health, International Development, Health, Social or Behavioral Sciences, Epidemiology, Biology, Infectious Disease, Medicine, Pharmacy, Immunization or relevant qualification required
A minimum of ten (10) years of progressively responsible experience in the field of public health programming in developing or middle-income countries, with a focus on immunization.
Minimum of six (6) years of experience in infectious diseases control, particularly childhood TB and D-R TB.
Prior experience working with or for bilateral or multilateral donors/stakeholders such as the World Bank, the Global Fund, UN agencies, or national-level public sector projects and ensuring compliance with U.S. Government rules and regulations.
Demonstrated technical leadership, and problem-solving skills
Understanding of USG rules and regulations preferred.
Ability to work both independently and in a team environment to achieve consensus on policy, program and administrative matters.
Ability to work effectively with a broad range of Nigerian Government and US Government personnel and partners and have demonstrated skills in donor coordination and collaboration.
Ability to work effectively in a team environment and communicate information to both health and non-health audiences, and achieve consensus on policy, project, research, and administrative matters.
Proven ability to communicate clearly and concisely in English – both orally and in writing is essential.
Excellent verbal communication skills, tact and diplomacy are required to establish and develop sustainable working relationships at the highest level and a high level of trust with public/private organizations.
Demonstrated experience in teaching/training and capacity building.
Experience working with the key stakeholders in TB programs, preferably the national stakeholders and international donors.
Knowledge of Nigeria’s public health system, TB policies, and relevant legislation.
Ability to travel domestically as required and work effectively in team environments with diverse stakeholders.
Strong analytical and problem-solving skills.

Nice To Haves

Medical degree preferred but not required (e.g., MBChB, MBBS, MD, or equivalent).

Responsibilities

Situation Analysis and Planning Review national and subnational data on childhood TB and DR-TB performance indicators to identify existing case finding strategies and coverage, diagnostic and treatment bottlenecks.
Map existing diagnostic and treatment networks for pediatric and DR-TB services, including availability and utilization of GeneXpert, Truenat, LPA, culture/DST, and PDX-CAD platforms.
Conduct rapid assessments to identify capacity gaps among clinicians, nurses, and laboratory personnel on pediatric diagnosis and DR-TB management.
Develop a technical implementation plan with clear targets, mentoring priorities, and state focus areas.
Strengthening Childhood TB Detection and Management Provide technical guidance to integrate pediatric TB screening into child health entry points (IMCI clinics, pediatric wards, nutrition and immunization programs).
Provide technical guidance in identifying underservered communities/locations and designing targeted interventions to improve access to services Support rollout and mentorship on pediatric diagnostic algorithms, emphasizing the use of PDX-CAD, stool GeneXpert, and nasopharyngeal aspirate (NPA) collection.
Facilitate training and hands-on mentorship on pediatric specimen collection, sample referral, and interpretation of X-ray and GeneXpert results.
Support the prompt linkage of children diagnosed with TB to treatment and their notification to the National TB program.
Support development and dissemination of childhood TB job aids, SOPs, and clinical decision support tools.
Strengthen household contact investigation and integration of TPT for child contacts, ensuring linkage and follow-up through community platforms.
Enhancing DR-TB Diagnosis and Treatment Conduct a diagnostic cascade review to identify bottlenecks in GeneXpert, LPA, and DST coverage and turnaround times.
Support optimization of universal DST coverage for all individuals diagnosed/screened for TB Support the optimization of specimen referral systems for drug-resistance testing and results return.
Provide on-site mentorship on DR-TB regimen selection, decentralized treatment initiation, and adherence monitoring in line with national guidelines.
Strengthen systems for active drug-safety monitoring (aDSM) and improve use of electronic DR-TB registers (eDRTB, DHIS2) for treatment outcome monitoring.
Facilitate review meetings to harmonize DR-TB data, improve cohort reporting, and document lessons for program improvement.
Capacity Building and Coordination Build capacity of healthcare workers at state and facility levels through targeted workshops, supportive supervision, and mentorship on childhood and DR-TB management.
Strengthen coordination between NTBLCP, NASCP, and pediatric service providers to ensure integrated management of TB/HIV co-infected children.
Support national and subnational Childhood and DR-TB Technical Working Groups (TWGs) to track performance and implement quality improvement initiatives.
Contribute to the development of training modules and e-learning content for sustainable capacity building.
Monitoring, Reporting, and Knowledge Management Develop a monitoring dashboard for ongoing tracking of childhood TB and DR-TB performance across key indicators (screening, diagnosis, initiation, completion, aDSM).
Provide monthly technical briefs summarizing progress, innovations, and recommendations.
Document and disseminate at least two case studies or success stories showcasing improved childhood or DR-TB outcomes.
Produce a comprehensive end-of-assignment report summarizing interventions, outcomes, challenges, and sustainability recommendations.