Africa: Call for Experts - Regional Validation Committee (RVC) On the Elimination of Mother-to-Child Transmission (eMTCT) of HIV, Syphilis and Hepatitis B

African countries to work to eliminate mother-to-child of HIV, syphilis and Hepatitis B.
press release

The World Health Organization (WHO) is seeking experts to serve as members one of the Regional Validation Committee (RVC) on the Elimination of Mother-to-Child Transmission (eMTCT) of HIV, Syphilis and Hepatitis B. This "Call for experts" provides information about the advisory group in question, the expert profiles being sought, the process to express interest, and the process of selection.

Background

The global community has committed to the elimination of mother-to-child transmission (MTCT), of HIV, syphilis and hepatitis B virus (HBV) as a public health priority. The purpose of the elimination goal is to ensure the availability of quality reproductive and maternal and child health (MCH) services to reduce and control the transmission of HIV, syphilis and HBV between mothers and their offspring and to provide the best available treatment to the mother, such that new infections are reduced to a very low level and ceases to be a public health concern.

The World Health Organization (WHO) released the first edition of the guideline for global validation of elimination of mother-to-child (eMTCT) transmission HIV and syphilis in 2014. The guidance was further updated in 2017 to include revised validation criteria for eMTCT of HIV, an expanded description of the surveillance case definition of congenital syphilis, criteria for evaluation of human rights, gender equality and community engagement, etc. In 2021, the third edition of the guideline was released which includes validation of Hepatitis B virus (HBV) eMTCT, underlining the importance of elimination of eMTCT of three infections, HIV, Syphilis and HBV. The guidelines provide standardized processes and consensus-developed criteria to validate eMTCT of HIV, HBV and Syphilis, and emphasize country-led accountability, multilevel collaboration, including engagement of women living with HIV or HBV. Validation is a term used to attest that a country has successfully met the criteria for eMTCT of HIV and/or Syphilis and/or HBV.

Processes for validation of eMTCT or Path to Elimination (PTE)

The achievement of elimination of eMTCT or vertical transmission, of HIV, syphilis and HBV is a tremendous accomplishment, requiring health ministry-led accountability, rigorous data analysis, intensive programme assessment and multilevel collaboration at the national, regional, and global levels of a set of impact and process indicators and the fulfilment of the four foundational requirements for (i) data quality (ii) strong programmes (iii) laboratory quality and (iv) human rights, gender equality and community engagement.

Impact targets for validation

  • Mother to child transmission (MTCT) rate of HIV of <2% in non-breastfeeding populations or <5% in breastfeeding populations
  • New paediatric HIV infections due to MTCT of ≤50 cases per 100 000 live births
  • Congenital Syphilis rate of ≤50 per 100 000 live births
  • Hepatitis B surface antigen (HBsAg) prevalence of ≤0.1% in the ≤5-year-old birth cohort (and older children)
  • In countries that provide targeted timely HepB-BD (Birth Dose), an additional impact target of HBV MTCT rate of ≤2%

The process for validation requires validation structures at national, regional and global levels.

As per WHO governance guidance, at national level, a National Validation Secretariat (NVS), and National Validation Committee (NVC) should be established and engage with the Ministry of Health, WHO Country Office, women living with HIV and relevant United Nations partners such as UNAIDS, UNICEF and UNFPA. At the regional level, WHO regional office should host a Regional Validation Secretariat (RVS), which works in close partnership with UNAIDS, UNICEF and other relevant United Nations partners.

WHO will establish and convene the Regional Validation Committee (RVC) on the Elimination of Mother-to-Child Transmission (eMTCT) of HIV, Syphilis and Hepatitis B in the World Health Organization African Region (WHO AFRO) and shall provide the secretariat for the RVC, including necessary scientific, technical, administrative and other support. At the global level, the Global Validation Secretariat (GVS) and the Global Validation Advisory Committee (GVAC) are involved in the validation process. At all levels, committee members should have experience in one of the four foundational requirements for validation and should be able to act independently when reviewing and assessing whether a country has achieved or maintained the elimination targets. Committee members at all levels should serve as independent experts and not represent government or nongovernmental entities in their position.

Functions of the Regional Validation Committee (RVC) on the Elimination of Mother-to-Child Transmission (eMTCT) of HIV, Syphilis and Hepatitis B

In its capacity as an advisory body to WHO, the RVC shall have the following functions:

  1. To review national validation reports from the National Validation Committee (NVC) to determine and advise WHO on their compliance with the global criteria for validation of eMTCT through expert desk review and in-country mission or virtual validation assessment using the validation assessment tools;
  2. To liaise with the RVS to request and receive additional information and clarifications;
  3. To advise WHO on how countries could address gaps or barriers to global validation identified through the evaluation process;
  4. To prepare the regional validation report to inform WHO regarding compliance with global criteria for validation of eMTCT;
  5. To advise WHO as to whether candidate countries' achievements in eMTCT of HIV, HBV and Syphilis can be recommended for validation;
  6. To provide feedback to WHO on the validation assessment tools;
  7. To support WHO in the determination of detailed operational practices including evaluation approach and methods, organization of in-country missions or virtual validation assessments and communicating with the NVS, NVC and global partners.

Operations of the Regional Validation Committee (RVC) on the Elimination of Mother-to-Child Transmission (eMTCT) of HIV, Syphilis and Hepatitis B

  1. The RVC shall normally meet at least once each year. However, WHO may convene additional meetings. RVC meetings may be held in person (at WHO AFRO offices in Brazzaville or another location, as determined by WHO) or virtually, via video or teleconference.

RVC meetings may be held in open and/or closed session, as decided by the Chairperson in consultation with WHO.

  • Open sessions: Open sessions shall be convened for the sole purpose of the exchange of non-confidential information and views and may be attended by Observers (as defined in paragraph III.3 below).
  • Closed sessions: The sessions dealing with the formulation of recommendations and/or advice to WHO shall be restricted to the members of the RVC and essential WHO Secretariat staff.
  1. The quorum for RVC meetings shall be two thirds of the members.
  2. WHO may, at its sole discretion, invite external individuals from time to time to attend the open sessions of an advisory group, or parts thereof, as "observers". Observers may be invited either in their personal capacity, or as representatives from a governmental institution / intergovernmental organization, or from a non-State actor. WHO will request observers invited in their personal capacity to complete a confidentiality undertaking and a declaration of interests form prior to attending a session of the advisory group. Invitations to observers attending as representatives from non-State actors will be subject to WHO internal due diligence and risk assessment including conflict of interest considerations in accordance with the Framework for engagement with non-State actors (FENSA). Observers invited as representatives may also be requested to complete a confidentiality undertaking. Observers shall normally attend meetings of the RVC at their own expense and be responsible for making all arrangements in that regard.

At the invitation of the Chairperson, observers may be asked to present their personal views and/or the policies of their organization. Observers will not participate in the process of adopting recommendations of the RVC.

  1. The RVC may decide to establish smaller working groups (sub-groups of the RVC) to work on specific issues. Their deliberations shall take place via teleconference or video-conference. For these sub-groups, no quorum requirement will apply; the outcome of their deliberations will be submitted to the RVC for review at one of its meetings.
  2. RVC members are expected to attend meetings. If a member misses two consecutive meetings, WHO may end his/her appointment as a member of the RVC.
  3. Reports of each meeting and an yearly report shall be submitted by the RVC to WHO (the Regional Director ). All recommendations from the RVC are advisory to WHO, who retains full control over any subsequent decisions or actions regarding any proposals, policy issues or other matters considered by the RVC.
  4. The RVC shall normally make recommendations by consensus. If, in exceptional circumstances, a consensus on a particular issue cannot be reached, minority opinions will be reflected in the meeting report.
  5. Active participation is expected from all RVC members, including in working groups, teleconferences, and interaction over email. RVC members may, in advance of RVC meetings, be requested to review meeting materials and to provide their views for consideration by the RVC.
  6. WHO shall determine the modes of communication by the RVC, including between WHO and the RVC members, and the RVC members among themselves.
  7. RVC members shall not speak on behalf of, or represent, the RVC or WHO to any third party.

Who can express interest?

The Regional Validation Committee (RVC) on the Elimination of Mother-to-Child Transmission (eMTCT) of HIV, Syphilis and Hepatitis B will be multidisciplinary, with members who have a range of technical knowledge, skills and experience relevant to the underlisted areas. Approximately 15 members may be selected. WHO welcomes expressions of interest from candidates with expertise in the following areas:

  • Public health programme management: HIV, Sexually Transmitted Infections (STIs), and Hepatitis B;
  • Clinical: HIV, sexually transmitted infections, viral hepatitis, and immunization experts;
  • Health systems strengthening;
  • Strategic information;
  • Laboratory;
  • Maternal and child health;
  • Gender and human rights with a focus on people at higher risk;
  • Social and behavioural scientists;

Submitting your expression of interest

To register your interest in being considered for the [name of the advisory group], please submit the following documents by 28 May 2024, 24:00h (midnight) Brazzaville time to endingdiseaseinafrica [at] who.int using the subject line "Expression of interest for the Regional Validation Committee (RVC)":

  • A cover letter, indicating your motivation to apply and how you satisfy the selection criteria. Please note that, if selected, membership will be in a personal capacity. Therefore do not use the letterhead or other identification of your employer;
  • Your curriculum vitae (including your nationality/ies) and
  • A signed and completed Declaration of Interests (DOI) form for WHO Experts, available at https://www.who.int/about/ethics/declarations-of-interest.

After submission, your expression of interest will be reviewed by WHO. Due to an expected high volume of interest, only selected individuals will be informed.

Important information about the selection processes and conditions of appointment

Members of WHO advisory groups (AGs) must be free of any real, potential or apparent conflicts of interest. To this end, applicants are required to complete the WHO Declaration of Interests for WHO Experts, and the selection as a member of a AG is, amongst other things, dependent on WHO determining that there is no conflict of interest or that any identified conflicts could be appropriately managed (in addition to WHO's evaluation of an applicant's experience, expertise and motivation and other criteria).

All AG members will serve in their individual expert capacity and shall not represent any governments, any commercial industries or entities, any research, academic or civil society organizations, or any other bodies, entities, institutions or organizations. They are expected to fully comply with the Code of Conduct for WHO Experts (https://www.who.int/about/ethics/declarations-of-interest). AG members will be expected to sign and return a completed confidentiality undertaking prior to the beginning of the first meeting.

At any point during the selection process, telephone interviews may be scheduled between an applicant and the WHO Secretariat to enable WHO to ask questions relating to the applicant's experience and expertise and/or to assess whether the applicant meets the criteria for membership in the relevant AG.

The selection of members of the AGs will be made by WHO in its sole discretion, taking into account the following (non-exclusive) criteria: relevant technical expertise; experience in international and country policy work; communication skills; and ability to work constructively with people from different cultural backgrounds and orientations .The selection of AG members will also take account of the need for diverse perspectives from different regions, especially from low and middle-income countries, and for gender balance.

If selected by WHO, proposed members will be sent an invitation letter and a Memorandum of Agreement. Appointment as a member of a AG will be subject to the proposed member returning to WHO the countersigned copy of these two documents.

WHO reserves the right to accept or reject any expression of interest , to annul the open call process and reject all expressions of interest at any time without incurring any liability to the affected applicant or applicants and without any obligation to inform the affected applicant or applicants of the grounds for WHO's action. WHO may also decide, at any time, not to proceed with the establishment of the AG, disband an existing TAG or modify the work of the AG.

WHO shall not in any way be obliged to reveal, or discuss with any applicant, how an expression of interest was assessed, or to provide any other information relating to the evaluation/selection process or to state the reasons for not choosing a member.

WHO may publish the names and a short biography of the selected individuals on the WHO internet.

AG members will not be remunerated for their services in relation to the AG or otherwise. Travel and accommodation expenses of AG members to participate in AG meetings will be covered by WHO in accordance with its applicable policies, rules and procedures.

The appointment will be limited in time as indicated in the letter of appointment.

If you have any questions about this "Call for experts", please write to endingdiseaseinafrica [at] who.int well before the applicable deadline.

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