Introduction

The Fleming Fund (FF) is a U.K. Department of Health and Social Care programme to help low and middle-income countries fight Antimicrobial Resistance (AMR). AMR poses a severe global threat, expected to cause 10 million deaths annually by 2050. With potential costs reaching $100 trillion, its impact on the global economy is significant. Fleming Fund Grants aim to tackle the AMR challenge in developing countries including Pakistan. The grants are funded by the UK Department of Health and Social Care and managed by Mott MacDonald for the country, regional and fellowship grants. Pakistan has received Fleming Fund support since 2019 in the form of two Country Grants, 9 Fellowships, and central and local procurement of equipment, reagents, and consumables. Between 2017 and the end of phase-1 of the program in March 2023, the program has provided financial support to grantees to establish and support local development of national AMR surveillance systems.

In partnership with the Fleming Fund, DAI's programme in Pakistan collaborates with the Pakistani government to strengthen systems using a “One Health” (OH) approach – a multisectoral approach to complex health problems that reaches across human health, animal health, and environment sectors. As global leaders in One Health, the DAI team helps incorporate One Health across programme interventions. DAI is helping Pakistan become a leader in combating antimicrobial resistance, and a model for better management of antimicrobials in human and animal populations. DAI and its consortium partners have successfully secured an additional round, Phase 2, of the Fleming Fund Country Grant in Pakistan which spans from January 2024 to December 2025. The Phase 2 of the FFCG programme focuses on achieving four intermediate outcomes: 1) Production of quality AMR/U/C and burden of disease data; 2) Conducting quality data analysis; 3) Sharing quality data analysis with decision-makers; and 4) Contributing to sustainable investments at both the country and global levels to counter AMR.

Position Summary:

The Surveillance Specialist’s role will be multifaceted, encompassing disease surveillance, data analysis, data synthesis, and action plan development. This will lead to the successful implementation of AMR surveillance activities using the One Health Approach.

Key Responsibilities:

1. Training and Capacity Building

• Training Manual Development: Lead the development of a comprehensive training manual focused on "Microbiology Laboratories Capacity Enhancement," aligned with ISO 15189 standards, BSL-2 requirements, and LSHTM LMIC core components, with an emphasis on laboratories' antibiogram development.
• Capacity Strengthening Packages: Develop and implement comprehensive capacity-strengthening packages for both Fleming Fund-supported and non-supported laboratories, aligned with the LSHTM roadmap for AMR surveillance in low and middle-income countries (LMICs).
• Training Assessments: Assess pre- and post-training assessments for surveillance-related training programmes conducted by microbiology experts, and generate reports to evaluate the impact and outcomes of the training activities.
• Update Surveillance Improvement Plans: Based on assessment results, update the surveillance improvement plans and share them with the One-Health Surveillance team for further action.
• Training Planning: Develop training agendas, manage participant engagement, and create group work exercises for trainings conducted under the One-Health Surveillance team followed by report writing for senior partners and donor firms.

2. Technical Inputs and Laboratory Quality Enhancement

• LIMS Understanding: Understand the ongoing Laboratory Information Management Systems (LIMS) used by FFCGP-supported laboratories to facilitate effective data flow and reporting.
• Antibiogram Development: Provide technical guidance in developing antibiograms using WHONET or any other tool used by laboratories to improve empirical therapy in hospitals.
• Support to NIH: Assist the National Institutes of Health (NIH) in collating and analysing data for the creation of national and provincial antibiograms.
• ISO Accreditation Support: Support the ISO team in achieving ISO 17043 and ISO 15189 accreditation for targeted laboratories.
• Core Components Data Analysis: Analyse LSHTM core components data submitted on the DHIS portal and assist provincial microbiology teams in improvement planning and providing supportive supervision.
• Laboratory Tools Development: Review laboratory performance indicators on a quarterly basis and assist senior microbiology experts in developing required tools such as SOPs, clinical protocols, and laboratory bench aids.
• GLASS Reporting Support: Assist provincial microbiology experts and NIH in the development and implementation of SOPs for processing GLASS pathogens, including interpretation, reporting, and analysis as per international standards, and assist the NIH team for GLASS reporting.

3. Whole Genome Sequencing (WGS)

• WGS Training and Material Development: Lead Whole Genome Sequencing (WGS) training initiatives on behalf of FFCGP with NIH
• Supply Tracking and Replenishment: Track the supplies required for Whole Genome Sequencing (WGS) activities, ensuring stock replenishment in a timely manner to avoid disruptions.
• Collaboration with LSTM: Maintain collaboration with the WGS team at LSTM (Liverpool School of Tropical Medicine) for ongoing efforts in WGS implementation in Pakistan.
• Coordination Role: Assist the SOHS Manager and SME in coordinating between FFCGP, LSTM, and NIH as the focal person for WGS activities.

4. Environmental Surveillance

• Data Review and Technical Assistance: Review environmental surveillance data and provide technical assistance to the Pakistan Council of Research in Water Resources (PCRWR) for data analysis, ensuring data accuracy and proper implementation of AMR detection protocols.
• Antibiogram Development for Environmental Samples: Develop antibiograms for environmental AMR surveillance to facilitate the assessment of antimicrobial resistance trends in environmental samples.
• Supply Tracking and Replenishment: Track the supplies required for environmental surveillance activities, ensuring stock replenishment in a timely manner to avoid disruptions.

5. Surveillance and Data Management

• • Monthly Data Analysis: Conduct monthly data analysis of AMR surveillance activities and generate comprehensive reports summarising findings to inform decision-making processes.
• National Biorepository Coordination: Coordinate and manage the establishment of a national biorepository, ensuring efficient use of Biorepository Inventory Management Software.
• AMR Bulletin Contribution: Conduct in-depth analysis of AMR surveillance data generated from Fleming Fund-supported sentinel sites for quarterly inclusion in the AMR Bulletin published by NIH, Pakistan.
• Support for Publications: Provide technical support to the One-Health Surveillance team in drafting publications for reputed scientific journals.
• Quarterly Reporting: Support NIH in preparing quarterly reports and incorporate stakeholder feedback as required.

6. Supplies and Inventory Management

• NEQAS Supplies Management: Ensure that supplies related to the National External Quality Assessment Scheme (NEQAS) are well-maintained and readily available for ongoing activities.
• NEQAS Progress Tracking: Track the progress of NEQAS at NIH and provide assistance in all aspects as the focal person for NEQAS, serving as the point of contact between FFCGP and the NIH NEQAS team.
• Surveillance-Related Supplies: Maintain a regular inventory of surveillance-related supplies and track their usage, ensuring there are no shortages that could disrupt key activities.
• Inventory Monitoring: Monitor and manage inventory levels to ensure that all laboratories and environmental surveillance projects have the necessary resources for uninterrupted operations and keep the operations updated regarding inventory listing
• Coordination: Act as liaison for operations team during quarterly/bi-annum visit of operations team for inventory management.

7. Site Visits and Technical Assistance

• Visits to FFCGP Sites: Regularly visit Fleming Fund Country Grant Programme (FFCGP) supported sites across Pakistan to provide technical assistance as needed or as requested by the supervisor.
• Visits to NIH: Regularly visit NIH to maintain an open communication channel and foster rigorous collaboration regarding NEQAS, WGS, and other tasks as requested by the supervisor.
• Visits to PCRWR: Visit PCRWR on regular basis and provide assistance as and when required.

8. Additional Responsibilities

• Additional Tasks: Perform additional tasks relevant to One-Health Surveillance and AMR, as assigned by the supervisor.

9. Travel Requirements

• Travel Expectations: The role requires 30-50% travel across Pakistan to monitor activities, support capacity-building efforts, provide technical assistance, and ensure compliance with surveillance objectives.

Requirements (Education, Experience, Skills, Languages etc.):
Education:
a) Mandatory:

• Bachelor’s Degree in Biological Sciences.
• Master’s Degree in Microbiology.
• Master of Public Health (MPH).

b) Preference:

• PhD in Microbiology or a similar discipline.

c) Experience:

• Minimum of 7+ years of experience; OR
• 5+ years of experience with a PhD in Microbiology or a similar discipline.

d) Preference: Candidates with past experience in international organisations or in senior-level positions.
e) Nature of Experience: Experience working at the national level, including coordinating with laboratories across Pakistan.
f) Technical Skills:

• Expertise in Infection Prevention and Control.
• Experience in the development of Standard Operating Procedures (SOPs).
• Familiarity with the Global Health Security Agenda (GHSA) and other relevant fields.

g) Communication and Collaboration:

• Proven track record of strong communication skills.
• Diversified work experience with different stakeholders across the country.
• Excellent interpersonal skills, especially in developing effective relationships with hospital administration and laboratory staff.

h) Management Skills:

• Capability to meet challenging deadlines.
• Ability to manage multiple tasks and work efficiently under pressure.

i) Languages (Mandatory):

• Excellent written and spoken proficiency in English and Urdu.

j) Preference:

• Fluency in any other local languages will be and asset