Technical Consultant (National Policy) - TBIHSS

FHI 360/Philippines is urgently looking for a Technical Consultant to provide a short-term work engagement for USAID-funded “TB Innovations and Health Systems Strengthening” project in the Philippines for the Development of National Policy on the Use of Chest X-ray and Artificial Intelligence for TB.

Overview

Based on the 2016 National TB Prevalence Survey (NTPS), CXR is a more sensitive screening tool for TB compared to symptoms alone (92% versus 32%, respectively). The World Health Organization (WHO), in its latest publication, recommended that in community-wide systematic TB screening, a sensitive tool such as CXR followed by an accurate diagnostic test may be used in settings where TB prevalence is even lower than 1%.

In addition, it was also recommended by the WHO and DOH-NTP that computer-aided detection (CAD) or artificial intelligence (AI) software may be used as an alternative to human reader for the initial interpretation of plain digital CXR for screening for the early identification of clients with possible TB for immediate sputum collection for rapid molecular TB testing for bacteriologic confirmation. This will further shorten the turn-around time from initial consult to diagnosis and will help in saving time and cost for consults, therefore, initial lost to follow up will also be lessened. AI has been utilized in mobile x-ray services during community and workplace active case finding (ACF), and recently is being introduced in the workflows of selected health facilities as part of intensified case screening (ICF) or screen-all approach among health consults in public hospitals. With the availability of these new tools and technology, an absence or scarcity of radiologists will not hamper initial screening for TB.

Background

In collaboration with the Stop TB Partnership and the United States Agency for International Development (USAID), the Philippines is one among six (6) countries under the iNTP (Introducing New Tools Project), to receive a package of new tools to address the issues and challenges across the TB continuum of care. In coordination with the NTP, these tools will be introduced in six (6) selected sites in the country under programmatic conditions. One of the new tools in the iNTP package is the use of ultraportable CXR with Computer Aided Diagnosis (CAD) or Artificial Intelligence (AI). A special permit will be provided by FDA use of ultra-portable CXR and AI under the iNTP.

Introduction of new tools and technology and improvement in TB notification requires reviewing and revisiting government policies and guidelines. There will be a need to develop new guidelines that will support issuance of new government policies regarding the use of ultraportable X-ray and CXR-computer aided detection or artificial intelligence software as a tool in TB screening. Two consultants will be hired to work together to develop clinical guidelines and national policy on the use of CXR with CAD.

Reporting to the Deputy Chief of Party and Private Sector Advisor, the Technical Consultant is expected to perform the following tasks:

Attend FHI’s administrative, finance and procurement orientation.
Review and gather documents pertaining to clinical practice guidelines on the use of CXR and AI for TB triage, screening, diagnosis, and monitoring tuberculosis (TB policies on registration and licensing locally and internationally)
Facilitate dialogues and consultations with DOH-Food and Drug Administration (FDA), Health Facilities and Services Regulatory Bureau (HFSRB), World Health Organization (WHO) and other relevant stakeholders (i.e., end-users, x-ray suppliers, radiologists, other TB technical partners) as part of information gathering for the development of guidelines and recommendations.
Development of guidelines that will support the issuance of policies that will include the following: (in collaboration with Consultant on Clinical Practice Guideline Development)

a. Licensing and registration of portable/ultraportable X-ray and CXR AI

b. FDA licensing for X-ray facilities to include submission of TB screening activities using CXR (as part of hospital facility report to be submitted (Form 3) that will contribute to screening targets of PhilSTEP1