Noma Operational Research Consultancy: Economic evaluation of early identification, prevention and treatment of noma

Organization: Médecins Sans Frontières Closing date: 5 Oct 2026 Background Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters, and exclusion from healthcare. Noma is a rapidly progressing infection of the oral cavity which can cause necrosis of the cheek, lip, nose and/or eye. Without treatment, noma has a reported high mortality rate within weeks of symptom onset. Treatment in the early, reversible stages of the disease with antibiotics, wound debridement and nutritional support can greatly reduce morbidity and mortality. Access to timely treatment requires early identification by healthcare workers. Nigeria has produced more reported cases of noma than any other country, with Sokoto State being a key area of concern. The specialised Noma Children’s Hospital in Sokoto has operated since 1999, with MSF collaborating with the Nigerian Ministry of Health since 2014 to support a comprehensive noma prevention and treatment programme. Effective intervention efforts for noma include surveillance, early detection of cases, prompt treatment and referral, and strengthening healthcare worker knowledge across different levels of the health system. Objectives MSF is seeking external technical support to develop an economic evaluation model to assess the cost-effectiveness of interventions that improve early identification, prevention, diagnosis and treatment of noma. The objectives are to: • Review and synthesise relevant MSF inputs, available literature and programme information required to define the economic evaluation scope, decision problem and model structure. • Develop and finalise, in collaboration with MSF noma experts and Nigerian expert collaborators, an appropriate model structure to simulate noma disease progression and the potential impact of interventions that improve diagnosis, treatment, referral and/or prevention. • Parameterise the model using available data, expert input and documented assumptions, clearly identifying data gaps and uncertainty. • Develop preliminary estimates of the cost-effectiveness of selected intervention scenarios compared with an appropriate comparator, such as no intervention, standard practice or current practice, to be agreed during inception. • Produce a user-friendly model, preferably as an open-source RShiny application or a standalone Excel model, enabling MSF users to explore outcomes, assumptions and parameters. • Prepare clear documentation, a short technical report and/or presentation summarising methods, assumptions, data sources, findings, limitations and interpretation. • Provide handover and training to relevant MSF staff to support future use, adaptation and updating of the model. Expected Results/Outcomes: By the end of the consultancy, MSF expects to have: • A clear and documented economic evaluation model for noma intervention scenarios. • An improved understanding of the potential cost-effectiveness of interventions that increase early identification, diagnosis, treatment, referral and/or prevention of noma progression. • Transparent documentation of model assumptions, data sources, uncertainties and limitations. • Identification of key areas of uncertainty which would benefit from future research • A practical tool that MSF can use and adapt as new data or parameters become available. • A concise set of outputs that can inform internal discussion, programme learning, advocacy and future research planning. Your team should demonstrate relevant expertise and experience, including: • Demonstrable experience in health economics, economic evaluation and decision-analytic modelling, ideally in global health, infectious diseases, neglected diseases, humanitarian health or low-resource settings. • Experience developing cost-effectiveness models, including Markov models or other relevant modelling approaches. • Strong skills in R, RShiny, Excel-based modelling and/or other suitable modelling tools. • Ability to translate technical modelling outputs into clear, accessible findings for programme and policy audiences. • Experience working with incomplete or uncertain data and documenting assumptions transparently. • Experience collaborating with multidisciplinary teams, including clinical, epidemiological, operational and research stakeholders. • Alignment with humanitarian principles and sensitivity to the operational realities of MSF contexts. In your application, we ask you to submit: Organisation Overview • Brief introduction to your organisation, institution or consultancy team, including relevant experience and areas of expertise. Understanding of the Assignment • Your interpretation of the project objectives, key challenges, opportunities and intended use of the model. Proposed Approach and Methodology • A description of how you would deliver the economic evaluation, including proposed model type, comparator, outcomes, assumptions and approach to uncertainty. Workplan and Timeline • A high-level project plan outlining key phases, activities, deliverables, milestones and indicative timelines. Scope and Deliverables • Your understanding of what is included within the scope of work. • Any activities or deliverables you consider to be out of scope. Assumptions, Risks and Dependencies • Key assumptions underpinning your proposal. • Any anticipated risks, constraints, dependencies, questions or areas of uncertainty that may affect delivery. Relevant Experience and Portfolio • Examples of at least 2–3 comparable projects delivered within the last five years, where available. Proposed Team • Details of the personnel who will be involved in the project, including their roles, responsibilities and short biographies highlighting relevant qualifications and experience. • Identification of the project lead and primary point of contact. Budget and Fee Proposal • Total project cost. • Breakdown of fees, as appropriate. • Any additional costs, expenses or optional services not included in the fee. For further questions, please contact: gregoire.falq@london.msf.org How to apply Please submit the following to admin.mu@london.msf.org by Monday 5th October 2026: • A proposal to include (max. 2 pages): • Relevant previous experience • Motivations to apply • Proposed approach and timeline (highlighting any periods of unavailability) • Examples of previous work: at least two examples of previous projects, including at least one writing sample of a strategy or similar document authored by the consultant • CV (max. two pages) • Total fee proposal (including any travel costs)