The World Bank Belarus Emergency COVID-19 Response Project (P173828) REPORT NO.: RES49332 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF BELARUS EMERGENCY COVID-19 RESPONSE PROJECT APPROVED ON MAY 21, 2020 TO REPUBLIC OF BELARUS HEALTH, NUTRITION & POPULATION EUROPE AND CENTRAL ASIA Regional Vice President: Anna M. Bjerde Country Director: Arup Banerji Regional Director: Fadia M. Saadah Practice Manager/Manager: Tania Dmytraczenko Task Team Leader(s): Elvira Anadolu The World Bank Belarus Emergency COVID-19 Response Project (P173828) ABBREVIATIONS AND ACRONYMS BFP Bank-facilitated procurement COVID-19 Coronavirus disease ESCP Environmental and Social Commitment Plan ESMF Environmental and Social Management Framework ESS Environmental and Social Standards FM Financial management FY Fiscal year GRM Grievance Redress Mechanism IBRD International Bank for Reconstruction and Development IDA International Development Association MOH Ministry of Health MPA Multiphase Programmatic Approach PDO Project Development Objective PMU Project management unit POM Project Operations Manual SEP Stakeholder Engagement Plan UN United Nations UNDP United Nations Development Programme US$ US Dollar WB(G) World Bank (Group) The World Bank Belarus Emergency COVID-19 Response Project (P173828) BASIC DATA Product Information Project ID Financing Instrument P173828 Investment Project Financing Environmental and Social Risk Classification (ESRC) Substantial Approval Date Current Closing Date 21-May-2020 30-Jun-2022 Organizations Borrower Responsible Agency Republic of Belarus Ministry of Health of Belarus Multiphase Programmatic Approach (MPA) Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness Multiphase Programmatic Approach (MPA) Status (Public Disclosure) Status and Key Decisions (Public Disclosure) As of January 17, 2022, 87 MPA-projects had been approved with a total commitment of US$4.2 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Therefore, there are 86 MPA active operations. Fifty-eight (58) country projects or 67% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 58 projects, 35 operations or 60% have disbursed over 90% of commitments. The projects are benefitting around 3.7 billion people or 50% of the global population. Of the 86 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-five (85) or 99% of projects approved are disbursing. Total disbursements as of January 17, 2022, amounted to US$3.30 billion or 78% of overall commitments. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Six parent projects have been restructured to include vaccine-related procurement. Implementation is being guided by Bank teams The World Bank Belarus Emergency COVID-19 Response Project (P173828) working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Implementation continues to face challenges as several countries are still under different levels of lockdown or mobility restrictions, and counterparts and Bank teams are operating from home or partially from home. Also, countries are dealing with new waves of infections as the Omicron variant is spreading rapidly among populations. The variant which was first identified in South Africa and Botswana has been detected in more than 80 nations by mid-December. Many Bank teams continue to conduct implementation support missions virtually, which is challenging for both Bank teams and counterparts. This “virtual” world poses connectivity challenges as the internet is not reliable in many countries, especially IDA countries. Notwithstanding the challenges, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements attests to the strong implementation of the Bank' response thanks to the commitment of counterparts supported by Bank country teams. OPS_TABLE_PDO_CURRENTPDO Project Development Objective (PDO) Original PDO To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Belarus. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IBRD-91170 21-May-2020 01-Jun-2020 05-Aug-2020 30-Jun-2022 98.50 88.30 16.85 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. PROJECT STATUS 1. The Belarus Emergency COVID-19 Response Project was approved on May 21, 2020 and became effective on August 5, 2020 with a Project closing date of June 30, 2022. The Project Development Objective (PDO), which remains relevant, is “to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Belarus”. The Project has disbursed 83.5 pecent of the total loan. The World Bank Belarus Emergency COVID-19 Response Project (P173828) 2. Both Project Development Objective and Implementation Progress have consistently been rated Moderately Satisfactory. One out of the two PDO-level indicators (number of people tested for coronovirus identification) and three out of six intermediate results indicators (number of designated laboratories with staff trained to conduct COVID-19 diagnostics; number of public health messages developed and disseminated through media (internet, newspapers, TV, radio) public educational and health facilities; and hotlines for public feedback) have already been achieved and the remaining indicators are on track to be achieved. Hovewer, there is a risk that PDO “Number of fully equipped and functional ICUs to manage severe cases of COVID-19” may not be achived by the current closing date, as the delivery and installation of some equipment and related training may take place beyond that date in July-October 2022. 3. More than 200 hotlines were created across the country, to support provision of up to date and practical local information and solution finding. On average, hotlines receive from 8 to 100 calls per day (some up to 150 calls). Hotlines are dedicated to exchange of information on COVID-19 including for example: isolation, travels and quarantine; COVID-19 testing and labs distribution; vaccination process and organization. Hotlines also gave the opportunity to provide feedback on the project implementation or other related issues. Hotlines, gathering feedback and questions citizen have, serve PIU with the information on where to focus communication campaign and adapt it to the people's needs. 4. Procurement performance rating is Moderately Satisfactory, and Project procurement risk is Substantial. Implementation of the Project has experienced some delays due to internal bureaucratic procedures related to the preparation of bidding documents and their approval, time consuming discussions with UN Agencies and firms on the timely supply of the required goods and in sufficient quantities. Major risks for the timely procurement of goods are as follows: lack of available supply, cost increase, long lead time to delivery, underqualified manufacturers, disruptions in transportation. In addition, some types of medical equipment have not been previously delivered and used in Belarus and, therefore, require lengthy registration process according to country’s requirements. 5. Financial management (FM) rating is Satisfactory, and FM risk remains Moderate. FM and disbursement arrangements are in place and adequate and processes are well functioning. There are no overdue audits for this Project. 6. All legal covenants have been complied with. B. RATIONALE FOR RESTRUCTURING 7. The Ministry of Health (MoH) uses direct contracting, procurement via UN agencies, Bank-Facilitated Procurement (BFP), as well as Request for Quotations and Request for Bids selection methods to purchase medical equipment and supplies required for the diagnosis and treatment of COVID-19, envisaged under the Project. UNDP has been selected as the main supplier of the equipment under a US$56.4 million contract with a two-phase planned delivery: (a) first phase (US$14.5 million) in December 2021; (b) second phase (US$41.9 million) in May 2022. However, in October 2021, the MoH and the Bank team were informed by UNDP that the tender for the second phase resulted in having 5 (US$4.4 million) out of 21 items to be delivered by May 2022, 6 items (US$31.7 million) to be delivered over the period of June-October 2022, which would surpass the current closing date of June 30, 2022. The remaining items are not available based on the technical specifications requested by the MoH in the bidding document. The World Bank Belarus Emergency COVID-19 Response Project (P173828) 8. A meeting between representatives of MoH, UNDP, and the World Bank took place on November 10, 2021, to discuss options to speed up delivery and installation of the equipment ahead ot the current closing date. However, UNDP confirmed that even if some of the delivery takes place by June 2022, the installation of the equipment and related training would have to take place beyond that date. The main reasons for these delays pertain to global supply shortage and logistics, including global delays and disruptions with the production and distribution of medical equipment for emergency treatment of COVID-19. The delivery of 55 specialized vehicles currently being purchased may also be completed in July-October 2022. The MoH has requested the Bank to use the Bank- Facilitated Procurement mechanism to procure some of the items that cannot be delivered by UNDP. 9. A request from the MOH to extend the current Project closing date from June 30, 2022 to December 31, 2022 was received on December 28, 2021. 10. The proposed six-month extension of the closing date would allow for the completion of the procurement, delivery and installation of much needed equipment under all contracts (considering that all major suppliers have been selected and delivery times have been finally agreed) and fulfill the initially planned activities to achieve the PDO and support Belarus in fighting COVID-19 and strengthening health system resilience. This extension would also give an opportunity to implement additional communication, information and education activities on COVID-19. II. DESCRIPTION OF PROPOSED CHANGES 11. A six-month extension of the current Project closing date from June 30, 2022 to December 31, 2022. Disbursement estimates are adjusted to reflect the extension. Summary of E&S Performance 12. The compliance with Environmental and Social Framework (ESF) requirements is moderately unsatisfactory. The Environmental and Social Management Framework (ESMF) has been prepared and disclosed in-country, reviewed and agreed with beneficiary healthcare facilities. Subproject-specific Environmental and Social Management Plan (ESMP) checklists have been prepared and reviewed by the Project Management Unit (PMU). The Bank team has shared with the PMU the new guidance on the update of the Project ESMF to cover Life, Fire and Oxygen equipment safety procedures. It was agreed that the updated version would be disclosed and shared with beneficiary healthcare facilities and updated ESMP Checklists collected by the end of January 2022 (the draft revised document was received by the World Bank (WB) on January 14, 2022. Since the previous mission, the team has worked with the Borrower to achieve several outstanding commitments linked to Project effectiveness per the Project’s Environmental and Social Commitment Plan (ESCP). This has included updating the Project’s Stakeholder Engagement Plan (SEP) to align it with the Project’s communications program and ensure customized actions for different stakeholders. The revised SEP is expected to be redisclosed for stakeholder feedback and finalized by the end of January 2022. The team has reviewed the terms of reference for the missing social specialist role required to implement the Project’s SEP and Grievance Redress Mechanism (GRM). An expression of interest to be shared with potential candidates for the position is being prepared by the Borrower, with the specialist expected to be hired by the end of Febuary 2022. As part of the joint commitment to address the issues, the Bank team is providing enhanced implementation support to help the Borrower comply with these E&S requirements. Disclosure of the updated SEP and hiring of the Project social specialist to report on implementation progress of the SEP and associated GRM would constitute key milestones towards the necessary improvements. ES NOTE TABLE The World Bank Belarus Emergency COVID-19 Response Project (P173828) III. SUMMARY OF CHANGES Changed Not Changed Loan Closing Date(s) ✔ Disbursement Estimates ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ MPA Program Development Objective ✔ MPA Expected Results and Indicators ✔ Results Framework ✔ Components and Cost ✔ Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) The World Bank Belarus Emergency COVID-19 Response Project (P173828) MPA PROGRAM DEVELOPMENT OBJECTIVE Current MPA Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness EXPECTED MPA PROGRAM RESULTS Current Expected MPA Results and their Indicators for the MPA Program Progress towards the achievement of the PDO would be measured by outcome indicators. Individual country-specific projects (or phases) under the MPA Program will identify relevant indicators, including among others: • Country has activated their public health Emergency Operations Centre or a coordination mechanism for COVID-19; • Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents; • Number of acute healthcare facilities with isolation capacity; • Number of suspected cases of COVID-19 reported and investigated per approved protocol; • Number of diagnosed cases treated per approved protocol; • Personal and community non-pharmaceutical interventions adopted by the country (e.g., installation of handwashing facilities, provision of supplies and behavior change campaigns, continuity of water and sanitation service provision in public facilities and households, schools closures, telework and remote meetings, reduce/cancel mass gatherings); • Policies, regulations, guidelines, or other relevant government strategic documents incorporating a multi- sectoral health approach developed/or revised and adopted; • Multi-sectoral operational mechanism for coordinated response to outbreaks by human, animal and wildlife sectors in place; • Coordinated surveillance systems in place in the animal health and public health sectors for zoonotic diseases/pathogens identified as joint priorities; and • Mechanisms for responding to infectious and potential zoonotic diseases established and functional; and • Outbreak/pandemic emergency risk communication plan and activities developed and tested OPS_DETAILEDCHANGES_LOANCLOSING_TABLE The World Bank Belarus Emergency COVID-19 Response Project (P173828) LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline Ln/Cr/Tf Status Closing Closing(s) Closing for Withdrawal Applications IBRD-91170 Effective 30-Jun-2022 31-Dec-2022 30-Apr-2023 OPS_DETAILEDCHANGES_DISBURSEMENT_TABLE DISBURSEMENT ESTIMATES Change in Disbursement Estimates Yes Year Current Proposed 2020 0.00 0.00 2021 40,246,309.60 40,246,309.60 2022 59,793,690.40 46,503,690.40 2023 0.00 18,350,000.00 2024 0.00 0.00 2025 0.00 0.00 .