Mulanje House, City Center Tel: (265) 1770611 P.O. Box 30557 Fax: (265) 1771158 Lilongwe 3, Malawi 23-Apr-2024 Date: _______________________ Honourable Simplex Chithyola Banda, M.P. Minister of Finance and Economic Affairs Ministry of Finance and Economic Affairs P.O. Box 30049 Capital City Lilongwe 3 Republic of Malawi Dear Honourable Minister: Re: Republic of Malawi Grant No. D620-MW, Grant No. D887-MW Credit No. 7177-MW and Grant No. E0980-MW GFF Grant No. TF0B8719 (COVID-19 Emergency Response and Health Systems Preparedness Project) Amendment 3 to the Original Financing Agreement Amendment 2 to the First Additional Financing Agreement Amendment 1 to the Second Additional Financing Agreement Amendment 1 to the GFF Grant Agreement We refer to: (i) the Financing Agreement between the Republic of Malawi (the “Recipient”) and the International Development Association (the “Association”) dated April 17, 2020, as amended (the “Original Financing Agreement”); (ii) the Financing Agreement between the Recipient and the Association dated July 2, 2021, as amended (the “Additional Financing Agreement”); (iii) the Financing Agreement between the Recipient and the Association dated August 1, 2022, (the “Second Additional Financing Agreement”); and (iv) the Grant Agreement between the Recipient and the International Bank for Reconstruction and Development and International Development Association (the “Bank”), acting as administrator of the Global Financing Facility in Support of Every Woman Every Child Trust Fund (the “GFF Grant Agreement”) (collectively, the “Agreements”), for the abovementioned Project. Please note that the capitalized terms used in this amendment letter (“Amendment Letter”) and not defined herein have the meanings ascribed to them in the Agreements. Pursuant to your letter dated December 21, 2023, requesting the Association to amend certain provisions of the Agreements, we are pleased to inform you that the Association hereby agrees to amend the Agreements as set forth below: 1. The Project Development Objective in Schedule 1 to the Agreements is amended to read as follows: “The objectives of the Project are to prevent, detect and respond to the threat posed by COVID - 19 and strengthen national systems for public health preparedness and provide immediate and effective response to an eligible crisis or emergency.” -2- 2. Section III.B.2 of Schedule 2 to the Grant Agreement is hereby amended to read as follows: “The Closing Date is December 31, 2025.” 3. The activity description in Part 1.4(a) of Schedule 1 to the Agreements is amended to read as follow: “Maintaining essential health services in the context of COVID -19 response and recovery through: (i) improving human resource planning and management to improve the demand for and delivery of essential health services including adolescent sexual and reproductive health services at both the community and health facility level; (ii) procuring essential medicines and equipment and supplies to mitigate stockouts and ensure continued delivery of essential health services; (iii) strengthening of infection control at health facilities including reviewing and disseminating of the national policy on infection, prevention and control in the water and sanitation sectors; (iv) improving data availability to promote evidence-based decisions; (v) developing a health monitoring, evaluation and health information system strategy; and (vi) financing service level agreements (SLAs) between the MoH and Christian Hospitals Association of Malawi (CHAM) for the CHAM to continue providing primary health care to the population in hard-to-reach areas who would otherwise not be able to access routine and emergency health services.” 4. The tables in Section II.A of Schedule 2 to the Additional Financing Agreement and Section III.A of Schedule 2 to the Second Additional Financing Agreement are hereby amended as set forth in Annexes 1 and 2 of this Amendment Letter. Except as herein expressly amended, all other provisions of the Agreements shall remain in full force and effect. Please confirm your agreement on behalf of the Recipient, to the foregoing amendments and revisions by countersigning and dating this Amendment Letter. Sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION By: ________________________ Hugh Riddell Country Manager for Malawi Eastern and Southern Africa Region AGREED: REPUBLIC OF MALAWI By__________________________________ Authorized Representative Simplex Chithyola Banda Name _______________________________ Hon Title ________________________________ 30-Apr-2024 Date ________________________________ -3- Cleared with and bcc: E. Massiah, Practice Manager (HAEH1) Bcc: N. Belete, P. Arora, Y. Mwenewanda (AECE1); H. Riddell, E. Lozo, T. Mpando; T. Mwafongo (AEMMW); A. Arur (HAEDR); E. Massiah, J.B. Makumba, V. Rajan; C. Zamawe, E. Mziray, S. Rajora, Y. Atkins (HAEH1); T. Chimaliro (EAEG1); B. Dushime, O. Agyei, S. Kuwaza (WFACS); K. Lubinda, A. Msendema (EAERU); M. Chimpokosera-Mseu (SAEE2); D. Luhanga, C. Phillips (SAES2); N. Rukuba-Ngaiza (LEGAM); H. Chimbali (ECRAE); V. Ndikumwenayo, M. Ahmed (EDS14); Sharepoint (P173806). -4- Annex 1 Withdrawal Table for Additional Financing Agreement (Grant Number D887-MW) Amount of the Percentage of Expenditures “Category Financing Allocated to be Financed (expressed in SDR) (inclusive of Taxes) (1) Goods, works, non- consulting services, consulting services, Operating Costs and Training 5,805,029 100% for the Project (except for Parts 1.3 (a) to (d); 1.4 and 4 of the Project) (2) Goods, non-consulting services, consulting services 8,591,971 100% and Training for Part 1.3 (a) to (d) of the Project (3) Goods, non-consulting services, and consulting 2,900,000 services for Part 1.4 of the Project (4) Emergency Expenditures for 3,503,000 Part 4 of the Project TOTAL AMOUNT 20,800,000” -5- Annex 2 Withdrawal Table for Second Additional Financing Agreement (Credit No. 7177-MW and Grant No. E0980-MW) “Category Amount of the Amount of the Percentage of IDA Credit IDA Grant Expenditures to Allocated Allocated be Financed (expressed in (expressed in (inclusive of SDR) SDR) Taxes) (1) Goods, works, non- 0% until Category consulting services, (1) of the First consulting services, Additional Operating Costs and 18,900,000 8,370,000 Financing Training for the Project Agreement is fully (except for Parts 1.3 (a) disbursed, and to (d); 1.4 and 4 of the thereafter 100% Project) 0% until Category (2) Goods, non-consulting (2) of the First services, consulting Additional services and Training 0 4,340,000 Financing for Part 1.3 (a) to (d) of Agreement is fully the Project disbursed, and thereafter 100% (3) Goods, non-consulting 0 0 0% services, and consulting services for Part 1.4 of the Project (4) Emergency 0 5,590,000 100% Expenditures for Part 4 of the Project TOTAL AMOUNT 18,900,000 18,300,000”