The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) LATIN AMERICA AND CARIBBEAN | Peru | IBRD/IDA | Investment Project Financing (IPF) | FY 2021 | Seq No: 6 | Archived on 07-May-2024 | ISR00166 Implementing Agencies: Instituto Nacional de Salud 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 24-Jun-2021) To strengthen epidemiological surveillance and public health emergency preparedness in Peru. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Surveillance strategies, governance and protocols:(Cost 830,000,000,000.00) Supporting infrastructure, equipment and software:(Cost 77,170,000,000,000.00) Strengthening human resources capacity:(Cost 5,120,000,000,000.00) Project management and monitoring:(Cost 2,850,000,000,000.00) Contingent Emergency Response Component:(Cost 0.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Unsatisfactory Overall Risk Rating Substantial Substantial May 08, 2024 Page 1 of 8 The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions The Peru Strengthening of the Public Health Emergency Preparedness and Response Project is financed by a US$68 million loan that was approved by the World Bank Board of Directors on June 24, 2021, signed on December 23, 2021, and declared effective on March 22, 2022. The Project received external debt budget authorization for 2023 from the Ministry of Finance and staffing of the Project’s Implementation Unit was finalized in March 2023. Implementation of project-financed activities were initiated thereafter and a first disbursement under the Project was made in June 2023. The project supports the INS Public Investment Program: 'Improvement and expansion of the services provided by the national public health surveillance system in 25 departments. As of April 2024, some progress has been made with respect to the preparations for the civil works to be financed by the Project. The locations of the Macroregional Centers (CMRs) have been chosen to be in Huánuco, Lambayeque, and Puno and the preparation of the technical files (expediente tecnico) will start in the coming months as well as for the National Center for Epidemiology, Prevention, and Disease Control - CDC at the headquarters of the National Institute of Health. For the Center for Biotechnology and Diagnostics, the technical files are currently being prepared. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 05 - 19 Oct Proposed Rating 24 Jun 2021 2023 Political and Governance Substantial Substantial Substantial Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Overall Substantial Substantial Substantial May 08, 2024 Page 2 of 8 The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Updated surveillance system and support the prevention, detection and response to the COVID-19 Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of regional public 0.00 Sep/2020 21 29-Feb-2024 21 29-Feb-2024 15.00 Jun/2024 health laboratories equipped and implementing PCR testing for COVID-19 and other pathogens (Number) Updated and adopted No Sep/2020 No 29-Feb-2024 No 29-Feb-2024 Yes Jun/2024 national epidemiological Comments on To precisely define the indicator, the list of guidelines to be updated still needs to be defined. surveillance guidelines, achieving targets The task team is working with the PIU on these definitions. Achieving the official adoption of including COVID-19 guidelines depends on actions that are beyond the PIU's direct influence and for which the guidelines, NCDs, NCDs’ risk task team will support the PIU. factors, environmental health, mental health, violence and gender-based violence. (Yes/No) No Sep/2020 No 29-Feb-2024 No 29-Feb-2024 Yes Jun/2024 Updated electronic reporting Comments on As this indicator is binary (YES/NO), intermediate progress cannot be demonstrated through surveillance system is achieving targets the current indicator value. However, the project is collaborating with the CDC and INS to interoperable and define interoperability parameters tailored to the indicator requirements. Additionally, a pilot interconnected (Yes/No) program is underway to integrate healthcare data with the diabetes surveillance system in Huánuco. Public health emergency preparedness and response Indicator Name Baseline Actual (Previous) Actual (Current) Closing Period May 08, 2024 Page 3 of 8 The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) Value Month/Year Value Date Value Date Value Month/Year Public health emergency No Sep/2020 Yes 29-Feb-2024 Yes 29-Feb-2024 Yes Jun/2024 response plans elaborated Comments on Since 2023, the project has developed three emergency plans for Guillain-Barré Syndrome, with the involvement of achieving targets the El Niño Phenomenon, and Dengue. However, it's imperative to establish a specific list of national and subnational topics and identify stakeholders for each type of public health emergency. authorities and updated every 12 months with the engagement of multiple stakeholders. (Yes/No) 6.2 Intermediate Results Indicators by Components Surveillance strategies, governance and protocols Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of sentinel sites 0.00 Sep/2020 0.00 29-Feb-2024 0.00 29-Feb-2024 10.00 Jun/2024 implemented and reporting Comments on The indicator's progress cannot be assessed without an ongoing public health emergency weekly findings (Number) achieving targets which would make the implementation of sentinel sites necessary. Potential public health 30.00 Sep/2020 0 29-Feb-2024 0 29-Feb-2024 80.00 Jun/2024 emergency of international Comments on The PIU is working on an accurate definition of the indicator. The original baseline/target concern (PHEIC) timely achieving targets values lack clarity/consistency. reported to the WHO as define in the International Sanitary Regulations. (Percentage) No Sep/2020 No 29-Feb-2024 No 29-Feb-2024 Yes Jun/2024 Report on stockpiles and Comments on The exact definition of the indicator which would allow its measurement is being developed supply chain for outbreak achieving targets with the PIU. May 08, 2024 Page 4 of 8 The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) control and public health emergencies (Yes/No) Share of health facilities that 0.00 Sep/2020 15 29-Feb-2024 15 29-Feb-2024 60.00 Jun/2024 report GBV events through Comments on The reported value is approximate, as the denominator (representing the universe of the updated surveillance achieving targets healthcare facilities considered) needs to be defined with precision. system (Percentage) Surveillance systems No Nov/2020 No 29-Feb-2024 No 29-Feb-2024 Yes Jun/2024 established for climate- Comments on The task team is working with the PIU team to provide a definition of the specific vector-borne dependent vector-borne achieving targets diseases to be considered under the indicator. diseases (Yes/No) Meetings/workshops 0.00 Nov/2020 0.00 29-Feb-2024 0.00 29-Feb-2024 8.00 Jun/2024 performed with the involvement citizen organizations for the update of protocols and guidelines (Number) Supporting infrastructure, equipment and software Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Functional rapid response 0.00 Sep/2020 0.00 29-Feb-2024 0.00 29-Feb-2024 8.00 Jun/2024 teams established (Number) Percentage of potential 30.00 Sep/2020 30.00 29-Feb-2024 30.00 29-Feb-2024 80.00 Jun/2024 public health outbreaks Comments on The PIU is working on an accurate definition of the indicator. The original baseline/target studied as per national achieving targets values lack clarity/consistency. protocols and timely reported at national level (Percentage) May 08, 2024 Page 5 of 8 The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) Number of Macro-Regional 0.00 Sep/2020 0.00 29-Feb-2024 0.00 29-Feb-2024 3.00 Jun/2024 Centers operational (Number) Strengthening human resources capacity Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Volume and value of 10.00 Sep/2020 10.00 29-Feb-2024 10.00 29-Feb-2024 80.00 Jun/2024 scientific epidemiological Comments on This indicator belongs to a Government Program component which was included originally in research annually produced achieving targets the WB Project design, but which eventually was not implemented anymore. The indicator in the country (Number) should be deleted through a Project restructuring. 0.00 Sep/2020 669 29-Feb-2024 669 29-Feb-2024 1,200.00 Jun/2024 Professional trained in Comments on Health worked trained in Epidemiology (include short, medium and long-term training) Epidemiology (Number) achieving targets Public health officials and 0.00 Sep/2020 0.00 29-Feb-2024 0.00 29-Feb-2024 600.00 Jun/2024 selected health care workers Comments on The evaluation tasks for this indicator have yet to commence. This indicator assumes that all trained on the updated achieving targets surveillance tools are updated, which has not occurred yet. surveillance guidelines and tools, and outbreak control measures (Number) May 08, 2024 Page 6 of 8 The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IBRD-92740 Effective 68.00 68.00 0.00 4.05 63.95 5.96% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IBRD-92740 Effective 24-Jun-2021 23-Dec-2021 22-Mar-2022 30-Jun-2026 30-Jun-2026 8. KEY DATES May 08, 2024 Page 7 of 8 The World Bank Implementation Status & Results Report Peru: Strengthening of the Public Health Emergency Preparedness and Response (P174177) Key Events Planned Actual Approval 24-Jun-2021 24-Jun-2021 Effectiveness 22-Mar-2022 22-Mar-2022 Mid-Term Review No. 01 17-Jul-2024 Operation Closing/Cancellation 30-Jun-2026 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) There are no associated operations May 08, 2024 Page 8 of 8