The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) REPORT NO.: RES59872 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF REGIONAL DISEASE SURVEILLANCE SYSTEMS ENHANCEMENT PROJECT (REDISSE) PHASE IV APPROVED ON OCTOBER 1, 2019 TO CENTRAL AFRICAN REPUBLIC,DEMOCRATIC REPUBLIC OF CONGO,ECCAS COMMISSION,REPUBLIC OF ANGOLA,REPUBLIC OF CHAD,REPUBLIC OF CONGO HEALTH, NUTRITION & POPULATION WESTERN AND CENTRAL AFRICA Regional Vice President: Ousmane Diagana Country Director: Boutheina Guermazi Regional Director: Trina S. Haque Acting Practice Manager: Carolyn Shelton Task Team Leaders: Andre L. Carletto, Djibrilla Karamoko, Joao Pires, Kofi Amponsah, Meta Mobula, Innocent Nukuri The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) ABBREVIATIONS AND ACRONYMS AFENET African Field Epidemiology Network ECCAS Economic Community of Central African States CAR Central African Republic COVID-19 Coronavirus Disease, 2019 DRC Democratic Republic of Congo E&S Environment and Social FETP Field Epidemiology Training Program IBRD International Bank for Reconstruction and Development IDA International Development Agency IHR International Health Regulations JEE Joint External Evaluation MTR Mid-Term Review PDO Project Development Objective PIU Project Implementation Unit REDISSE Regional Disease Surveillance Systems Enhancement Program ROC Republic of Congo RSC Regional Steering Committee WHO World Health Organization The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) BASIC DATA Product Information Project ID Financing Instrument P167817 Investment Project Financing Environmental and Social Risk Classification (ESRC) Moderate Approval Date Current Closing Date 01-Oct-2019 31-May-2025 Organizations Borrower Responsible Agency Central African Republic,Democratic Republic of Congo,ECCAS COMMISSION,Republic of Angola,Republic of Chad,Republic of Congo Project Development Objective (PDO) Original PDO The project development objectives are: (i) to strengthen national and regional cross-sectoral capacity for collaborative disease surveillance and epidemic preparedness in the Participating Countries; and (ii) in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IBRD-90040 01-Oct-2019 15-Jan-2020 23-Jun-2020 31-Jul-2024 60.00 46.40 13.60 IDA-64980 01-Oct-2019 18-Oct-2019 01-Sep-2020 31-May-2025 75.00 50.75 24.25 IDA-64990 01-Oct-2019 19-Oct-2019 01-Sep-2020 31-Jul-2024 15.00 11.97 2.83 IDA-D5080 01-Oct-2019 19-Oct-2019 27-Aug-2020 31-Jul-2024 15.00 6.16 8.41 IDA-D5160 01-Oct-2019 18-Oct-2019 01-Sep-2020 31-May-2025 75.00 49.25 24.04 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) IDA-D5170 01-Oct-2019 08-Nov-2019 13-Mar-2020 31-Jul-2024 30.00 26.97 2.32 IDA-D5220 01-Oct-2019 11-Nov-2019 17-Mar-2020 31-Jul-2024 10.00 6.34 3.48 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING 1. This Restructuring Paper seeks Management approval for a Level 2 restructuring with the following proposed changes: (a) extension of the Closing Dates for Angola, Central African Republic, and ECCAS; and (b) changes in the Project’s results framework as detailed in Section II. A. PROJECT STATUS 2. The Regional Disease Surveillance Systems Enhancement Program – Phase 4 (REDISSE IV) was approved by the Executive Directors on October 1, 2019, for US$280 million equivalent to support the regional disease surveillance and response systems in Central Africa. The Project provides an IDA grant to the Economic Community of Central African States (ECCAS) to coordinate regional activities in the amount of US$10 million, and financing to the countries of Angola (US$60 million IBRD loan); Democratic Republic of Congo (DRC, US$75 million IDA grant and US$75 million IDA credit); Republic of Congo (ROC, US$15 million IDA credit); Central African Republic (CAR, US$15 million IDA grant); and Chad (US$30 million IDA grant). 3. Effectiveness was declared in all REDISSE IV countries and ECCAS by September 2020. Both progress toward the project development objective (PDO) and implementation progress are rated Moderately Satisfactory (MS) in the last Implementation Status and Results Report, dated February 2024 and based on the mid-term review (MTR) missions in April 2023. The PDO continues to be relevant and achievable. During the MTR, a slow start to the implementation of the project was noted due to the occurrence of the COVID-19 pandemic, natural disasters (volcanic eruption in the DRC), epidemic outbreaks (including several outbreaks of Ebola Virus Disease in the DRC) and the insecurity caused by the armed conflict in the DRC and CAR. Although the project had been under implementation for more than three years, most activities were completed in a year and a half or less due to COVID-19 restrictions. The MTR found that the project is on course to achieving its PDO. Since the execution of the action plan to boost project implementation (put in place in October 2023, the Project has increased activities during the last six months, improving performance (all countries have advanced in three out of six PDO indicators) and increasing disbursement rates). 4. To date, 70.73 percent of all Project funds have been disbursed: 77.3 percent for Angola, 41.06 percent for CAR, 89.9 percent for Chad, 65.66 percent for DRC, 75.6 percent for ROC, and 63.4 percent for ECCAS with a significant acceleration of disbursement during the past 12 months for all countries. 5. Financial Management was rated Moderately Unsatisfactory on January 22, 2024, due to issues related to ineligible expenditures, delayed audits, unsatisfactory quality of external audit report, unjustified advances, and low budget execution rate. An action plan has been put forward to address these shortcomings, currently some results include: (i) partial The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) reimbursement of funds done and completion of the full reimbursement agreed with the client expected by July 2024; (ii) audits have been properly conducted, and compliance with legal covenants for external auditors to be hired and complete the delayed audits is fixed. 6. Procurement has been rated Moderately Satisfactory since June 29, 2023, until now because of noncompliance with procurement prior review for some activities in some countries. There are also weaknesses in the follow up of contracts implementation, which has prompted the World Bank to put forward a mechanism to monitor contract implementation. 7. The environment and social (E&S) risk ratings remain moderate. All countries have developed the required environmental and social risk management instruments, which are being implemented and used, and they have been cleared and disclosed by the World Bank and the countries. GRM mechanisms are fully operational in all five countries. None of the ESF instruments need to be updated. 8. Progress towards PDO indicators: Compared to baseline, out of the six PDO indicators, Angola has shown improvement with 4 PDO indicators, CAR with 3 PDO indicators, DRC with 4 indicators, Chad with 4 PDO indicators and ROC with 4 PDO indictors using initial JEE criteria. The challenge to differentiate attribution vs. contribution with JEE results continues as countries do not conduct a thorough resource mapping for health security and some investments may have been offset from COVID-19 response interventions. However, the World Bank continues to be the major financier of health security interventions in these countries (including outbreak response), and REDISSE the main vehicle. 9. Monitoring and Evaluation (M&E): The Project Results Framework (RF) was prepared using results from the International Health Regulation Self-Assessment Annual Reports, which corresponds to the Joint External Evaluation (JEE) 1.0- 2.0. Countries carried out their first JEE 3.0 in 2023. The 2023 JEE 3.0 results, which have yet to be officially validated by the governments in each country, have different indicators compared to the JEE 1.0-2.0 which was used as the basis of the original RF. The new tool, developed by WHO, is expected to improve quality of assessment of preparedness capacities of Member States for timely detection, prevention, and effective response to public health emergencies. Ministry of Health teams have now adapted this tool and methodology, which will be used to evaluate IHR capacities. 10. A revision of the RF is therefore being proposed to ensure alignment with the new definition of certain JEE 3.0 indicators (see Table 1). Angola 11. The Project Implementation Unit (PIU) team has been fully staffed. A non-governmental organization was hired to ensure the SEA/SH Operational Plan was hired. The World Bank received a formal request for the extension of the closing date of the Angola REDISSE IV Project. The extension of the closing date was discussed during the implementation support mission which took place in Angola in October 2023. 12. Overall, the Project implementation is progressing well in all four components, with the following key activities that are directly tied to the JEE/Project indicators being undertaken: training of 79 health technicians in collecting, packaging and transporting infectious samples at national level as well 28 laboratory technicians in ISO 9001 and 17025 standards to improve laboratory services quality; financing for the procurement of triple packaging, the transport of samples from provincial to national level, as well as the procurement of reagents and equipment for the reference laboratories; hiring of 16 epidemiologists that are part of the epidemiological provincial antennas, significantly improving early detection of public health threats at the community; the recent definition and approval of the list of priority diseases (for human and animal health) as required by the International Health Regulations (IHR 2005); financing an in-depth review of the national health human resource management strategy for public health; signed a MoU with the Faculty of Medicine to finance the expansion of the Field Epidemiology Training Program to ensure increased pool of trained epidemiologists in country; as well as multiple training in DHIS2, M&E and waste The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) management. 13. In June 2023, a comprehensive evaluation of the results framework of the PAD, was carried out by the Ministry of Health with support from World Health Organization (WHO) Angola, which showed positive progress in the six PDO indicators (one already met) and on the intermediate indicators (two already met), putting the project on track to achieve the PDO. CAR The PIU has been recently fully staffed. A project restructuring request was officially sent to the World Bank to extend the closing date until May 31, 2025. The rehabilitation of the national laboratory and the procurement of two GeneXpert equipment has been completed. Training of field epidemiologists is underway with African Field Epidemiology Network (AFENET) and the ongoing lab assessment is expected to be completed beginning of next year. 14. The project supported training of Integrated Disease Surveillance and Response (IDSR3) and in Integrated Animal Disease Surveillance and Response countrywide and the project is piloting the electronic community-based surveillance system in 6 health districts. The project also supported the human resources in recruiting 7 epidemiologists, 4 entomologists, 2 lab technicians and 2 data managers to strengthen the country national surveillance capacity. The extension will allow for CAR to make further progress on PDO indicators, specifically with regards to PDO indicator 3, 4 and 5. ECCAS 15. Staff recruitment has been completed, while positions such as Laboratory and M&E will not be filled, as their functions will be absorbed by current technical staff or outsourced with project implementation partners based on the activities of the Annual Work Program and Budget. 16. A financial management review was carried out by the World Bank in August 2023, and noted, among other weaknesses: (i) undocumented expenditures for which the supporting documents produced were not deemed acceptable; and (ii) delay in submission fund withdrawal requests. 17. Progress has been made towards achieving PDO and IRI indicators. ECCAS has contributed to the creation of the regional One Health platform “One Health” (USS), and finalized contracts with technical partners, including the World Health Organization (WHO), the Fondation Mérieux, the World Organization for Animal Health and the AFENET, as well as the development of several regional strategic plans. The extension will allow for ECCAS to leverage existing MOUs to strengthen specific technical areas, that will contribute to PDO and IRI indicators at the country-level. CHAD 18. Though Chad has shown progress with PDO indicators, it is unlikely to achieve the PDO given additional factors such as the use of project funds for the humanitarian response. Significant progress has been made on familiarizing government counterparts at different levels with the IHR, with a total of 230 people trained. The Public Health Emergency Operation Center has been equipped with support from the Project. Rapid Response Teams have been trained in all 23 provinces. The Project was able to rehabilitate four laboratories, including two each for animal health and human health respectively. The One Health platform is currently operational. REDISSE IV-Chad will not be extended beyond July 31, 2024. DRC 19. Significant progress has been made in achieving PDO indicators, including progress made regarding detection of outbreaks with the rehabilitation of a BioSafety Level-2 (BSL-2) Provincial laboratory in the province of Ituri as well as five health zone -level laboratories in the province of Kwilu. Construction of four BSL-2 laboratories has begun in targeted provinces. The The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) project continues to support training of IDSR3 and in Integrated Animal Disease Surveillance and Response at the central, provincial, health zone and community levels. Training on community-based surveillance in all sectors took place in 7 provinces. The International Organization for Migration supported the training of trainers in Early Warning, Alert and Response System at the central level, as well as the development of legal texts and the deployment of equipment to strengthen surveillance at Points of Entry. The Project supported the development of a multi-risk health emergency preparedness and response plan. The Project has contributed to improving preparedness for Ebola virus disease outbreaks in the Province of Equateur and strengthened One Health coordination through the creation of the One Health Multisectoral Provincial Committee in the province of Équateur. The Project also supported a training on emergency management in collaboration with the Centers for Disease Control. A restructuring to extend the closing date of the Project to May 31, 2025, was processed and approved in November 2023. ROC 20. Though ROC has made progress with PDO indicators, it is unlikely it will achieve the PDO by closing of the project. The rehabilitation of the national public health laboratory is in progress in Pointe Noire. The process of setting up the One Health platform and the National Focal Point for the IHR (2005) is underway. The Project has helped to strengthen the health system through the training of 15 public health managers, including four in field epidemiology (FETP), five in community health, and six in health and the environment. The training of field epidemiologists will be complemented before the end of the Project. The final results of the cohort of 15 students at the University of Kinshasa School of Public Health are as follows: FETP (4/4); environmental health (3/6); community health (5/5). REDISSE IV-ROC will not be extended beyond July 31, 2024. B. RATIONALE FOR RESTRUCTURING (i) Extension of the Closing Date 21. In November 2023, the closing date of the financing agreement for the DRC credit and grant was extended from July 31, 2024, to May 31, 2025, to allow sufficient time for laboratory-related civil works to be completed. During the last supervision missions (October/November 2023) for Angola, CAR and ECCAS, it became apparent that each would need additional time to successfully conclude project activities (laboratory and epidemiology training, among others) in order to achieve the PDO. Furthermore, during the MTR, the Regional Steering Committee (RSC) requested an extension of the closing dates based on needs and performance. The closing dates for Chad and ROC will not be extended given the expected completion of activities and disbursement of funds provided by the PIUs during the November 2023 mission. 22. Angola. The Ministry of Finance requested, in a letter received by the World Bank on November 10, 2023 (Ref. No. 4432/09/01/GMF-MINFIN/2023) the extension of closing date of the Loan Agreement No. 90040-AO to allow the implementation of the remaining activities and fully disbursement of project funds. 23. CAR. Given the delay of the effectiveness of the Project and based on the current disbursement rate of 42 percent and the level of achievement of the project’s objectives, the Minister of State for the Economy, Planning and International Cooperation requested in a letter received by the World Bank on December 11, 2023 (Ref. No. 2096/2023/MEPC/DIRCAB/DGEPD) the extension of closing date for 10 months to ensure the finalization of all activities undertaken to achieve the PDOs. 24. ECCAS. Because the closing date is being extended from July 2024 to May 31, 2025, for CAR and Angola, the closing date will also be extended to May 31, 2025, for ECCAS, given its role in coordinating activities among the participating countries and completion of regional activities with existing MOUs (WHO and Fondation Mérieux). This extension was requested at the Project Steering Committee meeting carried out in Kinshasa in April 2023, after the Mid-Term Review, and a letter (Ref. No 064/CEEAC/COM/24) was received by the Bank on March 25, 2024, formalizing this request. The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) (ii) Restructuring of Results Framework 25. The results framework will be revised to reflect changes made to indicators under the new JEE Version 3.0. The new methodology, evaluation, and rating criteria under the JEE 3.0 are more ambitious than JEE 1.0 and 2.0. JEE 3.0 defines indicators differently, and as a result, additional steps for some indicators are required, as well as additional requirements for all indicators, such as the requirement of having a validated manual for all indicators to achieve a Level 2 (which was not required previously) and ensuring sustainable financing for all activities in order to achieve a Level 4. In order to adjust the levels that had been defined in the original RF, proposed changes include: (a) adjusting indicators to correspond to JEE 3.0, when required; (b) adjusting measurements by breaking down of national scores to report on district/province level where the project is operational; (c) keeping specific IRI indicators that are no longer in the JEE 3.0 as Project indicators; and (d) changing the JEE 3.0 target scores to 3 which is more consistent with a score of 4 for JEE 1.0-2.0. A discussion on the proposed revised Results Framework was held at the Regional Steering Committee meeting in Luanda, Angola, on April 12, 2024, and countries agreed on the proposed changes. Table 1: Proposed changes to the PDO indicators. Explanation for Proposed Changes Target number to Indicator Definition of countries Original REDISSE PDO Corresponding Indicators PDO Indicators (JEE 1.0-2.0) Based on JEE 3.0 Laboratory testing capacity for Laboratory testing NO CHANGE NEEDED as indicator 4 PDO 1 detection of priority diseases D.1.3 for detection definition has not changed. (national capacity scores) of priority diseases Maintain national capacity scores Progress in establishing RECOMMEND CHANGE TO JEE 3.0 4 indicator and event-based Event verification definition, now defined as: Event PDO 2 D.2.2 surveillance systems (national and investigation verification and investigation. capacity scores) Maintain national capacity scores Availability of human resources NO CHANGE NEEDED as indicator 4 Human resources to implement IHR core capacity definition has not changed. PDO 3 D.3.2 for implementation requirements (national capacity Maintain national capacity scores of IHR scores) Multi-hazard national public CHANGE TO JEE 3.0 definition, now 4 health emergency preparedness Emergency risk defined as: Emergency risk PDO 4 and response plan is developed R.1.1 assessment and assessment and readiness. and implemented (national readiness Maintain national capacity scores capacity scores) CHANGE TO JEE 3.0 definition, now 4 Progress on cross-border Core capacity defined as: Core capacity PDO 5 collaboration and exchange of PoE 1 requirements at all requirements at all times for PoEs. information across countries times for PoEs Maintain national capacity scores Coordinated Surveillance CHANGE TO the JEE 3.0 definition: 4 Systems in place in animal and Surveillance of zoonotic diseases. Surveillance of PDO 6 human health sectors for P.5.1 Maintain national capacity scores zoonotic diseases zoonotic diseases/pathogens identified as joint priorities Table 2: Proposed changes to the IRI Indicators The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) Corresponding Indicators Explanation for Proposed Target number Original REDISSE IRI Indicators IRI Based on Changes to Indicator Definition of countries (JEE 1.0-2.0) JEE 3.0 CHANGE TO JEE 3.0 definition: 4 Use of electronic tools: Analysis and information IRI Interoperable, interconnected, Analysis and D.2.3 sharing. 1 electronic real-time reporting information sharing Maintain national capacity system scores No change needed, as the 4 definition of the indicator has IRI Laboratory quality Laboratory systems quality D.1.2 not changed. 2 system Maintain national capacity scores No change needed, as the 4 definition of the indicator has IRI Specimen referral and transport Specimen referral D.1.1 not changed. 3 system and transport system Maintain national capacity scores IRI Systems for efficient reporting to Fonctions du Point to be deleted 0 P.3.1 4 WHO, OIE/FAO Focal National RSI NO CHANGE needed, as the 4 Progress towards establishing an Multisectoral definition of the indicator has IRI active, functional regional One P 3.2 coordination not changed. 5 Health platform mechanisms Maintain national capacity scores 4 Mechanisms for responding to CHANGE TO indicator from JEE IRI infectious zoonoses and potential Response to zoonotic 3.0 definition: Response to P.5.2 6 zoonoses are established and diseases zoonotic diseases. functional Maintain national capacity scores NO CHANGE TO original 4 Emergency logistic indicator (will keep as Project IRI Regional surge capacity and R.1.5 and supply chain indicator). 7 stockpiling mechanisms established management Maintain national capacity scores System in place for activating and CHANGE TO JEE 3.0 definition: 4 coordinating regional medical Emergency logistic Emergency logistic and supply IRI countermeasures and health R.1.5 and supply chain chain management. 8 personnel during a public health management Maintain national capacity emergency. scores No change needed, as the 4 Workforce Strategy: An updated definition of the indicator has IRI Multisectoral multisectoral staff strategy is in D.3.1 not changed. 9 workforce strategy place Maintain national capacity scores No change needed, as the 4 project has worked on establishment of a FETP training IRI FETP or Applied epidemiology D.3.3 Workforce training program since the project 10 training program in place inception. A change would not consider the efforts from each country. The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) Maintain national capacity scores to be deleted Percentage of people trained in IRI applied epidemiology who are 11 female Percentage of people trained in to be deleted IRI basic/short-term (3 months) applied 11 epidemiology who are female Percentage of people trained in to be deleted IRI advance (2 years) applied 13 epidemiology who are female Percentage of people trained in to be deleted IRI intermediate (9 months) applied 14 epidemiology in the country who are females Citizens and/or communities no change IRI involved in 15 planning/implementation/evaluation of development programs (Yes/No) II. DESCRIPTION OF PROPOSED CHANGES 26. This paper seeks management approval for a Level 2 restructuring with the following proposed changes: (a) Extension of the Closing Date for the following: - Loan Agreement (IBRD No. 90040-AO) dated January 15, 2020, between the Republic of Angola and the World Bank, from July 31, 2024, to May 31, 2025. - Financing Agreement (IDA Grant No. D5080-CF) dated October 19, 2019, between the Central African Republic and IDA, from July 31, 2024, to May 31, 2025. - Financing Agreement (IDA Grant No. D5220) dated November 11, 2019, between ECCAS and IDA, from July 31, 2024, to May 31, 2025. (b) Changes in the project’s Results Framework - Revise certain indicator definitions in the results framework to align them with JEE 3.0 for all REDISSE IV countries (Angola, CAR, Chad, DRC and ROC) and ECCAS. III. SUMMARY OF CHANGES Changed Not Changed Results Framework ✔ The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) Loan Closing Date(s) ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ PBCs ✔ Components and Cost ✔ Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ 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) OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline Ln/Cr/Tf Status Closing Closing(s) Closing for Withdrawal Applications IBRD-90040 Effective 31-Jul-2024 31-May-2025 30-Sep-2025 IDA-64980 Effective 31-Jul-2024 31-May-2025 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) IDA-64990 Effective 31-Jul-2024 IDA-D5080 Effective 31-Jul-2024 31-May-2025 30-Sep-2025 IDA-D5160 Effective 31-Jul-2024 31-May-2025 IDA-D5170 Effective 31-Jul-2024 IDA-D5220 Effective 31-Jul-2024 31-May-2025 30-Sep-2025 . The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) . Results framework COUNTRY: Central Africa Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV Project Development Objectives(s) The project development objectives are: (i) to strengthen national and regional cross-sectoral capacity for collaborative disease surveillance and epidemic preparedness in the Participating Countries; and (ii) in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. Project Development Objective Indicators by Objectives/ Outcomes RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Strengthen national and regional cross-sectoral capacity for collaborative disease surveillance Laboratory testing capacity for detection of priority diseases (national capacity scores) (Number of countries with a score of 3) 1.00 4.00 (Number) Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 JEE 1.0-2.0: (Target number of countries: 4; Actual number of countries: 1). (Scores: Angola: 3; CAR:2; Chad: 3; DRC: 4; RoC: 3) Action: This indicator has been Revised National: Country score of 3: Developed capacity: Attributes of a capacity are in place; however, sustainability has not bee n ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 1.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Action: This indicator has been Revised CAR (Number) 3.00 3.00 Action: This indicator has been Revised CHAD (Number) 1.00 3.00 Action: This indicator has been Revised DRC (Number) 3.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Event verification and investigation (Number) 1.00 4.00 Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 JEE 1.0-2.0 (Target number of countries: 4; Actual number of countries: 1). (Scores: Angola: 3; CAR:2; Chad: 3; DRC: 4; RoC: 3) Action: This indicator has been Revised National: Country score of 3: Develop ed capacity: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 3.00 3.00 Action: This indicator has been Revised CAR (Number) 3.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Action: This indicator has been Revised CHAD (Number) 3.00 3.00 Action: This indicator has been Revised DRC (Number) 3.00 3.00 Action: This indicator has been Revised RoC (Number) 3.00 3.00 Action: This indicator has been Revised Availability of human resources to implement IHR core capacity requirements (national capacity scores) (Number of countries 1.00 4.00 with a JEE score of 3) (Number) Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 JEE 1.0-2.0: (Target number of countries: 3; Actual number o f countries: 1). (Score: Angola: 2; CAR:2; Chad: 3; DRC: 3; RoC: 2) Action: This indicator has been Revised National: Country score of 3: Developed capacity: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 3.00 3.00 Action: This indicator has been Revised CAR (Number) 1.00 3.00 Action: This indicator has been Revised CHAD (Number) 3.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 2.00 3.00 Action: This indicator has been Revised Emergency risk assessment and readiness (Number) 0.00 4.00 Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 JEE 1.0-2.0: (Target number of countries: 4; Actual number of countries: 0). (Scores: Angola: 3; CAR:2; Chad: 1; DRC: 1; RoC: Action: This indicator has been Revised 2) National: Developed capacity: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 2.00 3.00 Action: This indicator has been Revised CAR (Number) 2.00 3.00 Action: This indicator has been Revised CHAD (Number) 2.00 3.00 Action: This indicator has been Revised DRC (Number) 3.00 3.00 Action: This indicator has been Revised RoC (Number) 2.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Action: This indicator has been Revised Core capacity requirements at all times for PoEs (Number) 0.00 4.00 Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 JEE 1.0-2.0: (Target number of countries: 4; Actual number o f countries: 0). (Scores: Angola: 2; CAR:2; Chad: 1; DRC: 1; RoC: 2) Action: This indicator has been Revised National: Country Score of 3: Developed capacity: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 1.00 3.00 Action: This indicator has been Revised CAR (Number) 1.00 3.00 Action: This indicator has been Revised CHAD (Number) 1.00 3.00 Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Surveillance of zoonotic diseases (Number of countries with a JEE 0.00 4.00 score of 3) (Number) The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 JEE 1.0-2.0: (Target number of countries: 3; Actual number of countries: 4). (Scores: Angola: 3; CAR:3; Chad: 3; DRC: 3; RoC: 2) Action: This indicator has been Revised National: Country Score of 3: Developed capacit y: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 2.00 3.00 Action: This indicator has been Revised CAR (Number) 2.00 3.00 Action: This indicator has been Revised CHAD (Number) 2.00 3.00 Action: This indicator has been Revised DRC (Number) 2.00 3.00 Action: This indicator has been Revised RoC (Number) 2.00 3.00 Action: This indicator has been Revised PDO Table SPACE The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) Intermediate Results Indicators by Components RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Strengthening Surveillance and laboratory capacity to rapidly detect outbreak Analysis and information sharing (Number) 0.00 4.00 Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 National: Country Score of 3: Developed capacity: At tributes of a capacity are in place; however, sustainability has not Action: This indicator has been Revised been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 2.00 3.00 Action: This indicator has been Revised CAR (Number) 3.00 3.00 Action: This indicator has been Revised CHAD (Number) 3.00 3.00 Action: This indicator has been Revised DRC (Number) 3.00 3.00 Action: This indicator has been Revised RoC (Number) 3.00 3.00 Action: This indicator has been Revised Laboratory systems quality (Number) 0.00 4.00 Rationale: Action: This indicator has been Revised Regional target: Number of countries with a JEE 3.0 score of 3 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target National: Country Score of 3: Developed capaci ty: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 2.00 3.00 Action: This indicator has been Revised CAR (Number) 1.00 3.00 Action: This indicator has been Revised CHAD (Number) 1.00 3.00 Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Specimen referral and transport system (Number) 1.00 4.00 Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 National: Country Score of 3: Developed capacity: At tributes of a capacity are in place; however, sustainability has not Action: This indicator has been Revised been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 2.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Revised CAR (Number) 1.00 3.00 Action: This indicator has been Revised CHAD (Number) 1.00 3.00 Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Systems for efficient reporting to WHO, OIE/FAO: number of 0.00 4.00 countries that achieve a JEE score of 4 (Number) (Number) Action: This indicator has been Marked for Deletion ANGOLA (Number) 0.00 0.00 Action: This indicator has been Marked for Deletion CAR (Number) 0.00 0.00 Action: This indicator has been Marked for Deletion CHAD (Number) 0.00 0.00 Action: This indicator has been Marked for Deletion DRC (Number) 0.00 0.00 Action: This indicator has been Marked for Deletion RoC (Number) 0.00 0.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Marked for Deletion Progress towards establishing an active, functional regional One 1.00 4.00 Health platform (Number) Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 National: Country Score of 3: Developed capacity: At tributes of a capacity are in place; however, sustainability has not Action: This indicator has been Revised been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). Angola (Number) 3.00 3.00 Action: This indicator has been Revised CAR (Number) 1.00 3.00 Action: This indicator has been Revised CHAD (Number) 2.00 3.00 Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Strengthening Emergency planning and management capacity to rapidly respond to outbreaks Response to zoonotic diseases (Number of countries with a JEE 0.00 4.00 score of 3) (Number) Action: This indicator has been Revised Rationale: The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Regional target: Number of countries with a JEE 3.0 score of 3 National: Country Score of 3: Developed capaci ty: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 3.00 3.00 Action: This indicator has been Revised CAR (Number) 1.00 3.00 Action: This indicator has been Revised CHAD (Number) 2.00 3.00 Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Regional surge capacity and stockpiling mechanisms established 1.00 4.00 (Number of countries with a JEE score of 3) (Number) Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 National: Country score: Country score of 3: & nbsp;Developed capacity: Attributes of a capacity are in place; however, Action: This indicator has been Revised sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Angola (Number) 1.00 3.00 Action: This indicator has been Revised CAR (Number) 2.00 3.00 Action: This indicator has been Revised Chad (Number) 1.00 3.00 Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Emergency logistic and supply chain management (Number of 1.00 4.00 countries with a JEE score of 3) (Number) Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 Action: This indicator has been Revised National: Country score of 3: Developed capacity: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). Angola (Number) 1.00 3.00 Action: This indicator has been Revised CAR (Number) 2.00 3.00 Action: This indicator has been Revised CHAD (Number) 1.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Revised DRC (Number) 1.00 3.00 Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised Public health workforce development Workforce Strategy: An updated multisectoral staff strategy is in 1.00 4.00 place (Number of countries with a JEE score of 3) (Number) Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 National: Country score of 3: Developed capaci ty: Attributes of a capacity are in place; however, sustainability has not Action: This indicator has been Revised been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source). ANGOLA (Number) 3.00 3.00 Action: This indicator has been Revised CAR (Number) 1.00 3.00 Action: This indicator has been Revised CHAD (Number) 2.00 3.00 Action: This indicator has been Revised DRC (Number) 1.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Revised RoC (Number) 1.00 3.00 Action: This indicator has been Revised FETP or Applied epidemiology training program in place (Number 3.00 4.00 of countries with a JEE score of 4) (Number) Rationale: Regional target: Number of countries with a JEE 3.0 score of 3 National: Capacity graded on a score of 1-5 where 1 = no capacity (no FETP or applied epidemiology training program established or no access to such a program in another country); 2 = limited capacity (no FETP or applied epidemiology training program is established within the country, but staff participate in a program hosted in another country through an existing agreement (at Basic, Intermediate and/or Advanced level); 3= developed capacity (one level of FETP (Basic, Action: This indicator has been Revised Intermediate, or Advanced) FETP or comparable applied epidemiology training program in place in the country or in another country through an existing agreement); 4 = demonstrated capacity (two levels of FETP (Basic, Intermediate and/or Advanced) or comparable applied epidemiology training program(s) in place in the country or in another country through an existing agreement); and 5 = sustainable capacity (three levels of FETP (Basic, Intermediate and Advanced) or comparable applied epidemiology training program(s) in place in the country or in another country through an existing agreement, with sustainable national funding). ANGOLA (Number) 4.00 3.00 Action: This indicator has been Revised CAR (Number) 4.00 3.00 Action: This indicator has been Revised CHAD (Number) 1.00 3.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Revised DRC (Number) 4.00 3.00 Action: This indicator has been Revised RoC (Number) 4.00 3.00 Action: This indicator has been Revised Percentage of people trained in applied epidemiology who are 0.00 20.40 female (all categories) (Percentage) Action: This indicator has been Marked for Deletion ANGOLA (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion CAR (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion CHAD (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion DRC (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion RoC (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion Percentage of people trained in basic/short-term (3 months) 0.00 0.00 applied epidemiology who are female (Percentage) Action: This indicator has been Marked for Deletion The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target ANGOLA (Percentage) 34.00 0.00 Action: This indicator has been Marked for Deletion CAR (Percentage) 24.00 0.00 Action: This indicator has been Marked for Deletion CHAD (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion DRC (Percentage) 18.00 0.00 Action: This indicator has been Marked for Deletion RoC (Percentage) 20.00 0.00 Action: This indicator has been Marked for Deletion Percentage of people trained in advance (2 years) applied 0.00 0.00 epidemiology who are female (Percentage) Action: This indicator has been Marked for Deletion ANGOLA (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion CAR (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion CHAD (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion DRC (Percentage) 0.00 0.00 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Marked for Deletion RoC (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion Percentage of people trained in intermediate (9 months) applied 0.00 0.00 epidemiology in the country who are females (Percentage) Action: This indicator has been Marked for Deletion ANGOLA (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion CAR (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion CHAD (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion DRC (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion RoC (Percentage) 0.00 0.00 Action: This indicator has been Marked for Deletion Institutional Capacity Building, Project Management, Coordination and Advocacy Citizens and/or communities involved in planning/implementation/evaluation of development programs No Yes (Yes/No) (Yes/No) The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target ANGOLA: Citizens and/or communities involved in planning/implementation/evaluation of development programs No Yes (Yes/No) (Yes/No) CAR: Citizens and/or communities involved in planning/implementation/evaluation of development programs No Yes (Yes/No) (Yes/No) CHAD: Citizens and/or communities involved in planning/implementation/evaluation of development programs No Yes (Yes/No) (Yes/No) DRC: Citizens and/or communities involved in planning/implementation/evaluation of development programs No Yes (Yes/No) (Yes/No) (Yes/No) RoC: Citizens and/or communities involved in planning/implementation/evaluation of development programs No Yes (Yes/No) (Yes/No) IO Table SPACE Click here to enter text.