The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) WESTERN AND CENTRAL AFRICA | Guinea | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 8 | ARCHIVED on 22-May-2023 | ISR55617 | Implementing Agencies: Ministere de la Santé, Republic of Guinea Key Dates Key Project Dates Bank Approval Date: 17-Jun-2020 Effectiveness Date: 28-Jul-2020 Planned Mid Term Review Date: 09-May-2022 Actual Mid-Term Review Date: 23-May-2022 Original Closing Date: 31-Jul-2022 Revised Closing Date: 31-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Guinea. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Emergency COVID-19 Response:(Cost $63.23 M) Project Implementation Management and Monitoring and Evaluation:(Cost $1.30 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The parent project and the first and second Additional Financing became effective on July 28, 2020, August 17, 2021, and December 14, 2022 respectively. As of March 31, 2023, the targets for the three Project Development Objectives (PDO) indicators included in the parent project had been surpassed. The PDO indicator “Percentage of population fully vaccinated, which is included in the priority population targets defined in the national plan” was added to the first Additional Financing. As of May 15, 2023, this indicator was on track with a value of 35.8 percent, compared to a target of 38.3 percent. Progress towards achievement of the PDO and overall implementation progress remain satisfactory. Le projet parent et les premier et deuxième financements additionnels sont entrés en vigueur respectivement le 28 juillet 2020, le 17 août 2021 et le 14 décembre 2022. À la date du 15 mai 2023, la cible des trois indicateurs des objectifs de développement du projet (ODP) inclus dans le projet parent était dépassée. L'indicateur de l'ODP "Pourcentage de la population entièrement vaccinée, qui est inclus dans les cibles prioritaires de la population définies dans le plan national" a été ajouté au premier financement additionnel. À la date du 15 mai 2023, cet indicateur avait une valeur de 35,8 pour cent, par rapport à une cible de 38,3 pour cent. Les progrès vers la réalisation de l'ODP et les progrès de la mise en œuvre globale restent satisfaisants. 5/22/2023 Page 1 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) MPA Program Development Objective MPA PDO Table 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 MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body Sustained efforts continue to be made to advance the implementation of the 87 MPA operations. As of May 15, 2023, 88 MPA-projects have been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Total disbursements as of May 15, 2023, amount to US$3.87 billion or 90% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. A large refund from the UN to the project account of the Myanmar operation was processed in late March due to the inability to implement the project. This transaction affected total disbursements. Also, (i) Loans and Credits denominated in SDRs and Euros are being affected because of fluctuations between the SDRs and Euros against the US dollar, and (ii) at this late stage of project implementation, several operations are processing refunds to the special/project accounts, which have an impact on total disbursements. Thirteen operations closed by the end of CY22. Thirty-three operations have closing dates by the end of CY23. However, at the request of governments, teams continue to process extensions, therefore, closing dates change frequently. As with the Mid Term Review (issued on March 25, 2023), no individual COVID-19 MPA operation will have to complete an ICR. Instead, one ICR will be prepared for the entire COVID-19 MPA Program based on final ISRs prepared by country operations’ teams. A template for the final ISR was issued by OPCS on March 25, 2022. The overall conclusion of the MTR was that the COVID-19 MPA Program embodied a rapid, innovative approach to new lending for human health response. The MTR concluded that the COVID-19 MPA has been successful, notwithstanding considerable uncertainty and multiple constraints in the early stages of the pandemic. The Bank’s emergency response was remarkably swift in the most vulnerable countries facing human capital losses and development setbacks. Further, the MTR concluded that notwithstanding the challenges, the COVID-19 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. Seventy (70) country projects or 80 percent of projects approved have reached 70-100+ percent disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 70 operations, 58 operations or 83 percent have disbursed over 90+% of commitments. Out of the 70 operations, 38 operations are fully disbursed, and 16 operations have disbursed 95-99 percent of commitments. As reported in mid-April, there are six operations with disbursements of 50 percent or less. Out of these six operations, one has not disbursed (AFW), and one operation has disbursed 30 percent (AFW). The projects are benefitting around 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting 4.1 billion of 51 percent of the global population. This is because some countries that do not have a parent project have AF-V operations. Eighty-six (86) or 99% of projects approved are disbursing. ECA has the highest percentage of disbursements (97%), followed by MNA (96%), SAR (94%), LAC (92%), EAP (85%), AFW (78%), and AFE (77%). AFE lower disbursements compared to other regions are a result of low disbursements under two operations. In the case of AFW low disbursements are a result of no disbursements under one operation and only 30 percent under another. Retroactive Financing (RF) continues to represent 20 percent of commitments. SAR has the highest percentage of RF at 37 percent, followed by ECA at 18 percent. IDA continues to represent 39 percent and IBRD 41 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. 5/22/2023 Page 2 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) The Additional Financing (MPA AF-V) to the COVID-19 Strategic Preparedness and Response Program utilizing the Multiphase Programmatic Approach (COVID-19 MPA) was approved by the Board on October 13, 2021. The AF-V was approved with an envelope of US$12 billion ($6 billion from IDA and $6 billion from IBRD) in financing. The AF-V is expected to enable vaccination for up to 750 million people, with potential surge capacity for an additional 250 million people in the poorest countries while scaling support to strengthen immunization delivery, with design flexibility at the country level. The AF-V is a scale-up of planned vaccination activities anticipated and supported under the COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. No additional AF-V operation has been approved since late October 2022. As of May 15, 2023, the Bank has approved 114 operations (including MPA-V operations) to support vaccine procurement and rollout in 78 countries. In March 2023, the number of operations approved was 116, however, the Costa Rica and Peru operations were cancelled at the request of both governments. Total commitment for the 114 operations is $9.21 billion. The 114 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Of the 114 approved operations: (i) 64 are in Africa – 29 in AFE and 35 in AFW; (ii) 10 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. Thirty-two operations are being implemented in Fragile and Conflict-affected situations. IDA continues to represent 43 percent and IBRD 57 percent of disbursements. Total disbursements under these projects as of May 15, 2023, amount to US$5.76 billion or 63 percent of overall commitments. Disbursements under MPA-V operations are included in this total while disbursements under the six restructured projects are counted under parent projects. Disbursements under AF-V operations have slowed down in the past months because of oversupply of donor funding for vaccines and therefore lower than anticipated needs for IBRD/IDA funds for the procurement of vaccines. Thirty-five (35) or 30 percent of AF-V and MPA-V operations have disbursed 70 percent or more of their commitments. Out of the 35, twelve operations have disbursed 90+ percent. Out of the twelve, three operations are fully disbursed, and five operations have disbursed 98-99 percent of commitments. Ninety (90) operations or 79 percent of total operations approved are disbursing. Retroactive Financing (RF) represents 37 percent of overall commitments. High levels of RF have been authorized under different operations - Ukraine (100%), Panama and Turkey (90%), Argentina and Guyana (80%), and Belize, and Sri Lanka (70%). One hundred and thirteen (113) loan/financing agreements or 99 percent of projects approved have been signed. One hundred and eleven (111) loan/financing agreements or 97 percent of projects approved have become effective. As with the COVID-19 MPA operations, streamlined procedures, delegated approval, wide use of Bank Facilitated Procurement, coupled with flexible project design, and intensified efforts across the Bank have contributed to the rapid design, processing, and implementation of the AF-V operations. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial High High Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Moderate Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial 5/22/2023 Page 3 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) Environment and Social Substantial Substantial Substantial Stakeholders Moderate Substantial Substantial Other Moderate Moderate Moderate Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes To prevent, detect and respond to COVID-19 and strengthen national systems for public health emergen IN01273245 ►Suspected cases of COVID-19 cases reported and investigated based on national guidelines (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 400.00 19,143.00 37,467.00 1,000.00 Date 28-Jul-2020 31-Jul-2022 31-Jul-2022 31-Jul-2022 IN01273326 ►Designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 4.00 12.00 12.00 8.00 Date 28-Jul-2020 31-Jul-2022 31-Jul-2022 31-Jul-2022 IN01273327 ►Acute healthcare facilities with isolation capacity (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 7.90 100.00 100.00 90.00 Date 28-Jul-2020 31-Jul-2022 31-Jul-2022 31-Jul-2022 Acute facilities are related to epidemiological treatment centers. There are 38 epidemiological treatment Comments: centers IN01273328 ►Population fully vaccinated, which is included in the priority population targets defined in the national plan, by gender (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.21 24.00 35.80 38.30 Date 15-Jun-2022 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273329 Women fully vaccinated, which is included in the priority population targets defined in the national plan (Percentage, Custom Breakdown) 5/22/2023 Page 4 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 44.00 44.00 50.00 Date 25-May-2021 14-Dec-2022 15-May-2023 31-Dec-2023 Overall Comments PDO Three Project Development Objectives (PDO) indicators were included in the parent project with July 31, 2022 as the end target date: 1. Number of suspected cases of COVID-19 reported and investigated based on national guidelines; 2. Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents; and 3. Percentage of acute healthcare facilities with isolation capacity. As of the closing date of the parent project, the target for these three indicators had been surpassed. The PDO indicator Percentage of population fully vaccinated, which is included in the priority population targets defined in the national plan, and its sub-indicator Percentage of women fully vaccinated among the total population fully vaccinated were added to the first Additional Financing (AF). They are both on track. As of May 15, 2023, the values of this indicator and its sub-indicator were 35.8 percent (compared to a target of 38.3 percent) and 44 percent (compared to a target of 50 percent), respectively. Intermediate Results Indicators by Components Emergency COVID-19 Response IN01273331 ►Health staff trained in infection prevention and control per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,154.00 1,154.00 1,000.00 Date 17-Jun-2020 31-Jul-2022 31-Jul-2022 31-Jul-2022 IN01273333 ►Designated laboratories with staff trained to conduct COVID-19 diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 4.00 12.00 12.00 8.00 Date 17-Jun-2020 31-Jul-2022 31-Jul-2022 31-Jul-2022 IN01273335 ►Country has prepared guidelines to care for COVID-19 patients (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 17-Jun-2020 31-Jul-2022 31-Jul-2022 31-Jul-2022 IN01273337 ►Start-ups recruited for the development of innovative and digital technology solution for accelerated COVID-19 prevention and response (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4.00 4.00 5.00 5/22/2023 Page 5 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) Date 17-Jun-2020 31-Jul-2022 31-Jul-2022 31-Jul-2022 IN01273338 ►Grievances addressed within the time specified in the project implementation manual (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 08-Oct-2020 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273339 ►Key gender-responsive messages and materials developed for public communications and advocacy, in alignment with demand plan (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 16-Apr-2021 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273340 ►Cold rooms fully equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2.00 Date 16-Apr-2021 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273341 ►Health regions with an AEFI monitoring committee (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 16-Apr-2021 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273342 ►Beneficiaries reporting that community engagement and outreach meet their needs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 10-Jun-2021 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273343 ►Adolescents fully vaccinated, which is included in the priority population targets defined in the national plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.40 1.40 9.90 5.00 Date 25-May-2022 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273344 5/22/2023 Page 6 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) ►Population receiving a booster, which is included in the population targets defined in the national plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 20.70 10.00 Date 25-May-2022 14-Dec-2022 15-May-2023 31-Dec-2023 Implementation Management and Monitoring and Evaluation IN01273330 ►M&E system established to monitor COVID-19 preparedness and response plan (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 17-Jun-2020 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273332 ►Vaccination sites that transmit their data via DHIS2 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 16-Apr-2021 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273334 ►HMIS collecting sex and age disaggregated data on COVID-19 indicators for testing, treatment, and vaccines (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 16-Apr-2021 14-Dec-2022 15-May-2023 31-Dec-2023 IN01273336 ►Vaccinators trained on GBV/SEA/SH (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 95.00 Date 11-Jun-2021 14-Dec-2022 15-May-2023 31-Dec-2023 Overall Comments IR Six intermediate indicators were included in the parent project, with July 31, 2022 as the end target date: 1. Number of health staff trained in infection prevention and control per MOH-approved protocols; 2. Number of designated laboratories with staff trained to conduct COVID-19 diagnosis; 3. Country has prepared guidelines to care for COVID-19 patients; 4. Number of start-ups recruited for the development of innovative and digital technological solutions for COVID-19 prevention and response; 5. Percentage of grievance addressed within the time specified in the project implementation manual; and 6. M&E system established to monitor COVID-19 preparedness and response plan. 5/22/2023 Page 7 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) Monitoring of the first four indicators stopped when the parent project closed. As of the closing date of the parent project, the target for these four indicators had either been attained or surpassed. The other two indicators are being used until the closing date of the two AFs since they relate to the overall fight against COVID-19: Grievances addressed within the time specified in the project implementation manual and M&E system established to monitor COVID-19 preparedness and response plan. As of May 15, 2023, only complaints received over the phone were recorded. Seven intermediate indicators were included in the first AF: 1. Key gender-responsive messages and materials developed for public communications and advocacy, in alignment with demand plan; 2. Number of cold rooms fully equipped; 3. Percentage of all eight (8) health regions with an AEFI monitoring committee; 4. Percentage of beneficiaries reporting that community engagement and outreach meet their needs; 5. Percentage of vaccination sites that transmit their data via DHIS2; 6. HMIS collecting sex and age disaggregated data on COVID-19 indicators for testing, treatment, and vaccines; and 7. Percentage of vaccinators trained on GBV/SEA/SH. As of May 15, 2023, the target for four indicators had been attained. These are (1) Key gender-responsive messages and materials developed for public communications and advocacy, in alignment with demand plan; (2) Percentage of all eight (8) health regions with an AEFI monitoring committee; (3) Percentage of vaccination sites that transmit their data via DHIS2; and (4) HMIS collecting sex and age disaggregated data on COVID-19 indicators for testing, treatment, and vaccines. Activities related to the other three indicators are on track: 1. The Government signed a contract with UNICEF for the procurement and commissioning of the cold rooms; the Government paid UNICEF on April 4, 2023. 2. The recruitment of the consultants who will conduct the beneficiaries’ satisfaction survey is underway. 3. All training modules have been prepared for the training of the vaccinators. The training is scheduled to take place at the central level in the next few weeks. The other two indicators were added as part of the second AF: 1. Adolescents fully vaccinated, which is included in the priority population targets defined in the national plan and 2. Population receiving a booster, which is included in the population targets defined in the national plan. Both had been surpassed by May 15, 2023. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P174032 IDA-67350 Closed USD 5.45 5.45 0.00 5.31 0.39 93% P174032 IDA-69700 Effective USD 14.10 14.10 0.00 3.57 9.67 27% P174032 IDA-71910 Effective USD 12.72 12.72 0.00 0.00 12.82 0% P174032 IDA-D6870 Closed USD 5.45 5.45 0.00 5.74 0.00 100% P174032 IDA-D8940 Effective USD 14.10 14.10 0.00 11.38 2.01 85% 5/22/2023 Page 8 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) P174032 IDA-E1080 Effective USD 12.72 12.72 0.00 0.00 12.82 0% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P174032 IDA-67350 Closed 17-Jun-2020 25-Jun-2020 28-Jul-2020 31-Jul-2022 31-Jul-2022 P174032 IDA-69700 Effective 29-Jun-2021 01-Jul-2021 17-Aug-2021 31-Dec-2022 31-Dec-2023 P174032 IDA-71910 Effective 23-Jun-2022 05-Jul-2022 14-Dec-2022 31-Dec-2023 31-Dec-2023 P174032 IDA-D6870 Closed 17-Jun-2020 25-Jun-2020 28-Jul-2020 31-Jul-2022 31-Jul-2022 P174032 IDA-D8940 Effective 29-Jun-2021 01-Jul-2021 17-Aug-2021 31-Dec-2022 31-Dec-2023 P174032 IDA-E1080 Effective 23-Jun-2022 05-Jul-2022 14-Dec-2022 31-Dec-2023 31-Dec-2023 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) P176706-Additional Financing for COVID-19 Emergency Response and System Preparedness Strengthening Project ,P178602-Second Additional Financing to Guinea COVID-19 Emergency Response and System Preparedness Strengthening Project ,P180984-Third Additional Financing to Guinea COVID-19 Emergency Response and System Preparedness Strengthening Project ,P180986-THIRD ADDITIONAL FINANCING TO GUINEA COVID-19 EMERGENCY RESPONSE AND SYSTEM PREPAREDNESS STRENGTHENING PROJECT 5/22/2023 Page 9 of 10 The World Bank Implementation Status & Results Report GUINEA COVID-19 PREPAREDNESS AND RESPONSE PROJECT (P174032) 5/22/2023 Page 10 of 10