The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) Papua New Guinea COVID-19 Emergency Response Project (P173834) EAST ASIA AND PACIFIC | Papua New Guinea | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 6 | ARCHIVED on 22-Jun-2023 | ISR56241 | Implementing Agencies: Department of Treasury, National Department of Health Key Dates Key Project Dates Bank Approval Date: 10-Apr-2020 Effectiveness Date: 17-Apr-2020 Planned Mid Term Review Date: 28-Mar-2022 Actual Mid-Term Review Date: 28-Mar-2022 Original Closing Date: 30-Apr-2023 Revised Closing Date: 31-Oct-2024 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 Papua New Guinea (PNG). Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Preparedness for COVID-19 Containment and Mitigation:(Cost $7.30 M) Health Systems Strengthening:(Cost $21.30 M) Managing Implementation and Monitoring & Evaluation:(Cost $1.40 M) Contingent Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating High High Implementation Status and Key Decisions This report covers findings from the implementation support mission conducted from May 15-June 6, 2023. The project was restructured to (a) extend the closing date from April 30, 2023 to October 31, 2024; (b) partially cancel the IDA process amounting to Special Drawing Rights (SDR) 14,856,743.85; and (c) revise project components and costs as well as the Results Framework. The partial cancellation has resulted in the closing of Credit 6797 and reducing the amount available under Credit 6785 to approximately US$9.42 million equivalent, with a revised total project financing of approximately US$29.42 million equivalent. The focus under the extension period will be to complete priority activities already commenced, namely the installation and commissioning of equipments related to infection prevention, control and health care waste management, diagnostics, and requisite training on their use and operations including environmental and social risk management. 6/22/2023 Page 1 of 8 The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) 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 June 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 June 15, 2023, amount to US$3.89 billion or 91% 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 five operations have closing dates by the end of CY23. However, there are several projects that are/will be processing extensions so this number is likely to change. 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 after the closing date of the Program -- December 31, 2025. This Global ICR will be based on final ISRs packages prepared by country operations’ teams. A template for the final ISR was issued by OPCS on March 25, 2022. Several operations have/are preparing final ISR packages. 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 MPA is on track to achieve its PrDO, “prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.“ Seventy one (71) country projects or 83 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 71 operations, 59 operations or 83% have disbursed 90+% of commitments. Out of the 71 operations, 38 operations are fully disbursed and sixteen (16) operations have disbursed 95-99% 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 at 99%, followed by MNA with 96%, SAR with 94%, LAC with 92%, EAP with 85%, AFE and AFW with 78%. Disbursements for EAP operations are being affected by relatively low disbursements in Fiji, Kiribati, Samoa, and Solomon Islands. AFE lower disbursements compared to other regions are a result of low disbursements under two operations. In the case of AFW low overall 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. 6/22/2023 Page 2 of 8 The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) 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. 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, 2020. 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. No additional AF-V operation has been approved since late October 2022. As of June 15, 2023, the Bank has approved 113 operations to support vaccine procurement and rollout in 78 countries. A new operation is being processed in Senegal. One hundred and sixteen (116) operations had been approved amounting to $10 billion, but: (i) the Costa Rica operation ($120 million), (ii) the Peru operation ($500 million), and the (iii) Gabon ($12 million) were cancelled at the request of the governments. Also, the Afghanistan operation commitment of $113 million was reduced to $60 million. Total commitment for the 113 operations is $9.19 billion. The 113 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 113 approved operations: (i) 63 are in Africa – 29 in AFE and 34 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 June 15, 2023, amount to US$5.84 billion or 64 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. With less than planned demand for IDA/IBRD funds for vaccine procurement because, inter alia, over supply of vaccines from donations from various sources, several projects are being and more will need to be restructured to reallocate funds allocated for procurement of COVID-19 vaccines and deployment. A Guidance Note has been prepared by HNP together with OPCS and other departments to seek approval by management for utilization of undisbursed funds. The Note will provide guidance to teams regarding the utilization of committed but unused funds under AF-V operations for the procurement of commodities, including routine vaccines. Thirty-six (36) AF-V/MPA-V operations or 32% of operations approved have disbursed over 70% of their commitments. Out of the 36, twelve operations or 33% have disbursed 90+. Out of the 12, three operations are fully disbursed (Argentina, Sri Lanka AF-V 1, and Ukraine AF-V 3). Five operations have disbursed 98-99% of commitments (Ecuador AF-V 1, Indonesia, Iraq, Sierra Leone AF-V 1, and Yemen). Seven operations have disbursed 95-99%. Ninety-one (91) operations or 81 percent of total operations approved are disbursing. ECA has the highest percentage of disbursements at 85%, followed by SAR at 77%, EAP at 72%, LAC at 69%, MNA at 65%, AFE at 52% and AFW at 48%. 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 100 percent of projects approved have been signed. One hundred and twelve (112) loan/financing agreements or 99 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 6/22/2023 Page 3 of 8 The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial High High Macroeconomic High Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Substantial Substantial Other -- Substantial Moderate Overall High High High Results PDO Indicators by Objectives / Outcomes Proportion of laboratory-confirmed cases of COVID-19 responded to within 48 hours IN01303744 ►Proportion of laboratory-confirmed cases of COVID-19 responded to within 48 hours (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 24.00 30.00 Date 05-May-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 IN01303752 Proportion of laboratory-confirmed cases of COVID-19 responded to within 48 hours (Male) (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 61.00 50.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 IN01303754 Proportion of laboratory-confirmed cases of COVID-19 responded to within 48 hours (Female) (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 39.00 50.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 Proportion of samples from suspected cases of COVID-19/ SARI that are responded to within 48 hours IN01303742 6/22/2023 Page 4 of 8 The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) ►Proportion of samples from suspected cases of COVID-19 / SARI that are confirmed within 48 hours (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 53.00 60.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2021 31-Oct-2024 IN01303751 Proportion of samples from suspected cases of COVID-19/SARI of which testing is completed and reported within 48 hours (Male) (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 72.00 50.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 IN01303753 Proportion of samples from suspected cases of COVID-19/SARI of which testing is completed and reported within 48 hours (Female) (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 27.00 50.00 Date 07-May-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 Number of Provinces with personal protective equipment (PPE) and infection prevention & control (IPC IN01303743 ►Number of Provinces with personal protective equipment (PPE) and infection prevention & control (IPC) products and supplies, without stock-outs in preceding two weeks (Number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 22.00 22.00 22.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 Intermediate Results Indicators by Components Component 1.1: Risk Communication and Community Engagement IN01303749 ►Complaints to the Grievance Redress Mechanism (GRM) satisfactorily addressed within the specified timeframe of initial complaint being received (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 35.00 70.00 Date 17-Mar-2021 31-Dec-2021 31-Dec-2022 31-Oct-2024 Component 2.1: Building Testing Capacity 6/22/2023 Page 5 of 8 The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) IN01303745 ►Number of designated laboratories with COVID-19/SARI diagnostic Polymerized Chain Reaction (PCR) and/or GeneXpert capacities established per NDOH guidelines (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 22.00 67.00 50.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 Component 2.2: Enhancing Containment and Clinical Management Capacity IN01303746 ►Number of provincial hospitals with fully equipped isolation facilities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 17.00 22.00 22.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 IN01303747 ►Number of Provincial Hospitals that have a medical waste management plan in line with NDOH protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3.00 4.00 22.00 Date 17-Apr-2020 31-Dec-2021 31-Dec-2022 31-Oct-2024 IN01303748 ►Number of provincial hospitals with oxygen concentrators to manage COVID-19 patients (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 22.00 22.00 Date 17-Mar-2021 31-Dec-2021 31-Dec-2022 31-Oct-2024 IN01303750 ►Number of designated laboratories with COVID-19/SARI diagnostic PCR and/or GeneXpert capacity which has Biosafety Class II installed and certified (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8.00 -- 8.00 22.00 Date 31-Jan-2023 -- 31-Jan-2023 31-Oct-2024 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) 6/22/2023 Page 6 of 8 The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173834 IDA-66140 Effective USD 20.00 20.00 0.00 15.73 4.27 79% P173834 IDA-67850 Effective USD 20.00 9.42 10.58 0.12 7.89 1.5% P173834 IDA-67970 Closed USD 10.00 0.58 9.42 0.00 0.00 0% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173834 IDA-66140 Effective 10-Apr-2020 15-Apr-2020 17-Apr-2020 30-Apr-2023 31-Oct-2024 P173834 IDA-67850 Effective 22-Jun-2021 12-Oct-2021 07-Jan-2022 30-Apr-2023 31-Oct-2024 P173834 IDA-67970 Closed 22-Jun-2021 12-Oct-2021 07-Jan-2022 30-Apr-2023 30-Apr-2023 Cumulative Disbursements Restructuring History Level 2 Approved on 21-Apr-2023 Related Project(s) 6/22/2023 Page 7 of 8 The World Bank Implementation Status & Results Report Papua New Guinea COVID-19 Emergency Response Project (P173834) P174717-Papua New Guinea COVID-19 Emergency Response Additional Financing 6/22/2023 Page 8 of 8