09-Oct-2023 Date:_________________ H.E. Ginésio Valentim Afonso da Mata Minister of Planning, Finance and Blue Economy Ministry of Planning, Finance and Blue Economy Agua Grande Caixa Postal No. 168 Sao Tome, Republic of Sao Tome and Principe Re: Democratic Republic of Sao Tome and Principe COVID-19 Emergency Response Project Grant No. IDA-D606-ST, Grant No. IDA-D813-ST and HERP Grant No. TF0B5690 Amendment to legal agreements Excellency: We refer to the above-referenced legal agreements (“Legal Agreements”) between the Democratic Republic of Sao Tome and Principe (“Recipient”) and the International Development Association (“Association”), as follows: (a) Financing Agreement dated April 6, 2020, as amended, Grant No. IDA-D606-ST (“Original FA”); (b) Financing Agreement dated May 31, 2021, as amended, Grant No. IDA-D813-ST (“Additional Financing 2 FA”); and (c) Health Emergency Preparedness and Response Multi-Donor Trust Fund Grant Agreement dated May 31, 2021, HEPR Grant No. TF0B5690-ST (“HEPR GA”). We also refer to the letter from the Ministry of Planning, Finance and Blue Economy, dated July 31, 2023, requesting the extension of the Closing Date of the Legal Agreements. In view of the above and our recent discussions, the Bank proposes to amend the Legal Agreements as follows: I. Original FA 1. Schedule 1 is hereby amended to read as Annex 1 to this amendment letter. 2. Section I.A of Schedule 2 is hereby amended to read as follows: “A. Institutional Arrangements 1. Without limitation to the provisions of Section 3.01, the Recipient, through the Ministry of Health, and with the assistance of AFAP, shall carry out the Project in accordance with this Agreement, the Subsidiary Agreement and the Project Operations Manual, and for this purpose, the H.E. Ginésio Valentim Afonso da Mata -2- Recipient, through the Ministry of Health, shall establish and maintain throughout Project implementation, a Project Coordination Unit (the “PCU”) with a structure, staff, functions, responsibilities and adequate resources, all acceptable to the Association. 2. The Recipient, through the Ministry of Health, shall maintain throughout Project implementation a steering committee (“Steering Committee”) with a composition and terms of reference acceptable to the Association, to be responsible of providing oversight and strategic guidance in the implementation of the Project.” 3. A new paragraph 3 is added at the end of Section II of Schedule 2 to read as follows: “3. The Recipient, through the Ministry of Health, shall cause AFAP to provide to the Recipient not later than 5 months after the Closing Date, for incorporation in the report referred to in Section 5.08(c) of the General Conditions all such information as the Recipient or the Association shall reasonably request for the purposes of such Section." 4. Section III.B.2 of Schedule 2 is hereby amended to read as follows: “2. The Closing Date is June 30, 2025.” II. Additional Financing 2 FA 1. Schedule 1 is hereby amended to read as Annex 1 to this amendment letter. 2. A new paragraph 4 is added at the end of Section I.A of Schedule 2 to read as follows: “4. The Recipient, through the Ministry of Health, shall maintain throughout Project implementation a steering committee (“Steering Committee”) with a composition and terms of reference acceptable to the Association, to be responsible of providing oversight and strategic guidance in the implementation of the Project.” 3. A new paragraph 3 is added at the end of Section II of Schedule II to read as follows: “3. The Recipient, through the Ministry of Health, shall cause AFAP to provide to the Recipient not later than 5 months after the Closing Date, for incorporation in the report referred to in Section 5.08(c) of the General Conditions all such information as the Recipient or the Association shall reasonably request for the purposes of such Section.” H.E. Ginésio Valentim Afonso da Mata -3- 4. The table in Section III.A of Schedule 2 is hereby amended to read as follows: Amount of the Percentage of Grant Allocated Expenditures to be Category (expressed in Financed SDR) (inclusive of Taxes) (1) Goods, works, non-consulting 1,750,000 100% services, consulting services, Training and Operating Costs under the Project (except Emergency Expenditures) (2) Emergency Expenditures 450,000 100% TOTAL AMOUNT 2,200,000 5. Section III.B.2 of Schedule 2 is hereby amended to read as follows: “2. The Closing Date is June 30, 2025.” III. HEPR GA 1. Schedule 1 is hereby amended to read as Annex 1 to this amendment letter. 2. A new paragraph 4 is added at the end of Section I.A of Schedule 2 to read as follows: “4. The Recipient, through the Ministry of Health, shall maintain throughout Project implementation a steering committee (“Steering Committee”) with a composition and terms of reference acceptable to the Bank, to be responsible of providing oversight and strategic guidance in the implementation of the Project.” 3. A new paragraph 3 is added at the end of Section II of Schedule 2 to read as follows: “3. The Recipient, through the Ministry of Health, shall cause AFAP to provide to the Recipient not later than 5 months after the Closing Date, for incorporation in the report referred to in Section 2.06 of the Standard Conditions all such information as the Recipient and the Bank shall reasonably request for the purposes of such Section.” 4. Section III.B.2 of Schedule 2 is hereby amended to read as follows: “2. The Closing Date is June 30, 2025.” All other terms and conditions of the Legal Agreements remain in full force and effect. Please confirm your agreement with the foregoing amendment, on behalf of the Recipient, by signing and dating this letter in the spaces provided below. The provisions set forth in this amendment letter will become effective as of the date of the countersignature, upon receipt by the Association of one fully executed original of this letter. H.E. Ginésio Valentim Afonso da Mata -4- Please also note that the Project Paper dated August 31, 2023, a copy of which is enclosed herewith, will be disclosed on the Association’s external website as per the Association’s policy on Access to Information. Very truly yours, INTERNATIONAL DEVELOPMENT ASSOCIATION By ______________________________ Albert Zeufack Country Director Angola, Burundi, Democratic Republic of Congo and Sao Tome and Principe Africa Region - East AGREED: DEMOCRATIC REPUBLIC OF SAO TOME AND PRINCIPE By: _______________________________ Authorized Representative H.E. Ginésio Valentim Afonso da Mata Name: _______________________________ Ministro das Finanças Title: _______________________________ 11-Oct-2023 Date: ______________________________ Enclosures H.E. Ginésio Valentim Afonso da Mata -5- ANNEX 1 SCHEDULE 1 Project Description The objectives of the Project are to prevent, detect and respond to the threat posed by COVID-19, strengthen national systems for public health preparedness in the Recipient’s territory, and in case of an Eligible Crisis or Emergency, respond promptly and effectively to it. The Project constitutes a phase of the MPA Program, and consists of the following parts: A. Emergency COVID-19 Response Support for the implementation of containment strategies under the STP COVID Preparedness and Response Plan, including: 1. (1) case detection, confirmation, contact tracing, recording and reporting; (2) risk communication, community engagement for vaccine demand creation and reduction of vaccine hesitancy, and promotion of social distancing; (3) strengthening health systems capacity to respond to COVID-19; (4) development and implementation of a COVID-19 national deployment and vaccination plan, and strengthening the Project COVID-19 Vaccine supply chain, including cold chain; and (5) acquisition, delivery and storage of Project COVID-19 Vaccines and required consumables, all through, inter alia, the provision of: (a) laboratory equipment, reagents, testing kits and other consumable supplies for laboratories; (b) drugs, nutrition support, medical supplies and equipment for case management and prevention; (c) training and technical expertise to enhance clinical capacity and strengthen community disease surveillance and multi-stakeholder commitment; (d) technical assistance for updating legislation to ensure implementation of COVID-19 national deployment and vaccination plan, and provision of capacity building on plan implementation; and (e) support for strengthening and adapting pharmacovigilance system to detect adverse effects following Project COVID-19 Vaccine immunization; and 2. (1) solarization of selected health facilities and acquisition and installation of resilient and green cold chains and refrigeration; and deployment of electric vehicles and charging infrastructure. B. Strengthening Multi-Sector, National Institutions and Platforms for Policy Development and Coordination of Prevention and Preparedness Including One Health Approach 1. Support for the coordination of the Recipient’s public health emergency response through, inter alia: (a) preparation of standard operating procedures, job descriptions, roles and responsibilities; (b) establishment of an emergency operations center within the Ministry of Health to coordinate multisectoral COVID-19 preparedness and response activities; and (c) establishment of multi-sectoral coordination committees for COVID-19 response. 2. Strengthening the One Health Approach through the development of a uniform disease information system in the Recipient’s territory to provide better analytical capaci ty for global disease information sharing and to include zoonotic disease information. H.E. Ginésio Valentim Afonso da Mata -6- C. Implementation management and monitoring and evaluation Support for implementation management and monitoring and evaluation through, inter alia: (a) strengthening of public structures for the coordination and management of Project implementation, monitoring and evaluation, financial management and procurement; and (b) strengthening the Recipient’s institutional capacity on clinical and public health research, including veterinary, and joint-learning across and within country. D. Contingent Emergency Response Component Provision of immediate response to an Eligible Crisis or Emergency, as needed.