The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) REPORT NO.: RES58185 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, 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: Meskerem Mulatu Practice Manager/Manager: Trina S. Haque Task Team Leaders: Andre L. Carletto, Djibrilla Karamoko, Joao Verissimo Figueiredo Rodrigues E Pires, Kofi Amponsah, Meta Mobula The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) ABBREVIATIONS AND ACRONYMS ESRC Environmental and Social Risk Classification 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 IBRD International Bank for Reconstruction and Development IDA International Development Agency PDO Project Development Objective REDISSE Regional Disease Surveillance Systems Enhancement Program 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-Jul-2024 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 30.80 29.20 IDA-64980 01-Oct-2019 18-Oct-2019 01-Sep-2020 31-Jul-2024 75.00 41.78 33.22 IDA-64990 01-Oct-2019 19-Oct-2019 01-Sep-2020 31-Jul-2024 15.00 7.62 7.04 IDA-D5080 01-Oct-2019 19-Oct-2019 27-Aug-2020 31-Jul-2024 15.00 5.20 9.29 IDA-D5160 01-Oct-2019 18-Oct-2019 01-Sep-2020 31-Jul-2024 75.00 41.78 31.58 IDA-D5170 01-Oct-2019 08-Nov-2019 13-Mar-2020 31-Jul-2024 30.00 18.88 10.39 The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) IDA-D5220 01-Oct-2019 11-Nov-2019 17-Mar-2020 31-Jul-2024 10.00 5.29 4.46 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. PROJECT STATUS 1. The Regional Disease Surveillance Systems Enhancement Program – Phase 4 (REDISSE IV) was approved by the Executive Directors on October 1, 2019, for an amount of 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 IBRD loan, IDA credit and grant financing to the countries of Angola (US$60 million loan); Democratic Republic of Congo (DRC,US$75 million grant, US$75 million credit); Republic of Congo (US$15 million credit); Central African Republic (CAR, US$15 million grant); and Chad (US$30 million grant). 2. 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 June 2023 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 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 2022, 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. 3. To date, 51 percent of all Project funds have been disbursed, and 53.1 percent of funds for DRC with a significant acceleration of disbursement during the past 12 months. B. RATIONALE FOR RESTRUCTURING Democratic Republic of the Congo 4. Change in activity for Component 1. An independent firm conducted an evaluation of seven BioSafetey Level-2 (BSL-2) laboratories to be rehabilitated as part of a network of laboratories in seven Provinces of DRC. The independent firm concluded that the feasibility of rehabilitating these laboratories remained near impossible. It would be more cost-effective to construct rather than rehabilitate laboratories that date back to the 1960s. The DRC Ministry of Finance has therefore officially requested in a letter received by the World Bank on August 11, 2023 (Ref. No. 1809/CAB/MIN FINANCES/PP/END/2023), a change in the Financing Agreement to include the construction of laboratories in component 1. The Ministry of Public Health, Hygiene and Prevention has completed all technical assessments, proposed technical specifications for the BSL-2 laboratories and equipment, and these have been reviewed by the US Centers of Disease Control, the World Health Organization and Africa CDC. II. DESCRIPTION OF PROPOSED CHANGES 5. This paper seeks management approval for a Level 2 restructuring with the following proposed changes: The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) (a) DRC: Change of activities for Component 1. The proposed changes consist of allowing for construction of BSL-2 laboratories as part of Component 1, instead of just rehabilitation. This would not lead to a change in cost for Component 1. All environmental and social impact assessments have been completed by the recipient for proposed laboratories. These are currently being reviewed by the World Bank. Subsequently, Schedule I – Part 1.3 (c) of the Financing Agreement will be changed to the following: “Renovating, constructing and upgrading of the Recipient’s existing networking laboratories facilities, ensuring adequate supplies and strengthening supply chain management and improved capacity to diagnose diseases, identify public health threats, and conduct surveillance with a view to serve as effective platforms for learning and knowledge sharing.” (b) Extension of the Project closing date from July 30, 2024, to May 31, 2025. The recipient has established a roadmap for the construction of laboratories and it has been estimated that an additional 10 months would allow for the completion of the construction of laboratories. An extension is only being proposed for DRC; a decision will be made regarding an extension in other REDISSE IV countries after Supervision Missions take place by the end of November. 6. The environment and social (E&S) risk ratings remain moderate. Performance of implementation of the E&S risks and impacts is moderately satisfactory at this stage in DRC. Preparation of requested E&S risks and impacts management instruments: E&S risks and impacts management instruments (Environmental and Social Management Frameworks, Resettlement Policy Framework, Healthcare and Hazardous Waste Management Plans, Indigenous Peoples Planning Framework, Labor Management Procedures; Gender-Based Violence Risk Assessment, Stakeholder Engagement Plan have been completed. None of the ESF instruments need to be updated. Staffing: The recruitment process of environmental and social specialists for project i units has been completed. 7. Financial Management is rated Moderately Satisfactory at the last archived Portfolio and Risk Management. There are no outstanding interim financial reports and the latest external audit report issued an unmodifed opinon on 2022 Project Financial Statements. However, there are the following issues: (i) there is delay on advance justification with outstanding advances of US$19.4 million on UN contracts and US$1.4 million outstanding advances made to implementing entities (ii) internal audit reports are transmitted with delay; and (iii) supervision/audit recommandations have not been fully implemented. NOTE TABLE The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) III. SUMMARY OF CHANGES Changed Not Changed Components and Cost ✔ Loan Closing Date(s) ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ Results Framework ✔ Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) The World Bank Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV (P167817) OPS_DETAILEDCHANGES_COMPONENTS_TABLE COMPONENTS Current Current Proposed Proposed Cost Action Component Name Component Name Cost (US$M) (US$M) Component 1: Strengthening Component 1: Strengthening Surveillance and Laboratory Surveillance and Laboratory 126.45 No Change 126.45 Capacity to Rapidly detect Capacity to Rapidly detect Outbreaks Outbreaks Component 2: Strengthening Component 2: Strengthening Emergency Planning and Emergency Planning and 66.45 No Change 66.45 Management Capacity to Rapidly Management Capacity to respond to Outbreaks Rapidly respond to Outbreaks Component 3: Public Health Component 3: Public Health 47.60 No Change 47.60 Workforce Development Workforce Development Component 4: Institutional Component 4: Institutional Capacity Building, Project Capacity Building, Project 39.50 No Change 39.50 Management, Coordination and Management, Coordination Advocacy and Advocacy TOTAL 280.00 280.00 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 IDA-64980 Effective 31-Jul-2024 31-May-2025 30-Sep-2025 IDA-64990 Effective 31-Jul-2024 IDA-D5080 Effective 31-Jul-2024 IDA-D5160 Effective 31-Jul-2024 31-May-2025 30-Sep-2025 IDA-D5170 Effective 31-Jul-2024 IDA-D5220 Effective 31-Jul-2024 . Click here to enter text.