The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) AR: COVID-19 Emergency Response Project (P173767) LATIN AMERICA AND CARIBBEAN | Argentina | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 8 | ARCHIVED on 08-Dec-2023 | ISR58751 | Implementing Agencies: Argentine Republic, National Ministry of Health Key Dates Key Project Dates Bank Approval Date: 02-Apr-2020 Effectiveness Date: 07-May-2020 Planned Mid Term Review Date: 30-Sep-2022 Actual Mid-Term Review Date: 30-Mar-2022 Original Closing Date: 29-Apr-2022 Revised Closing Date: 30-Apr-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To strengthen preparedness and response efforts against the COVID-19 pandemic and national systems for public health preparedness in Argentina Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Emergency COVID-19 Response Efforts:(Cost $532.90 M) Implementation, Monitoring and Evaluation:(Cost $2.10 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Highly Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The Argentina COVID-19 Emergency Response Project, financed by a US$35 million IBRD loan, was approved by the WB Board of Directors on April 2, 2020 with the objective of strengthening the national health system for emergency preparedness and response to COVID-19 pandemic. This Project is part of a World Bank Multi-Phase Programmatic Approach to support countries affected by the COVID-19 pandemic. The Project was declared effective on May 7, 2020. On September 30, 2021 the Board approved an Additional Financing (AF) in an amount of US$ 500 million mainly to support the financing of vaccines. The additional loan was declared effective on October 6, 2021. As of November 22, 2023, all project activities are under implementation and 99.66 percent of the total loan proceeds is disbursed (100 percent of the initial loan and 99.66 percent of the additional loan). 12/8/2023 Page 1 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) 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 COVID-19 MPA - ISR Write-up as of November 16, 2023 Sustained efforts continue to be made to advance the implementation of the 87 MPA operations. After a great deal of activity (restructurings and disbursements) processed at the end of FY23 when several operations were restructured just before or on June 30, 2023, the past three months have seen a slower period of disbursements. The overall level of disbursements is being affected by three main reasons: (i) low disbursements in six countries, (ii) pausing of disbursements in two other countries – Afghanistan, and Myanmar, and (iii) processing of refunds to the project accounts at this late stage of project implementation. In addition, (i) 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, and (ii) the amounts of Loans and Credits denominated in SDRs and Euros have been affected because of fluctuations between the SDRs and Euros against the US dollar. As of November 16, 2023, 88 MPA-projects had been approved with a total commitment of US$4.27 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Total disbursements as of November 16, 2023, amount to US$3.97 billion or 93% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Ten operations closed by the end of CY22 and nine operations closed on June 30, 2023. While there are thirteen (13) operations with closing dates by the end of CY23, there are plans for some projects to process extensions so this number will change. As with the Mid Term Review (MTR) issued on March 25, 2023, no individual COVID-19 MPA operation will need an ICR. Only one ICR will be prepared upon completion of the SPRP COVID-19 MPA Program, which closes on December 31, 2025. The Global ICR will be based on final ISRs packages prepared by country operations’ teams. A template for the final ISR was issued by OPCS on March 21, 2023. Several operations have/are preparing final ISR packages. The overall conclusion of the MTR was that: (i) the COVID-19 MPA Program embodied a rapid, innovative approach to new lending for human health response; (ii) the COVID-19 MPA has been successful, notwithstanding considerable uncertainty and multiple constraints in the early stages of the pandemic; (iii) the Bank’s emergency response was remarkably swift in the most vulnerable countries facing human capital losses and development setbacks; and (iv) notwithstanding the challenges, the MPA is on track to achieve its PrDO, “prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.“ Seventy-three (73) country projects or 86 percent of projects approved have reached 70-100+ percent disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 73 operations, 63 operations or 86 percent have disbursed 90+ percent of commitments. Out of the 73 operations, 49 operations or 67 percent are fully disbursed and ten (10) operations have disbursed 95-99 percent of commitments. There are four operations with disbursements of 50 percent or less. Out of these four operations, one operation has disbursed 35 percent (AFW), two operations in EAP have disbursed 46-48 percent and one operation in SAR has disbursed 49 percent. The projects are benefitting about 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting about 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. All projects approved are disbursing. Operations in ECA and MNA are fully disbursed. In other regions, disbursements have reached: (i) LAC 97 percent, (ii) SAR 95 percent, (iii) EAP 87 percent, (iv) AFW 85 percent, and (v) AFE 79 percent. Disbursements for EAP operations are being affected by low disbursements in three country projects that have disbursed between 46 and 56 percent. AFE lower disbursements compared to other regions are a result of low disbursements under two operations, which have disbursed 55- 66 percent respectively. In the case of AFW low overall disbursements are a result of low disbursements under one operation (35 percent). Retroactive Financing (RF) represents 20 percent of commitments. SAR has the highest percentage of RF at 37 percent, followed by ECA 12/8/2023 Page 2 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) at 18 percent. Direct Payment (DP) disbursements represent 22 percent of commitments. EAP has the highest level of disbursements using DP – 80 percent, followed by AFW at 38 percent. IDA continues to represent 40 percent while IBRD represents 60 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts by counterparts and Bank teams have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations which have supported vaccine procurement and deployment efforts. COVID-19 MPA AF-V - ISR Write-up as of November 16, 2023 As of November 16, 2023, the Bank has approved 116 operations (including MPA-V operations) to support vaccine procurement and rollout in 78 countries amounting to $9.25 billion. The Senegal AF2 operation for $15 million financed by a Grant from The Global Finance Facility was approved on June 30, 2023. Also, a Second AF (IDA Grant of $1.50 million) was approved on August 31, 2023, for Sao Tome and Principe. One hundred and nineteen (119) operations had been approved amounting to $10 billion, but the: (i) Costa Rica operation ($120 million), (ii) Peru operation ($500 million), and (iii) Gabon operation ($12 million) were cancelled. The first two at the request of the governments and the third because the date of effectiveness lapsed. Also, the Afghanistan operation commitment of $113 million was reduced to $60 million. Partial cancellations have been processed in the past months under several operations, thereby the overall commitment has decreased in the past months. Of the 116 approved operations: (i) 66 are in Africa – 31 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. The 116 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. Thirty-two (32) operations are being implemented in Fragile and Conflict-affected situations. IDA represents 45 percent and IBRD 55 percent of disbursements. Total disbursements under these projects as of November 16, 2023, amount to US$6.31 billion or 68 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 have been/are being restructured and more will need to be restructured to reallocate funds allocated to procurement of COVID-19 vaccines and deployment. Guidance was issued under an Email from Juan Pablo Uribe of July 7, 2023, which provided direction for the use of undisbursed funds under COVID-19 operations. Four (4) operations are fully disbursed (Argentina, Indonesia, Sri Lanka AF-V 1, and Ukraine AF-V 3). Forty-eight (48) operations or 41 percent of operations approved have disbursed over 70 percent of their commitments. Out of the 48, eleven (11) operations have disbursed 95-99 percent. Ninety-five (95) operations or 82 percent of total operations approved are disbursing. ECA has the highest percentage of disbursements at 86 percent, followed by SAR and MNA at 77 percent, LAC at 76 percent, EAP at 74 percent, AFE at 59 percent and AFW at 57 percent. As of August 1, 2023, the World Bank had purchased 635.4 million doses of the COVID-19 vaccine of which 506.8 million had been delivered to client countries and 500.7 million administered. Retroactive Financing (RF) continues to represent 36 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%). All loan/financing agreements approved have been signed. As with the COVID-19 MPA operations, streamlined procedures, delegated approval, wide use of Bank Facilitated Procurement (BFP), coupled with flexible project design, and intensified efforts from counterparts and Bank staff have contributed to the rapid design, processing, and implementation of the AF-V operations. 12/8/2023 Page 3 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic High Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Moderate Substantial Substantial Stakeholders Low Low Low Other -- -- -- Overall Substantial Moderate Moderate Results PDO Indicators by Objectives / Outcomes Support detection and response efforts in the fight against COVID-19 IN01367440 ►Percentage of suspected cases of COVID-19 reported and investigated per approved protocols (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 96.00 96.00 90.00 Date 28-Feb-2020 31-May-2022 31-May-2022 29-Dec-2023 End- Project target has been achieved. Comments: IN01367471 ►Percentage of diagnosed cases treated per approved protocols (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 90.00 Date 28-Feb-2020 31-May-2022 31-May-2022 29-Dec-2023 End- Project target has been achieved. Comments: IN01367472 ►Percentage of acute healthcare facilities with increased isolation capacity (Percentage, Custom) 12/8/2023 Page 4 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 28-Feb-2020 31-Dec-2022 30-Jun-2023 31-Dec-2021 End- Project target has been achieved. Comments: IN01367473 ►Percentage of population vaccinated, which is included in the priority population targets, as defined in the NSVP for the Introduction of the Vaccine against COVID-19 (disaggregated by sex) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 61.27 49.46 32.70 Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. The target has been calculated based on the share of contracts financed by the WB and the assumption of a two-dose regiment. This target has been exceeded as most of the vaccines have been used to cover the second dose or the booster reinforce immunity. During Comments: supervision mission in June 2023, the measure of the indicator was revised to adjust the percentage to the share of contracts financed by the WB. IN01367474 ►Percentage of female population vaccinated, which is included in the priority population targets, as defined in the NSVP for the Introduction of the Vaccine against COVID-19 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 64.10 52.03 32.70 Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. The target has been calculated based on the share of contracts financed by the WB and the assumption of a two-dose regiment. This target has been exceeded as most of the vaccines have been used to cover the second dose or the booster reinforce immunity. During Comments: supervision mission in June 2023, the measure of the indicator was revised to adjust the percentage to the share of contracts financed by the WB. Intermediate Results Indicators by Components Emergency COVID-19 Response Efforts IN01367475 ►Number of laboratories conducting COVID-19 sample testing (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 35.00 35.00 24.00 Date 28-Feb-2020 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. Comments: IN01367476 ►Percentage of public hospitals with Intensive Care Units strengthened (Percentage, Custom) 12/8/2023 Page 5 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 74.24 86.90 90.00 Date 28-Feb-2020 31-Dec-2022 30-Jun-2023 31-Dec-2021 IN01367477 ►Percentage of public hospitals with Intensive Care Units that received training according approved protocols (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 87.34 87.34 80.00 Date 28-Feb-2020 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project Target has been achieved Comments: IN01367478 ►Percentage of participating hospitals with personal protective equipment and infection control products and supplies, provided (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 76.42 89.08 90.00 Date 28-Feb-2020 31-Dec-2022 30-Jun-2023 31-Dec-2021 IN01367479 ►AR COVID-19 Fatality Rate (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.40 1.40 2.50 Date 28-Feb-2020 28-Feb-2022 30-Jun-2022 29-Dec-2023 End- Project Target has been achieved Comments: IN01367480 ►Provincial Emergency Committees with multisectoral participation, including civil society organizations, created and operational” (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 70.83 70.83 70.00 Date 19-Mar-2020 31-Dec-2022 30-Jun-2023 29-Dec-2023 Percentage of provinces that implement an Emergency Committees ( COE) since the beginning of the pandemic, according to the guidelines of the Ministry of Health (MoH) with the participation of Civil Society Comments: Organizations (SCO) and/or private health sector representatives. End- Project target has been achieved. IN01367481 ►Number of doses of COVID-19 vaccine procured with Project funding (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30,026,331.00 33,397,056.00 30,000,000.00 12/8/2023 Page 6 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. Comments: IN01367482 ►Health staff trained in COVID-19 vaccination process according to protocols approved by the NMOH (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5,000.00 7,588.00 13,560.00 10,000.00 Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project Target has been achieved Comments: IN01367483 ►Percentage of provinces with updated vaccination plans to implement the NSVP against COVID-19 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 90.00 Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. Comments: IN01367484 ►Updated health management and information system to deploy a Pharmacovigilance strategy of AEFIs for COVID-19 vaccination with new guidelines according the NSVP and NMOH technical guidelines (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. Comments: IN01367485 ►New Communication strategies developed and disseminated in support of the NSVP (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. Comments: IN01367486 ►Share of women vaccinated against COVID-19 with at least one dose in the Northeastern region, in line with national average (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 51.00 85.80 85.60 59.00 Date 03-Aug-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 12/8/2023 Page 7 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) End- Project target has been achieved. The percentage is lower than the previously informed as the total Comments: population was adjusted to new information form the Population Census 2022. IN01367487 ►Share of women trained as vaccinators (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 79.00 79.00 60.00 Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. Comments: IN01367488 ►Share of female workers responsible for COVID-19 vaccination campaigns in Expanded Programs on Immunization (EPI) throughout the country (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.00 79.00 79.00 50.00 Date 30-Jun-2021 28-Feb-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. Comments: IN01367489 ►Population fully vaccinated included in the priority population targets defined in the NSVP and NMOH technical guidelines (total and disaggregated by sex) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 14.00 82.10 81.60 70.00 Date 30-Jun-2021 31-Dec-2022 30-Jun-2023 29-Dec-2023 End- Project target has been achieved. The percentage is lower than the previously informed as the total Comments: population was adjusted to new information form the Population Census 2022. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173767 IBRD-90830 Closed USD 35.00 35.00 0.00 35.00 0.00 100% P173767 IBRD-92920 Effective USD 500.00 500.00 0.00 498.20 1.80 100% Key Dates (by loan) 12/8/2023 Page 8 of 9 The World Bank Implementation Status & Results Report AR: COVID-19 Emergency Response Project (P173767) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173767 IBRD-90830 Closed 02-Apr-2020 05-May-2020 07-May-2020 29-Apr-2022 29-Apr-2022 P173767 IBRD-92920 Effective 30-Sep-2021 04-Oct-2021 06-Oct-2021 30-Apr-2024 30-Apr-2024 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) P177246-Additional Financing for the Argentina: COVID-19 Emergency Response Project 12/8/2023 Page 9 of 9