Jr riliL SATU HAHKONEN Country Director, Indonesia and Timor Leste OUT3 Letter No. 223/WB/XII/2022 December 16, 2022 Mr. Suminto Director General of Budget Financing and Risk Management Ministry of Finance Gd. Frans Seda Jl. DR. Wahidin Raya No. 1 Jakarta Pusat Dear Mr. Suminto, Republic ofIndonesia: IBRD Loan No. 9263-ID Additional Financingfor Indonesia Emergency Response to CO VID-19 Program Amendment to the Loan Agreement We refer to the loan agreement between the Republic of Indonesia ("Borrower") and the International Bank for Reconstruction and Development ("Bank") dated June 25, 2021 (the "Loan Agreement") for the Additional Financing for Indonesia Emergency Response to COVID-19 Program ("Program"). We also refer to your letter No. S- l 94/MK.8/2022 dated September 28, 2022 requesting revisions to several Disbursement Linked Results (DLRs) and an extension of the Closing Date. After due consideration, the Bank concurs with your requests. Accordingly, the Bank hereby proposes to amend the Loan Agreement by way of this letter ("Amendment Letter") all as set out below: 1. The table under Section IV.A.2 of Schedule 2 to the Loan Agreement is deleted in its entirety and replaced by the table set forth in Attachment 1 to this Amendment Letter. 2. Section IV.B.4 of Schedule 2 to the Loan Agreement is deleted in its entirety and replaced by the following: "The Closing Date is June 30, 2023." Unless the context otherwise requires and except where otherwise defined in this Amendment Letter, all capitalized terms contained herein shall have the meanings given to them in the Loan Agreement. Except as specifically set out in this Amendment Letter, all terms and conditions in the Loan Agreement remain unchanged. 1818 H Street NW, Washington DC 20433 USA 2 Please confirm your agreement to the foregoing on behalf of the Borrower by countersigning and dating both copies of this Amendment Letter in the space provided below, and returning one fully countersigned original of this Amendment Letter to the Bank. Subject to the Bank's receipt of this Amendment Letter duly countersigned by an authorized representative of the Borrower, the above amendments to the Loan Agreement shall become effective on the date of such countersignature. Sincerely INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT {, • .-~ By _ Satu Kahkonen Country Director, Indonesia and Timor-Leste CONFIRMED: REPUBLIC OF INDONESIA By: Name: Title: rte(o Genera\] c}et_Fran«r ps toa@rent Date: De@ bor 2€, 2022 1818 H Street NW, Washington DC 20433 USA 3 Attachment 1 Category isbursement Linked Amount of the Formula (including Disbursement Result (as applicable) Loan Linked Indicator as Allocated applicable) (expressed in USO) (1) DLI # 1 : Specific DLR #1.2: The 40,000,000 DLR#l.2: additional measures to Implementation Guidelines $40,000,000 support and compensate for Health Professionals' health professionals for Support for COVID-19 Unit Price: $3,333,333 added COVID-19 related response remain in place and per calendar month in workload and risk are the payment of benefits has 2021 that the implemented been continued in 2021. Implementation Guidelines for Health Professionals' Support for COVID-19 response remain in place and the payment of benefits has been continued. (2) DLI #3: DLR#3.3: 10,000,000 DLR#3.3: Increased capacity for MOH has: (a) completed $10,000,000 patient isolation and payment processing of at least medical care 90% of eligible and verified Baseline: 0 hospital claims for treating COVID-19 patients during the Unit Price: calendar year of 2021; and (b) $2,500,000 for every published and disseminated a calendar quarter of 2021 that comprehensive guideline on the Target is met. hospital claims processing for Target: In each calendar hospitalized COVID-19 cases, quarter of 2021, at least all by December 30, 2022. 90% of hospital claim payments for treating COVID-19 patients have been received by the hospital within 10 business days after the receipt of the verification for such claims by MOH DLR#3.4: Number of COVID-19 60,000,000 DLR #3.4: patients with moderate to $60,000,000 severe illnesses that receive hospitalization and have their Baseline: 0 claims paid for by the MOH, on or after the date of signature Unit Price: $300 for each of this Agreement. claim paid foTCOVID-I9 patients receiving free hospital treatment, up to the Target. Target: 200,000 patients 18 18 H Street NW, Washington DC 204 3 3 USA 4 (3) DLI #4: Health DLR #4.2: 2000 additional 50,000,000 DLR#4.2: facilities' readiness for thigh care beds in existing $50,000,000 emergency response medical facilities outside Jakarta are equipped to Baseline: 2355 manage severe respiratory illnesses pursuant to the Unit Price: $25,000 per National Protocol (of which at high care bed fully least 50% are equipped with equipped pursuant to the ventilators) National Protocol, up to 2,000 new beds over and above the Baseline. (4) DLI #7: Installed DLR #7.3: Borrower has tested 45,000,000 DLR#7.3: capacity of quality- 1 person per 1 000 population $45,000,000 assured COVID-19 per week (including confirmatory tests per day polymerase chain reaction Unit Price: (PCR), rapid molecular and $3,000,000 per new rapid antigen tests) in the Additional Province Additional Provinces. where 1 person per 1000 population per week is tested up to the Target. Target: 15 Additional Provinces. DLR #7.4: The Borrower 51,000,000 DLR #7.4: $51,000,000 lhas introduced Rapid [Antigen Testing in all Baseline: 0 Provinces Provinces. Unit Price: $1,500,000 per Province that has completed the first 10,000 Rapid Antigen Testing up to the Target. Target: 34 Provinces DLR# 7.5: The Borrower is 15,000,000 DLR# 7.5: $15,000.000 undertaking regular genomic surveillance for Unit Price: $5,000,000 variants of the COVID-19 per calendar semester in virus which at least 300 samples are tested per semester for genomic variants of the COVID- 1818 H Street NW, Washington DC 20433 USA 5 19 virus during the Target period Target: January 2021 to June 2022. (5) DLI #9: DLR #9.2: By no later than 10,000,000 DLR#9.2: Communications strategy on September 30, 2021, MOH $10,000,000 COVID-19 based on has updated the experience and lessons- communication strategy for learned information on COYID-19 vaccines, their rollout, eligibility, and grievance redress as well as adverse event information (6) DLI # 11: Assess and DLR #11.1: 10,000,000 DLR#ll.l: plan actions to address gaps By no later than October 31, $10,000,000 in supply chain and 2021, the Borrower has logistics for maintaining the developed an action plan to cold chain for storage and address identified gaps in distribution of vaccines. the supply chain and logistics for maintaining the cold chain from points of entry to points of service for vaccines DLR #11.2: The Borrower 15,000,000 DLR #l l .2(a): has deployed remote $15,000,000 temperature monitoring devices in vaccine storage Baseline: 0 Unit locations (not including Jakarta) and specifically: Price: (a) remote temperature $150,000 for each monitoring is installed and percentage point of functioning at the Province Identified Districts where and district level; remote temperature monitoring is installed and functioning at the Province and district level. 15,000,000 DLR #l l .2(b): (b) remote temperature monitoring is installed and $15,000,000 functioning at the Puskesmas level; Baseline: 0 1818H Street NW Washinoton IC 90433 1IA 6 Unit Price: $150,000 for each percentage point of Identified Districts where remote temperature monitoring is installed and functioning at the Puskesmas up to the Target Target: all Identified Districts (c) end to end supply chain 15,000,000 DLR#l 1.2(c): management and logistics $15,000,000 information system is functional (at least for Unit Price: $7,500 per COVID-19 vaccines) and Puskesmas where end to regularly in use in 2000 end supply chain Puskesmas as of March 31, management and 2023. logistics information system is functional (at least for COVID-19 vaccines) and regularly in use, as of March 3 1, 2023. 1818 H Street NW, Washington DC 20433 USA I (7) DLI #12: Maintaining DLR #12.1: By no later 10,000,000 DLR #12.1: unintended impact of than July 31, 2021, the $10,000,000 COVID response on Borrower has developed a essential non-COVID deployment/mobilization health services plan for ongoing COVID- 19 response and mass vaccination in a manner that preserves a share of staffing to maintain Essential Non- COVID Health and [Nutrition Services. DLR #12.2: The Borrower 20,000,000 DLR#l2.2: has confirmed that $20,000,000 appropriate capacity building/ training of human Baseline: No districts resources for COVID-19 vaccine delivery has been Unit Price: $40,000 per carried out. district that has confirmed that appropriate capacity building/training of human resources for COVID-19 vaccine delivery has been carried out up to the Target Target: 500 districts DLR #12.3: Essential Non- 69,000,000 DLR #12.3: COVID Health and $69,000,000 Nutrition Services are utilized at more than 90% Baseline: DLR #12.3 of pre-COVID utilization, Baseline (see except for the tuberculosis Appendix) program, which is utilized 82% or higher of pre- Unit Price: $3,000,000 COVID utilization per calendar quarter for each program achieving the Target Target: program is utilized at more than 90% ofpre-COVID utilization, except for the tuberculosis program, which is utilized at 82% or 1818 H Street NW, Washington DC 20433 USA 8 higher of pre-COVID utilization: (a) in 3 quarters between April 2021 and March 2023 in the case of the nutrition program; and (b) in each quarter between April 2021 and March 2023 for all other programs (8) DLI #13: Vaccine DLR #13 .I: The Borrower 5,000,000 DLR #13.1: $5,000,000 prioritization and has developed fair and distribution is based on equitable criteria for pre-determined, fair and prioritization and objective criteria. distribution of COVID-19 vaccines across its geographical areas through a consultative and transparent process. DLR #13.2: As of 10,000,000 DLR #13.2: September 30, 2021, the $10,000,000 prioritization, deployment and distribution ofCOVID- 19 vaccines has conformed to the fair and equitable criteria referred to in DLR #13.1 . DLR #13.3: As of 10,000,000 DLR #13.3: December 31, 2021, the $10,000,000 prioritization, deployment and distribution of COVID- 1 9 vaccines has conformed to the fair and equitable criteria referred to in DLR 13.1 1818 H Street NW, Washington DC 20433 USA (9) DLI #14: A DLR #14.1: The Borrower 10,000,000 DLR #14.1: pharmacovigilance has developed and $10,000,000 system is in place to report implemented a adverse events in a pharmacovigilance system timely manner to monitor any adverse events related to the COVID-19 vaccine(s). DLR 14.2: As of September 15,000,000 DLR # 14.2: 15,000,000 30, 2021, the pharmacovigilance system has been implemented and is functioning in accordance with the ITAGI Guidance, to monitor any adverse events related to the COVID-19 vaccine. DLR 14.3: As of March 31, 15,000,000 DLR #14.3: 2022, the 15,000,000 pharmacovigilance system has been implemented and is functioning in accordance with the ITAGI Guidance, to monitor any adverse events related to the COVID-19 vaccine. TOTAL AMOUNT 500,000,000 1818 H Street NW, Washington DC 20433 USA