The World Bank Report No: ISR2113 Implementation Status & Results Romania Public Disclosure Copy Avian Influenza Control & Human Pandemic Preparedness & Response Project (P100470) Operation Name: Avian Influenza Control & Human Pandemic Preparedness & Project Stage: Implementation Seq.No: 10 Status: ARCHIVED Last Modified Date: 29-Dec-2010 Response Project (P100470) Country: Romania Approval FY: 2007 Product Line: IBRD/IDA Region: EUROPE AND CENTRAL ASIA Lending Instrument: Emergency Recovery Loan Implementing Agency(ies): Ministry of Health, National Agency for Sanitary, Veterinary and Food Safety (ANSVSA) Key Dates Board Approval Date 08-Sep-2006 Original Closing Date 31-Dec-2009 Planned Mid Term Review Date 18-Aug-2008 Last Archived ISR Date 28-Jun-2010 Effectiveness Date 19-Mar-2007 Revised Closing Date 31-Dec-2010 Actual Mid Term Review Date 24-Nov-2008 Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the Project is to assist the Borrower in building its capacity to respond to potential future infections of humans by HPAI and other zoonoses, and preparing for, controlling and responding to influenza pandemics and other infectious disease emergencies in humans. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component 2. Human Health 28.36 Component 3. Public Awareness, Communications and Implementation Support 1.55 Overall Ratings Public Disclosure Copy Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating Implementation Status Overview Though no human cases of Avian Influenza have been reported to date, the project has been successful in building the necessary capacity for the country to respond to threats that may arise. However, some activities will not be completed by project closing, including the rehabilitation works at the vaccine production unit of the Cantacuzino Institute (CI). Despite this, the vaccine production capacity nevertheless increased more than two-fold after installation of part of the processing equipment (from an average of 30 doses of trivalent influenza vaccine produced per week in 2007-2008 to 79 doses per week in 2008-2009). Page 1 of 9 The World Bank Report No: ISR2113 The project has been successful in starting the upgrading of the National Influenza Laboratory (NIL) at the CI to a Bio-Safety Level (BSL 3) facility. All equipment for the Intensive Care Units (ICU) of the 2 main infectious disease hospitals in Bucharest and 7 regional hospitals have been delivered and almost all with the exception of ICU beds have been Public Disclosure Copy installed and are in use. Results Project Development Objective Indicators Indicator Baseline Current End Target Indicator Name Value Value Value Appropriate contingency plans for avian influenza and human influenza Plans incomplete and lacking Indicator eliminated in July 2009 Appropriate plans exist and are pandemic prepared; and effective capacity to implement these plans coordination, needing substantial restructuring. officially approved / issued. built. upgrading. Mechanisms and Effectivemechanisms with Date capacities for plan implementation demonstrated capacity for plan Type Unit of Measure are weak. 16-Dec-2009 implementation are in place. Custom Indicator Text Date Comment Date 29-Jun-2006 31-Aug-2009 Comment Comment Indicator Baseline Current End Target Indicator Name Value Value Value HPAI outbreaks in poultry effectively contained. 183 outbreaks between October Indicator eliminated in July 2009 HPAI outbreaks in poultry are 2005 and June 2006. Effectivity of restructuring. effectively contained (actual prevention of and response to Date outbreaks or simulation exercises). HPAI outbreaks in poultry needs to Date Type Unit of Measure be improved. 16-Dec-2009 Comment 31-Aug-2009 Custom Indicator Text Date Comment 29-Jun-2006 Public Disclosure Copy Comment Page 2 of 9 The World Bank Report No: ISR2113 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Production capacity for human influenza vaccines (to reduce the risk of No human cases as of July 5, Indicator eliminated in July 2009 Additional vaccine production infection) and capacity for infectious disease treatment are improved. 2006. Vaccine production capacity restructuring. capacity built and fully operational, is limited (< 1 million doses). ICU Date andICU capacities for infectious capacity for infectious disease diseases improved. Type Unit of Measure treatment limited. 16-Dec-2009 Date Custom Indicator Text Date Comment 31-Aug-2009 05-Jul-2006 This indicator was rephrased in the restructuring project paper, and Comment Comment more explicitly broken down in 2. According to the board approved- updated results framework, progress towards the DO is measured by looking at a) whether there are human cases of Avian Flu and b) the completion of the vaccine production line renovation to increase capacity. Indicator b) is also listed among intermediate results indicator. Indicator Baseline Current End Target Indicator Name Value Value Value Number of Human Cases of Avian Influenza 0.00 0.00 0.00 Date Date Date 31-Dec-2006 22-Dec-2010 31-Dec-2010 Type Unit of Measure Comment Comment Comment Custom Indicator Number Target met. This indicator was made explicit in July 2009 Public Disclosure Copy restructuring. Page 3 of 9 The World Bank Report No: ISR2113 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Vaccine production increases Vaccine production capacity is Influenza vaccine production Vaccine production has increased limited (< 1 million doses) capacity has improved from 30 (no numerical target set) Date doses per week in 2008 to 79 Date doses per week in 2009 Type Unit of Measure 31-Dec-2006 31-Dec-2010 Date Custom Indicator Text Comment Comment 22-Dec-2010 Comment Target met. This indicator was made explicit in July 2009 restructuring. Intermediate Results Indicators Indicator Baseline Current End Target Indicator Name Value Value Value Enhanced effectiveness of disease control at county level. Mobility, institutional structure and Indicator eliminated in July 2009 Local veterinary staff fully skilled skill level of local veterinary staff restructuring. and equipped for timely response, insufficient. Date and enhanced effectiveness of Date disease control demonstrated in Type Unit of Measure 16-Dec-2009 real outbreaks or simluation 29-Jun-2006 Comment exercises. Custom Indicator Text Comment Date 31-Aug-2009 Comment Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value County laboratories provide timely (according to EC legislation and OIE Time between sampling and Indicator eliminated in July 2009 Recommended time threshold guidelines) disease diagnoses. diagnostic result above restructuring. observed on routine basis. recommended threshold(24 hours). Date Date Date 16-Dec-2009 31-Aug-2009 Type Unit of Measure 29-Jun-2006 Comment Comment Custom Indicator Text Comment Page 4 of 9 The World Bank Report No: ISR2113 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Efficient animal disease information system operational in compliance Existing systems are not Indicator eliminated in July 2009 Information system established with EC legislation and OIE guidelines. comprehensive and not integrated. restructuring. and fully operational and staff Date Date being trained. 29-Jun-2006 16-Dec-2009 Date Type Unit of Measure Comment Comment 31-Aug-2009 Custom Indicator Text Comment Indicator Baseline Current End Target Indicator Name Value Value Value Quarantine, culling and disposal measures are improved, in Technical capacity for outbreak Indicator eliminated in July 2009 Trained staff have new equipment accordance with environmental and animal welfare guidelines. control (quarantine, culling, restructuring. that is fully operational, enabling disposal)needs improvement. Date outbreak control measures in line Date with applicable guidelines. Type Unit of Measure 16-Dec-2009 29-Jun-2006 Date Custom Indicator Text Comment Comment 31-Aug-2009 Comment Indicator Baseline Current End Target Indicator Name Value Value Value Behavioral & managerial changes to higher bio-security in small-holder Low bio-security level in small- Indicator eliminated in July 2009 Farmers aware of options for poultry systems, after development of and consultations for bio-security holder poultry production systems. restructuring. increased bio-security in small- investments and implementation of awareness campaigns. holder poultry production systems, Date Date and some farmers start to Type Unit of Measure 29-Jun-2006 16-Dec-2009 implementsome of their options of Comment Comment choice. Public Disclosure Copy Custom Indicator Text Date 31-Aug-2009 Comment Page 5 of 9 The World Bank Report No: ISR2113 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Strengthened (human health) surveillance and laboratory capacity. Good capacity at the central level. Civil works for the NIL at the CI for National Influenza Laboratory Capacity at the regional and district a Bio-Safety Level (BSL 3) facility upgraded to BSL3 3 & regional level needs to be strengthened. completed labs equipped with r eal time PCR Date Date and staff training. Type Unit of Measure Date 29-Jun-2006 29-Dec-2010 Custom Indicator Text 31-Dec-2010 Comment Comment Target met Comment Indicator Baseline Current End Target Indicator Name Value Value Value Strengthened health care response capacity - vaccination. Current vaccine production Influenza vaccine production Vaccine production unit at the capacity is limited (< 1 million capacity has improved from 30 Cantacuzino Institute upgraded. doses) and needs to be developed. doses per week in 2008 to 79 Date Date doses per week in 2009 Type Unit of Measure 31-Dec-2010 29-Jun-2006 Date Custom Indicator Text Comment Comment 22-Dec-2010 Comment Target met Indicator Baseline Current End Target Indicator Name Value Value Value Strengthened health care response capacity - ICUs. Insufficient isolation capacity at All equipment delivered to all Infectious disease hospitals (2) in central and regional level. hospitals and almost all installed Bucharest upgraded and ICUs in Date and in use regional hosp itals (7) built and Date operational. Type Unit of Measure 29-Jun-2006 Public Disclosure Copy 22-Dec-2010 Date Custom Indicator Text Comment Comment 31-Dec-2010 Target met Comment Page 6 of 9 The World Bank Report No: ISR2113 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Political and civic leadership organized around a national strategic risk AI Contingency Plan to be revised Indicator eliminated in July 2009 100% complete communication plan. to include a National Strategic Risk restructuring. Date Communication Plan. Date 31-Aug-2009 Date 16-Dec-2009 Type Unit of Measure Comment 29-Jun-2006 Comment Custom Indicator Text Comment Indicator Baseline Current End Target Indicator Name Value Value Value Awareness-raising and behavior change interventions adapted to 25% of knowledge, attitude and Indicator eliminated in July 2009 100% complete population at risk using appropriate communications channels. practices studies and design of restructuring. Date communications products Date implemented. 31-Aug-2009 Type Unit of Measure 16-Dec-2009 Comment Date Custom Indicator Text Comment 31-Jul-2006 Comment Indicator Baseline Current End Target Indicator Name Value Value Value Program Planning and coordination enhanced (Human Health) Plan exists but needs further Plan updated and made public. Plan operationalized and public development and Date health services improved. operationalization. Chain of Date comma nd needs clarification and 16-Dec-2009 Type Unit of Measure coordination enhancement. Comment 31-Dec-2010 Comment Public Disclosure Copy Custom Indicator Text Date Target met. This activity was 31-Jul-2006 undertaken by the Ministry of Health in July 2009 in view of the Comment H1N1 pandemic but not funded throughthe project. Page 7 of 9 The World Bank Report No: ISR2113 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Health facilities constructed, renovated, and/or equipped 0.00 9.00 9.00 Date Date Date 31-Dec-2006 22-Dec-2010 31-Dec-2010 Type Unit of Measure Comment Comment Comment Core Indicator Number No isolation units for the Target met. All equipment 2 in Bucharest and 7 in regions management of highly contagious delivered and almost all is installed ICU patients in use in the 2 hospitals in Bucharest and the 7 regional infectious disease hospitals Data on Financial Performance (as of 29-Dec-2010) Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P100470 IBRD-48390 Effective 08-Sep-2006 05-Oct-2006 19-Mar-2007 31-Dec-2010 Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P100470 IBRD-48390 Effective USD 37.70 27.89 9.81 17.68 11.90 63.00 Disbursement Graph Public Disclosure Copy Page 8 of 9 The World Bank Report No: ISR2113 Public Disclosure Copy Key Decisions Regarding Implementation The project will close as scheduled on December 31, 2010. The portion of unused credit funds for the incomplete activities of approximately 4.2 million Euros will be canceled. Restructuring History Board Approved on 28-Jul-2009 Related Projects There are no related projects. Public Disclosure Copy Page 9 of 9