The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) STP COVID-19 Emergency Response Project (P173783) AFRICA EAST | Sao Tome and Principe | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 3 | ARCHIVED on 18-Oct-2021 | ISR47979 | Implementing Agencies: Ministry of Health, Democratic Republic of Sao Tome Key Dates Key Project Dates Bank Approval Date: 02-Apr-2020 Effectiveness Date: 06-Apr-2020 Planned Mid Term Review Date: 15-Jan-2022 Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2022 Revised Closing Date: 30-Jun-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in São Tomé e Príncipe. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1. Emergency COVID-19 Response:(Cost $8.44 M) Component 2. Strengthening Multi-sector, National institutions and platforms for policy development, and coordination of prevention and preparedness including One Health approach:(Cost $0.80 M) Component 3. Implementation Management and Monitoring and Evaluation:(Cost $0.70 M) Component 4. Contingent Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating High High Implementation Status and Key Decisions The 'STP Covid-19 Emergency Response' was approved on April 2, 2020 as part of the World Bank's response to the global COVID-19 pandemic and became effective on April 6, 2020. The project implementation is progressing as planned for all activities. The project has supported (i) the procurement of Personal Protective Equipment (PPEs) for surveillance teams at points of (including ports and airports), for healthcare workers, and laboratory technicians; (ii) procurement of laboratory equipment, reagents and commodities, and diagnostic equipment; (iii) the provision of durable medical equipment, surgical instruments, and other life-support equipment. 10/19/2021 Page 1 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) mpaTable Multiphase Programmatic Approach (MPA) Status mpaTableBody Progress on implementation of the SPRP MPA: The implementation of the MPA-funded projects continues to progress well. As of September 17, 2021, 87 MPA-projects have been approved providing a total commitment of US$4.2 billion. Disbursements during the past month have increased at a rapid pace. Forty-nine (49) country projects or 56% of projects approved have reached 70-100% disbursements. The projects benefit around 3.7 billion people or 50% of the global population. Of the 87 approved projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 12 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-one (81) or 93% projects are disbursing. Total disbursements as of September 17, 2021, amount to $2,901.9m or $2.9 billion or 69% of overall commitments. Streamlined procedures, delegated approval coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Several projects have/are being restructured to include vaccine related procurement. Implementation is being guided by Bank teams working in parallel in other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts in countries. Implementation continues to face challenges as many countries are still under different levels of lockdown or mobility restrictions and counterparts and Bank teams are operating from home or partially from home. Also, countries are phasing new waves of infections with the Delta variant spreading rapidly among populations. Most Bank teams continue to conduct implementation support missions virtually, which is challenging for both Bank teams and counterparts. This “virtual” world poses connectivity challenges as internet is not reliable in many countries, especially IDA countries. Notwithstanding challenges, the MPA is on track to achieving its PDO – to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements in just over 19 months attest to the strong implementation efforts of the Bank response thanks to the commitment of counterparts supported by Bank country teams. Progress on Implementation of the SPRP-AF (Vaccines): The Additional Financing (MPA AF-V) to the COVID-19 Strategic Preparedness and Response Program utilizing the Multiphase Programmatic Approach (“Global COVID-19 MPA”) was approved by the Board on October 13, 2021. The AF-V is significantly expanding Bank support to client countries for COVID-19 vaccination, with the aim to support vaccination of 1 billion people globally. The AF-V was approved with an envelope of US$12 billion ($6 billion from IDA and $6 billion from IBRD) in financing. This financing is critical to expand affordable and equitable financing for vaccine purchase and deployment. The AF-V is expected to enable vaccination for up to 750 million people, with potential surge capacity for an additional 250 million people in the poorest countries (depending on the delivered price of approved vaccines) while scaling support to strengthen immunization delivery, with design flexibility at the country level. The AF-V is a scale-up of planned vaccination activities already anticipated and supported under the Global COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. As of September 17, 2021, the Bank has approved 56 operations to support vaccine procurement and rollout in 54 countries amounting to $4.6 billion. The 56 AF-V operations approved, includes 3 operations that involved restructuring of parent projects (Philippines and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. One other parent project is being restructured in LAC. Of the 56 approved operations: (i) 30 are in Africa – 15 in AFE and 15 in AFW; (ii) 7 in East Asia; (iii) 6 in Europe and Central Asia; (iv) 4 in Latin America and the Caribbean; (v) 4 in Middle East and North Africa; and (vi) 5 in South Asia. Twenty-two (22) projects are disbursing. Total disbursements as of September 17, 2021, under these projects amount to US$500.1 million or 11% of overall commitments. As with the MPA operations, streamlined procedures, delegated approval, coupled with flexible project design and intensified efforts across the Bank contributed to the rapid design and processing of the operations. Fifty-two (52) loan/financing agreements have already been signed. Also, forty-one (41) loan/financing agreements have become effective; several others are expected to become effective in the coming days/weeks. Implementation of the AF-V operations, as with MPA operations is facing challenges as many countries are still under different levels of lockdown or mobility restrictions and counterparts and Bank teams are operating from home. 10/19/2021 Page 2 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Substantial High High Institutional Capacity for Implementation and Substantial High High Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial High High Results PDO Indicators by Objectives / Outcomes Emergency COVID-19 Response IN01031624 ►Country has activated their public health Emergency Operations Centre or a coordination mechanism for COVID-19 (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 The country has activated their public health Emergency Operations Centre or a coordination mechanism Comments: for COVID-19 (Center for Emergency and Catastrophe Operations – COMPREC). IN01031707 ►Percentage of suspected cases of COVID-19 cases that were investigated, laboratory confirmed and reported based on national guidelines; (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 90.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 This indicator is calculated using the following data. Numerator: suspected cases of COVID-19 cases that were investigated, laboratory confirmed and reported based on national guidelines. Denominator: Number Comments: of suspected COVID-19 cases. IN01031709 10/19/2021 Page 3 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) ►Percentage of population vaccinated, which is included in the priority population targets defined in national plan [disaggregated by sex] (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 49.50 70.00 Date 08-Feb-2021 08-Feb-2021 20-Jun-2021 28-Jun-2024 Health System Strengthening IN01031625 ►Percentage of acute healthcare facilities with isolation capacity (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 50.00 50.00 60.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 This indicator captures the number of health care facilities with isolation capacity over total number of Comments: health care facilities in country. IN01031708 ►Country adopted personal and community non-pharmaceutical interventions (school closures, telework and remote meetings, reduce/cancel mass gatherings) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 85.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 The preventive interventions were implemented by the country during the State of Emergency and the Public Calamity that was in effect from March to September 2020. This included 100% of school closures Comments: and 100% of public and private institutions practicing remote work. Implementation Management and Monitoring and Evaluation IN01031706 ►M&E system established to monitor COVID-19 preparedness and response plan (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 M&E system established to monitor COVID-19 preparedness and response plan. The PIU has hired an Comments: M&E specialist who coordinates data collection, inputs, and analysis with the MOH team. Intermediate Results Indicators by Components Comp 1. Emergency COVID-19 Response IN01031711 ►Number of health staff trained in infection prevention and control per MOH-approved protocols (disaggregated by sex) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,000.00 1,000.00 2,500.00 10/19/2021 Page 4 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 IN01031714 ►Country has prepared a referral system to care for COVID-19 patients (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 Referral system to care for COVID-19 patients in place and patients being referred per protocol. Comments: IN01031716 ►Number of designated laboratories with staff trained to conduct COVID-19 diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 2.00 3.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 The island of Principe does have a laboratory that is equipped, however, it lacks the Cabin certification which can be completed with the arrival of an international expert expected in the first semester of 2021. Once this laboratory is certified, the country will have two laboratories with staff trained to conduct Comments: COVID-19 diagnosis. IN01031717 ►Percentage of eligible households provided with food and basic supplies within quarantined populations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 Information is still being collected and will need to be consolidated and cross-checked with the Social Protection project. This indicator is calculated with the following information: Numerator: number eligible households provided with food and basic supplies within quarantined populations Denominator: number of Comments: eligible households. IN01031718 ►Number of refurbished/upgraded health facilities implementing customer satisfaction survey (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 20.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 There is an absolute need to implement this at the level of all health units once, as of the second trimester of 2021. The roll-out of this activity is in the plan of the Ministry of Health director. This indicator captures Comments: the number of refurbished health facilities implementing customer satisfaction survey. IN01031719 ►Community Health workers trained in event based surveillance for COVID-19 and other epidemic-prone diseases (disaggregated by sex) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 150.00 10/19/2021 Page 5 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Date 21-Aug-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 This is one of the three indicators that was introduced as part of the first Additional Financing that was approved on November 10, 2020. The project team will be reporting on this indicator for the next ISR to Comments: allow sufficient time for data collection. IN01031720 ►Laboratory technicians trained on COVID19 diagnosis as well as in 5 key priority diseases as per the IHR (2005) (disaggregated by sex) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 10.00 Date 21-Aug-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 This is one of the three indicators that was introduced as part of the first Additional Financing that was approved on November 10, 2020. The project team will be reporting on this indicator for the next ISR to Comments: allow sufficient time for data collection. IN01031721 ►Percentage of PHC facilities implementing exit surveys in a one-year period, present to MOH, and implement action plan to address issues as part of Project Operational Plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 100.00 Date 21-Aug-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 This is one of the three indicators that was introduced as part of the first Additional Financing that was approved on November 10, 2020. The project team will be reporting on this indicator for the next ISR to Comments: allow sufficient time for data collection. IN01031722 ►A National Deployment and Vaccination Plan (NDVP) implemented with input from relevant bodies (Text) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 08-Feb-2021 08-Feb-2021 20-Jun-2021 28-Jun-2024 IN01031723 ►Vaccine stock management tools and operating procedures updated to reflect the characteristics of COVID-19 vaccines. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 08-Feb-2021 08-Feb-2021 20-Jun-2021 28-Jun-2024 IN01031724 ►Effective Vaccine Management assessments implemented with composite scores of 80% or higher (Text) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 08-Feb-2021 08-Feb-2021 20-Jun-2021 28-Jun-2024 IN01031725 ►Community engagement plan implemented for increasing demand creation for the Covid-19 vaccine by the population (Text, Custom) 10/19/2021 Page 6 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 08-Feb-2021 08-Feb-2021 20-Jun-2021 28-Jun-2024 IN01031726 ►Pharmacovigilance System (PVS) adapted to detect Adverse Events Following Vaccination (AEFI) for the COVID-19 vaccine (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 08-Feb-2021 08-Feb-2021 20-Jun-2021 28-Jun-2024 Comp 2. Strengthening multi-sector coordination & platforms for policy including One Health approach IN01031710 ►At least one multi- sectoral simulation exercise conducted by the EOC with results incorporated into national COVID-19 preparedness and response plans (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2.00 2.00 2.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 Two multi- sectoral simulation exercise were conducted by the EOC and results were incorporated into national COVID-19 preparedness and response plans. Two additional simulation exercises are planned in Comments: the first half of this calendar year. IN01031713 ►At least two meetings per year of an intersectoral committee on One Health (MoH, Ministry of Agriculture, Ministry of Environment) to ensure strengthened surveillance in the human-health-environment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 4.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 The committee exists and has met once with the goal being to promote at least two meetings across 2021 Comments: on the "One Health" strategy and approach. Implementation Management and Monitoring and Evaluation IN01031712 ►Percentage of monthly and quarterly project M&E reports submitted on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 70.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 The M&E report was submitted as part of the project report shared with the team in December 2020. Comments: IN01031715 ►Number of annual progress reports submitted complete and on time (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 10/19/2021 Page 7 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Value 0.00 1.00 1.00 2.00 Date 27-Mar-2020 31-Dec-2020 20-Jun-2021 30-Jun-2022 An annual progress report was submitted. Comments: Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173783 IDA-D6060 Effective USD 2.50 2.50 0.00 2.36 0.32 88% P173783 IDA-D8130 Effective USD 3.00 3.00 0.00 0.68 2.42 22% P173783 TF-B3913 Closed USD 0.94 0.94 0.00 0.94 0.00 100% P173783 TF-B5690 Effective USD 3.50 3.50 0.00 0.23 3.27 6.5% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173783 IDA-D6060 Effective 02-Apr-2020 06-Apr-2020 06-Apr-2020 30-Jun-2022 30-Jun-2022 P173783 IDA-D8130 Effective 13-May-2021 31-May-2021 28-Jun-2021 30-Jun-2024 30-Jun-2024 P173783 TF-B3913 Closed 09-Dec-2020 15-Dec-2020 15-Dec-2020 31-Jan-2021 31-Jan-2021 P173783 TF-B5690 Effective 31-May-2021 31-May-2021 28-Jun-2021 30-Jun-2024 30-Jun-2024 Cumulative Disbursements 10/19/2021 Page 8 of 9 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Restructuring History There has been no restructuring to date. Related Project(s) P174880-Additional Financing to STP COVID-19 Emergency Response Project ,P176152-STP COVID-19 Emergency Response Project, Second Additional Financing 10/19/2021 Page 9 of 9