The World Bank Report No: ISR12968 Implementation Status & Results India India: National Vector Borne Disease Control & Polio Eradication Support Project (P094360) Public Disclosure Copy Operation Name: India: National Vector Borne Disease Control & Polio Project Stage: Implementation Seq.No: 11 Status: ARCHIVED Archive Date: 25-Dec-2013 Eradication Support Project (P094360) Country: India Approval FY: 2009 Product Line: IBRD/IDA Region: SOUTH ASIA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 31-Jul-2008 Original Closing Date 31-Dec-2013 Planned Mid Term Review Date 18-Apr-2011 Last Archived ISR Date 15-Nov-2013 Effectiveness Date 06-Mar-2009 Revised Closing Date 31-Dec-2013 Actual Mid Term Review Date 02-May-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to enhance the effectiveness of government response to control malaria, eliminate kala azar and eradicate polio. This will be achieved by an increase in the number of people benefiting from effective prevention, diagnosis and treatment services for malaria and kala azar, and vaccination against polio. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Improving access to and use of services for control of malaria 146.50 Improving access to and use of services for kala azar elimination 51.40 Policy and strategy development and monitoring and evaluation 52.10 Supply of polio vaccine 271.00 Public Disclosure Copy Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating Implementation Status Overview Implementation progress and the achievement of PDOs under the project had consistently been rated moderately satisfactory/satisfactory over the past 3 years, despite periodic interruptions in procurement, issues with the hiring and retention of staff, and delays in M&E. This was due to the observed increases in the utilization of public services at the national Page 1 of 11 The World Bank Report No: ISR12968 level, decreases in disease prevalence and mortality resulting from malaria and kala azar, and the landmark progress made on the eradication of polio in India. On the vector borne components, available evidence suggested that the increased utilization of services and the decreases in prevalence and mortality were correlated with the improved use of project inputs for the diagnosis and treatment of malaria and kala azar, effective Indoor Residual Spraying (IRS), IEC/BCC activities and effective monitoring and supervision. The recruitment of critical technical and monitoring staff, such as the VBD Consultants and the malaria/kala azar Technical Supervisors at the district and sub-district level, were also Public Disclosure Copy perceived to be contributing to the success of the disease control efforts - in fact, given the progress made, these technical positions have now been integrated, as part of the 12th Five-Year Plan, into the national vector borne disease programs under NRHM. The polio component, in turn, has been very successful, contributing to India now being taken off the list of polio-endemic countries. Over the past year, however, the observed improvements on malaria and kala azar have stalled, due primarily to issues with the vector control activities, as well as the recent significant delays in the procurement of commodities - such as LLINs, ACT Combipacks and Miltefosine capsules - under the project, which have preempted the effective implementation of the two national programs. Locations Country First Administrative Division Location Planned Actual India Bengal West Dinajpur India State of Andhra Pradesh Vishakhapatnam India State of Bihar Vaishali India State of Gujarat Vadodara India Bengal Twenty-four Parganas India State of Karnataka Tumkur India State of Maharashtra Thane India State of Chhattisgarh Surguja India State of Gujarat Surendranagar India State of Gujarat Surat India State of Orissa Sundargarh Public Disclosure Copy India State of Andhra Pradesh Srikakulam India State of Bihar Siwan India State of Bihar Sitamarhi India State of Jharkhand Pashchim Singhbhum India State of Madhya Pradesh Sidhi India State of Madhya Pradesh Shivpuri Page 2 of 11 The World Bank Report No: ISR12968 Country First Administrative Division Location Planned Actual India State of Madhya Pradesh Shahdol Public Disclosure Copy India State of Madhya Pradesh Seoni India State of Madhya Pradesh Satna India State of Bihar Saran India State of Orissa Sambalpur India State of Bihar Samastipur India State of Bihar Saharsa India State of Madhya Pradesh Sagar India State of Madhya Pradesh Ratlam India State of Jharkhand Ranchi India State of Gujarat Rajkot India State of Madhya Pradesh Rajgarh India State of Chhattisgarh Raipur India State of Chhattisgarh Raigarh India State of Karnataka Raichur India State of Bihar Purnia India State of Bihar Purba Champaran India State of Bihar Patna Public Disclosure Copy India State of Bihar Pashchim Champaran India State of Madhya Pradesh Panna India State of Bihar Nalanda India Bengal Nadia India Bengal Nadia India State of Bihar Muzaffarpur India State of Bihar Munger Page 3 of 11 The World Bank Report No: ISR12968 India State of Orissa Mayurbhanj India State of Madhya Pradesh Mandla Public Disclosure Copy India Bengal Maldah India State of Bihar Madhubani India State of Orissa Koraput India State of Karnataka Kolar India State of Gujarat Kheda India State of Andhra Pradesh Khammam India State of Orissa Keonjhar India State of Orissa Kalahandi India State of Gujarat Kachchh India State of Gujarat Junagadh India State of Gujarat Junagadh India State of Madhya Pradesh Jhabua India State of Madhya Pradesh Jabalpur India Bengal Hugli India State of Madhya Pradesh Guna India State of Maharashtra Greater Bombay India State of Bihar Gopalganj Public Disclosure Copy India State of Andhra Pradesh East Godavari India State of Chhattisgarh Durg India State of Madhya Pradesh Dhar India State of Jharkhand Dhanbad India Bengal Darjiling India State of Bihar Darbhanga Page 4 of 11 The World Bank Report No: ISR12968 India State of Karnataka Dakshin Kannad India State of Karnataka Chitradurga Public Disclosure Copy India State of Madhya Pradesh Chhindwara India State of Maharashtra Chandrapur India Bengal Birbhum India State of Chhattisgarh Bilaspur India State of Bihar Bhojpur India State of Bihar Bhagalpur India State of Madhya Pradesh Betul India State of Karnataka Belgaum India State of Bihar Begusarai India State of Chhattisgarh Bastar India Bengal Barddhaman India State of Madhya Pradesh Balaghat India State of Gujarat Ahmadabad India State of Maharashtra Garhchiroli India State of Maharashtra Raigarh India State of Bihar Supaul India State of Bihar Araria Public Disclosure Copy India State of Andhra Pradesh Vizianagaram India State of Madhya Pradesh Korba India State of Madhya Pradesh Dhamtari India State of Madhya Pradesh Dantewada India State of Madhya Pradesh Kanker India State of Bihar Simdega Page 5 of 11 The World Bank Report No: ISR12968 India State of Bihar Godda India State of Bihar Dumka Public Disclosure Copy India State of Bihar Latehar India State of Bihar Lohardaga India State of Madhya Pradesh Dindori India State of Orissa Jharsuguda India State of Orissa Kandhamal India State of Orissa Malkangiri India State of Orissa Rayagada India State of Gujarat Anand India State of Bihar Jehanabad India State of Bihar Buxar India State of Madhya Pradesh Janjgir-Champa India State of Gujarat Dahod India State of Gujarat Godhra India State of Gujarat Godhra India State of Bihar Jamtara India State of Bihar Katihar India State of Madhya Pradesh Kawardha Public Disclosure Copy India State of Bihar Khagaria India State of Bihar Kishanganj India State of Karnataka Koppal India State of Bihar Lakhisarai India State of Madhya Pradesh Mahasamund India Bengal Murshidabad Page 6 of 11 The World Bank Report No: ISR12968 India State of Gujarat Patan India State of Bihar Sheohar Public Disclosure Copy India State of Madhya Pradesh Sheopur India State of Jharkhand Gumla India State of Madhya Pradesh Koriya India State of Madhya Pradesh Jashpur India State of Madhya Pradesh Raj Nandgaon India State of Bihar Saraikela India State of Bihar Sahibganj India State of Bihar Pakur India State of Bihar Garhwa India State of Bihar Sheikhpura Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percentage of fever cases in project districts Text Value 0% (The diagnostic tests Not available 70% receiving a malaria test result no later than the supported by the Project have day after the first contact only been recently approved by the Program) Date 29-Nov-2013 31-Dec-2013 Comments No further assessments have Public Disclosure Copy been made since the previous one in March 2013. More recent LQAS data is likely to become available by project closure, but the end-line survey is no longer feasible. Percentage of individuals in project areas Text Value 0% (The Program has Not available 50% belonging to eligible Long Lasting Insecticidal recently approved the policy Net (LLIN) target population who slept under for adopting LLINs) an LLIN during the previous night Date 30-Jan-2009 29-Nov-2013 31-Dec-2013 Page 7 of 11 The World Bank Report No: ISR12968 Comments No further assessments have been made since the previous one in March 2013. More recent LQAS data is likely to Public Disclosure Copy become available by project closure, but the end-line survey is no longer feasible. At least 50% of the sampled blocks which at Text Value 236 blocks in 3 states (Bihar, Data currently being collated 50% baseline have not achieved the elimination goal Jharkhand, West Bengal) in and analyzed. of less than one kala azar case per 10,000 2010 reported to have annual persons, will achieve elimination goal by incidence of greater than 1 endline per 10,000 population (being confirmed by NVBDCP) Date 31-Oct-2008 29-Nov-2013 31-Dec-2013 Comments This is a conservative The assessment is currently estimate, based on cases in progress and is expected to reported from each block in be available prior to project 2010. Actual figures are likely closure. to be several times higher, but more accurate estimates are not available from any source. At least 80% of the households with eligible Text Value >80% (Threshold reached) >98% >80% children covered during the national and sub- Date 31-Jan-2008 30-Nov-2012 31-Dec-2013 national immunization days in high risk districts Comments *all activities and procurement under this component has been closed. This estimate is based on previous estimates. The goal of polio eradication has been achieved. Continuous monitoring and further activities are being carried on by the GoI through Public Disclosure Copy their own funds. Intermediate Results Indicators Page 8 of 11 The World Bank Report No: ISR12968 Indicator Name Core Unit of Measure Baseline Current End Target Percentage of Rapid Diagnostic Test (RDT) Text Value 0% (District-wide ACT Not available 70% positive cases in project districts receiving introduction is being done Public Disclosure Copy Artemisinin-based Combination Therapy (ACT) under the project) no less than the day after the first contact Date 31-Jul-2008 29-Nov-2013 31-Dec-2013 Comments No further assessments have been made since the previous one in March 2013. More recent LQAS data is likely to become available by project closure, but the end-line survey is no longer feasible. Percentage of designated providers of malaria Text Value 0% (ACT and RDK are being Not available 90% diagnosis and treatment who have not had an introduced under the project) ACT or RDT stockout during last 3 months. Date 31-Jul-2008 29-Nov-2013 31-Dec-2013 Comments No further assessments have been made since the previous one in March 2013. More recent LQAS data is likely to become available by project closure, but the end-line survey is no longer feasible. Percentage of diagnosed kala azar cases Text Value 55% (Based on preliminary Data currently being collated 80% completing the standard treatment as per the surveys) and analyzed. national guidelines. Date 31-Jan-2007 29-Nov-2013 31-Dec-2013 Comments The assessment is currently in progress and is expected to be available prior to project closure. Percentage of facilities reporting no stock-outs Text Value 73% (For first-line medicines) Data currenly being collated 90% of rapid disgnostic test for kala azar and first and analyzed. Public Disclosure Copy line medicines. Date 31-Jan-2007 29-Nov-2013 31-Dec-2013 Comments The assessment is currently in progress and is expected to be available prior to project closure. Percentage of planned additional staff who are Text Value 0 Not available. 100% in position at central, state and district levels Date 31-Jan-2007 29-Nov-2013 31-Dec-2013 and received induction training. Comments Data is currently being collated. Page 9 of 11 The World Bank Report No: ISR12968 Porportion of eligible districts meeting the Text Value 0% (These criteria are being 100% 100% readiness criteria for each period of applied under the project) implementation. Date 31-Jul-2008 29-Nov-2013 31-Dec-2013 Public Disclosure Copy Comments Phase 1 districts during 2010 and phase 2 districts during 2012. 124 malaria endemic districts (50 phase 1 and 74 phase 2 districts) and 46 kala azar endemic districts were declared ready. The supply of oral polio vaccines for Text Value No stockout No Stock outs No Stock outs Supplemental Immunization Activities is Date 31-Jul-2008 29-Nov-2013 31-Dec-2013 sustained. Comments **all procurement under this component has been closed. This estimate is based on previous estimates. The goal of polio eradication has been achieved. Further procurement is being carried on by the GoI through their own funds . Long-lasting insecticide-treated malaria nets Number Value 0.00 6179114.00 8350000.00 purchased and/or distributed (number) Date 06-Mar-2009 29-Nov-2013 31-Dec-2013 Comments India started distributing the No further procurements have Total number of LLINS LLINs with this project occurred since the previous proposed to be purchased period. under the project Health personnel receiving training (number) Number Value 0.00 910.00 950.00 Date 06-Mar-2009 29-Nov-2013 31-Dec-2013 Comments Based on PIU reports. Total number of staff to be trained in new treatment Public Disclosure Copy Staff attrition has been a guidelines as well as the problem resulting in a induction training for the new decrease in trained staff. staff and international Training for newly joined staff fellowships continues to be carried out. Data on Financial Performance (as of 18-Nov-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date Page 10 of 11 The World Bank Report No: ISR12968 Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P094360 IDA-44610 Effective 31-Jul-2008 13-Feb-2009 06-Mar-2009 31-Dec-2013 31-Dec-2013 Disbursements (in Millions) Public Disclosure Copy Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P094360 IDA-44610 Effective XDR 319.90 216.73 103.17 153.85 62.89 71.00 Disbursement Graph Key Decisions Regarding Implementation As noted, the project has been slow to disburse under the VBD component primarily due to delays in the central procurement of Long Lasting Insecticidal Nets (LLINs) and other key diagnostic and treatment related commodities. In order to support the timely disbursement of project funds and ensure that stock-outs of commodities do not occur, both decentralized procurement by certain states, as well as the engagement of UNICEF for the procurement of LLINs centrally, was requested by the client and approved by the Bank. However, owing Public Disclosure Copy to pricing and specification issues compounded by time constraints, the central procurement of LLINs through UNICEF, as well as the decentralized procurement at state level, were canceled. This has led to substantial shortfalls in expenditure as a major share of the remaining funding under the VBD component of the project was for the centralized procurement of commodities. Since the project is closing on December 31, 2013, and since it is unlikely that these procurements will be completed in time even if a rebidding process using the existing government system were to be initiated, the GoI has requested a cancellation of US$ 100 million from the credit, which is being processed. Restructuring History Level two Approved on 16-Dec-2010, Level two Approved on 19-Dec-2012 Related Projects There are no related projects. Page 11 of 11