The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) Document of The World Bank FOR OFFICIAL USE ONLY REPORT NO.: RES45490 INTERNATIONAL DEVELOPMENT ASSOCIATION RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF THE COVID-19 PANDEMIC EMERGENCY FINANCING FACILITY PROJECT APPROVED ON SEPTEMBER 1, 2020 TO THE UNITED REPUBLIC OF TANZANIA HEALTH, NUTRITION & POPULATION GLOBAL PRACTICE EASTERN AND SOUTHERN AFRICA The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) Regional Vice President: Hafez M. H. Ghanem Country Director: Mara K. Warwick Global Director: Muhammad Ali Pate Practice Manager/Manager: Ernest E. Massiah Task Team Leader(s): Mariam Ally Juma The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) ABBREVIATIONS AND ACRONYMS CAG Controller and Auditor General COVID-19 Coronavirus Disease 2019 FM Financial Management GoT Government of Tanzania GRM Grievance Redress Mechanism MoHCDGEC Ministry of Health, Community Development, Gender, Elderly and Children NPHL National Public Health Laboratory PEF Pandemic Emergency Financing Facility SARS Severe Acute Respiratory Syndrome SARS-Cov-2 Novel coronavirus SEP Stakeholder Engagement Plan STEP Systematic Tracking of Exchanges in Procurement WB World Bank The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) BASIC DATA Product Information Project ID Financing Instrument P174366 Investment Project Financing Environmental and Social Risk Classification (ESRC) Substantial Approval Date Current Closing Date 01-Sep-2020 31-Jan-2021 Organizations Borrower Responsible Agency Ministry of Health, Community Development, Gender, United Republic of Tanzania Elderly and Children Financing (in USD Million) FIN_SUMM_PUB_TBL SUMMARY Total Project Cost 0 Total Financing 0 Financing Gap 0 DETAILS -NewFin3 Project Development Objective (PDO) Original PDO To strengthen capacity for laboratory diagnosis and management of COVID-19 cases. OPS_TABLE_PDO_CURRENTPDO The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) Summary Status of Financing (US$, Millions) Net TF Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed TF-B3767 01-Sep-2020 22-Sep-2020 22-Sep-2020 31-Jan-2021 3.79 3.79 0 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING 1. The COVID-19 Pandemic Emergency Financing Facility Project (US$3.79 million) supports Tanzania’s response to the coronavirus disease (COVID-19) pandemic following the outbreak caused by the 2019 novel coronavirus (SARS-CoV-2). The project is financed by the Pandemic Emergency Financing Facility (PEF). The PEF was launched in 2016 to provide financial support to IDA-eligible countries in case of major multi-country disease outbreaks and was triggered in April 2020 for COVID-19. The project was approved on September 1, 2020, became effective on September 22, 2020 and is due to close on January 31, 2021. 2. The Project Development Objective is to strengthen capacity for laboratory diagnosis and management of COVID-19 cases. The project comprises three components: a. Component 1: Strengthening Laboratory Diagnosis Capacity. The objective of component 1 is to strengthen capacity for diagnosis and testing of SARS-CoV-2 at the National Public Health Laboratory with the aim of reaching capacity to conduct 500 tests per day by the end of the project. This is to be achieved through (a) training of laboratory staff; and (b) procurement and distribution of required equipment, reagents and supplies. b. Component 2: Improving Case Management. Under this component the project aims to improve capacity for the case management of COVID-19 through: (i) procurement and installation of oxygen generating plants and manifolds in 7 regional referral hospitals (RRHs) as well as supply of oxygen cylinders to 126 neighboring health facilities; (ii) procurement of essential medicines and supplies; and (iii) training of biomedical technicians on production and management of oxygen plants, nurses on proper provision of oxygen gas to patients and laboratory staff on diagnosis of SARS-CoV-2. The targeted RRHs in turn supply oxygen to neighboring health facilities. The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) c. Component 3: Implementation Management and Monitoring and Evaluation (M&E). This component supports the strengthening of the existing structures for coordination and management of the project, including arrangements for financial management and procurement. 3. Overall progress towards achievement of the Project Development Objective (PDO) is rated Moderately Satisfactory. Of the two PDO indicators, one has exceeded the end-project target (SARS-CoV-2 tests carried out at the National Public Health Laboratory). The second PDO indicator (Targeted hospitals with functional oxygen generation plants) has not yet been achieved because the oxygen generation plants have not yet been received from the supplier. They are expected to be received by February 10, 2021. The necessary pre-installation works for the plants has been concluded and the mainfolds are installed, only the installation of the plants is pending. With regard to the intermediate outcome (IO) indicators, overall progress is good. Three out of four IO indicators ((a) biomedical staff in the targeted regional referral hospitals trained in medical oxygen generation, (b) laboratory staff trained in laboratory diagnosis of SARS-CoV-2, and (c) health care workers trained on the provision of oxygen therapy) have achieved their end of project targets as all the trainings have been conducted. The fourth IO indicator - oxygen cylinders refilled in the targeted regional referral hospitals – has not yet been achieved because the oxygen plants are not yet installed. The project is fully disbursed and overall implementation progress is rated Moderately Satisfactory. 4. Financial management of the project has been Moderately Satisfactory. Based on January 25, 2021 financial records the project had fully disbursed funds for implementation. The project has no overdue financial report and audit, there are no issues with compliance with legal covenants and no grievance redress mechanism (GRM) issues. 5. The project is scheduled to close on January 31, 2021. The oxygen generation plants have been shipped and are expected to arrive by February 10, 2021, after the Project’s Closing Date. The short implementation period coupled with supply chain and logistics challenges meant that the supplier was unable to ship the plants within the original contract period. The Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) discussed the revised delivery schedule with the supplier and has obtained assurance from the supplier that the plants will be delivered in Dar es Salaam by February 10, 2021. To allow time for the plants to be delivered and installed, in a letter dated January 27, 2021, the MOHCDGEC requested the World Bank to extend the Closing Date by one-month to February 28, 2021. Since the necessary pre-installation works are concluded, the proposed extension is sufficient for the plants to be delivered, cleared, installed and commissioned. The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) II. DESCRIPTION OF PROPOSED CHANGES 6. This restructuring seeks authorization to extend the Project Closing Date by one month from January 31, 2021 to February 28, 2021. The proposed extension was discussed and agreed with the Pandemic Emergency Financing Facility and Finance and Accounting teams, see attached correspondences. The end disbursement date will remain March 31, 2021. III. SUMMARY OF CHANGES Changed Not Changed Loan Closing Date(s) ✔ Disbursement Estimates ✔ Change in Overall Risk Rating ✔ Implementation Schedule ✔ Implementing Agency ✔ Project's Development Objectives ✔ Results Framework ✔ Components and Cost ✔ Cancellations Proposed ✔ Additional Financing Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ The World Bank COVID-19 Pandemic Emergency Financing Facility Project (P174366) IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline TF Status Closing Closing(s) Closing for Withdrawal Applications TF-B3767 Effective 31-Jan-2021 28-Feb-2021 28-Jun-2021 OPS_DETAILEDCHANGES_DISBURSEMENT_TABLE DISBURSEMENT ESTIMATES Change in Disbursement Estimates Yes Expected Disbursements (In US$) Fiscal Year Annual Cumulative 2021 0.00 0.00 OPS_DETAILEDCHANGES_SORT_TABLE OVERALL RISK RATING Risk Category Rating at Approval Current Rating Overall  Substantial  Moderate Note to Task Teams: End of system generated content, document is editable from here.