Project Financial Statements and Independent Auditor's Report The Ministry of Health, Romania - Project Management Unit Health Sector Reform - Improving Health System Quality and Efficiency Project IBRD Loan no. 8362-RO For the period from January 1, 2019 to December 31, 2019 Contents Independent auditor's report 3 List of abbreviations 6 Statement of financial position 7 Statement of funds received and uses of funds 8 Summary of funds received and uses of funds 9 Statement of expenditures 10 Notes to the project financial statements 11 *ObakertitLy 4B Gara Herastrau Street 10' FI , 2' Sector 020334, Bucharest Romania T: +40 21 3156100 F: +40 21 3156102 info@bakerlly ,o wvw bakertilly -o INDEPENDENT AUDITOR'S REPORT TO THE MINISTRY OF HEALTH - PROJECT MANAGEMENT UNIT HEALTH SECTOR REFORM - IMPROVING HEALTH SYSTEM QUALITY AND EFFICIENCY PROJECT Unqualified Opinion 1. We have audited the accompanying financial statements of the Improving Health System Quality and Efficiency Project for the period of January 01, 2019 - December 31, 2019. The project is financed by the International Bank for Reconstruction and Development (IBRD) through Loan no. 8326 - RO signed on June 17, 2014, ratified by Law No. 179/16.12.2014. The audited project financial statements for the period of January 01, 2019 - December 31, 2019 consist of: Statement of financial position, Statement of funds received and uses of funds, Summary of funds received and uses of funds, Statement of expenditures and Notes to the project financial statements. 2. In our opinion, the financial statements of the Improving Health System Quality and Efficiency Project, for the period from January 01, 2019 until December 31, 2019 are prepared, in all material respects, in accordance with the financial reporting provisions stipulated in the Law No. 179/16.12.2014 and of the Loan Agreement No. 8362 RO, signed on June 17, 2014. Basis for Opinion 3. We conducted our audit in accordance with International Standards on Auditing (ISAs). Our responsibilities under those standards are further described in the Auditor's Responsibilities for the Audit of the Financial Statements section of our report. We are independent of the PMU, according to the ethical requirements relevant to the audit of the financial statements in Romania and we have fulfilled our other ethical responsibilities according to these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. Emphasis of matters 4. Without qualifying our opinion, we draw attention to the following matters: a) As mentioned in the Note 9 "Legislation and the fiscal environment in Romania" to the project financial statements, the legal system from Romania is affected by macroeconomic factors which include influences of the worldwide economic slowdown. As a result of this, the Romanian Government might change the fiscal and monetary policy. Due to the above-mentioned aspects there might be a negative impact on the evolution of the Project. 09bakertitLy b) As mentioned in the Note 2 "Basis of preparation" to the project financial statements, these financial statements were prepared for complying with the Loan requirements and with the appropriate LBRD guidelines, and therefore are not intended to be a complete presentation of the Project's operations. c) As mentioned in Nota 12 "Milestones to track project progress" to the financial statements, the project needs to meet certain milestones with specific deadlines. Although management is confident that the milestones will be met, there is the risk that not meeting these milestones as agreed will trigger significant restructuring of the initial plans including partial withdraw of initial financing allowed. Our opinion is not modified in this respect. Management's Responsibility for the Financial Statements 5. Management of the PMU is responsible for the preparation of these financial statements in accordance with the financial reporting provisions included in the ratification law no 179.16.12.2014 and IBRD loan agreement no. 8362-RO signed on 17 June 2014, and for such internal control as management determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. 6. In preparing the financial statements, management is responsible for evaluating the project's ability to continue as a going concern, for disclosure, as applicable, matters related to going concern and using the going concern basis of accounting unless management either intends to liquidate the project or to cease operations, or has no realistic alternative but to do so. Those charged with governance are responsible for overseeing the PMU's financial reporting process. Auditor's Responsibilities for the Audit of the Financial Statements 7. Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or aggregated, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. 8. As part of an audit in accordance with ISAs, we exercise professional judgment and maintain professional scepticism throughout the audit. We also: * Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional * bakertilly omissions, misrepresentations, or the override of internal control. * Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the PMU's internal control. * Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by management. * Conclude on the appropriateness of management's use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the PMU's ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor's report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditor's report. However, future events or conditions may cause the PMU to cease to continue as a going concern. * Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation. 9. We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit. Other Matter 10. This report, including the opinion, has been prepared for the use of the PMU and submission to the International Bank for Reconstruction and Development and should not be used for any other purposes beside those meant for a financial audit report. Within the boundaries of the law, we do not, in giving this opinion, accept or assume responsibility for any other purposes or to any other person to whose knowledge this report may come to. Auditor: ^uton,tIt'. jnsru %uPr.Iwt:Il.t.t Iubltc. . Activit.lI dir Audit St.tutar (ASPAAS) Ruxandra Bilius )Aor Financiar: an IU Registrated in the Electronic Register no. AF 1996 RUKANOA LULIANA RCeli%truiI'Pubhc I t,ctrconic.. At 19 On behalf of: BAKER TILLY KLITOU AND PARTNERS S.R.L. Registred in the Electronic Register no. FA 384 Au1i6ii,,, Pe41rU -%0P(JmVr:hV.i Ptibi, Activit.1tis uIV Audit SI.tuLt,t (ASPAAS Bucharest, Romania Auditor Finjicili BAKER T [V 3 August 2020 l IrOU AND PARTNrmS S IL 3A uPublICFlctronc [A 384 List of abbreviations MoH - Ministry of Health of Romania PMU - Project Management Unit, established within MoH for the Health Sector Reform Project IBRD - International Bank for Reconstruction and Development ElB - European Investment Bank Loan - the Loan Agreement (8362 - RO) for the Health Sector Reform Project MoPF - Ministry of Public Finance NBR - National Bank of Romania GoR - Government of Romania Statement of financial position In EUR Note 31 December 2019 31 December 2018 Current assets Balances in bank accounts (letter of credit) - - Inventories and other current assets 3,799 6,082 3,799 6,082 Non-current assets Equipment 12.272,690 16,165,715 Tangible assets in progress 4 2,629,528 139,530 Advances for non-current assets 6 385,477 2,229,907 15,284,695 18,535,152 Total assets 15,288,494 18,541,234 Funds and liabilities Pre-financing from the State Budget 33,774,070 45,308.796 Funds used (20,534,314) (29 256,692) Exchange rate difference (71,803) (93287) 13,167,953 15,958,817 Current liabilities Accounts payable 5 2.101,825 2,568,046 Other current liabilities 7 18,716 14,371 2,120,541 2,582,417 Total funds and liabilities 15,288,494 18,541,234 The exchange rate used for translating the dosing balance is the one published by the National Bank of Romania. On December 31, 2019, 1 EUR = 4.7793 RON, and on 31 December 2018 1 EUR = 4.6639 RON The project financial statements were approved on 3rd August 2020 by: Mr. Mihai Negrea Mrs. Mihaela Cimpoeasu Head of Ministry of Health, Romani - Financial Expert - Ministry of f)alth, Rpmania - Project Management Unit Project Management Unit This statement is to be read in conjunction w th the notes to and forming part of the project financial statements set out on pages 11 to 21 Statement of funds received and uses of funds In EUR Statement of the IBRD Loan Account of the Ministry of Health as at 31 December 2019 Loan amounts not disbursed December 31, December 31, 2018 2019 Loan amount approved 250,000,000 250,000,000 Less: Total disbursements from loan (89,515,609) (58,556,855) Total 160,484,391 191,443,145 December 31, 2019 December 31, 2018 Opening balance of disbursed amounts 58,556,855 10,640,058 Disbursements during the reporting period 30.958.754 47,916,797 Closing balance of disbursed amounts 89,515,609 58,556,854 Amount approved 250,000,000 250,000,000 Not disbursed amounts 160,484,391 191,443,146 Statement of the IBRD Loan Account of the Ministry of Health as at 31 December 2019 - by components Sources - IBRD contribution Cumulated Transferred Sources Cumulated per component Sources Sources Until December January 01, 2019 Until December 31,2018 December 31,2019 314 2019 Former Component A - - Former Component B _- - - Component A 54,465,392 30.462,113 84,927,505 Component B, former Component C 2,374,070 163,218 2,537,288 Component C, former Component D 1.717,393 333,423 2,050,816 Total disbursed amounts 58,556,855 30,958,754 89,515,609 Component A and B were merged starting with 21 August 2017, and became Component A- There will be 3 components: Component A (A + former B), Component B (former C) and Component C (former D). During the year 2019 the withdrawal applications No.9-13 for the period 02.11.2018-31.10.2019 in total amount of EUR 30,958:754 were disbursed, the withdrawal application No.14 of EUR 7,077,952 has been disbursed from IBRD in 2020 for expenses related to period 01.11.2019-31.01.2020. Approved on 3r August 2020 by: Mr. Mihai Negrea Mrs. Mihaela Cimpoeasu . Head of Ministry of Health, Romania Financial Expert - Ministr of Health Romania - Project Management Unit Project Management U This statement s to be read in conjunction with the notes to and forming part of the project financial statements set out on pages 11 to 21. Summary of funds received and uses of funds In EUR Description Cumulative January 01, 2019 - Cumulative at December 31, at December 2019 December 31, 2018 31, 2019 Opening cash balance (letter of credit) - - - Add: cash receipts 62566.958 33,925,808 State Treasury Designated Account - funds pre- financed by the MFP) 62,566,958 33,925,808 Less project expenditure related to: Hospital Network Rationalization - Component A - - (14,626,331) Ambulatory Care Strengthening - Component B* -8 Strengthening Health Service Delivery- Component A (former Component A and B) (58,718,440) (33,468,823) (92,187,263) Health Sector Governance and Stewardship Improvement - Component C (2,445,457) (163.218) (2,608,675) Project Management, Monitoring and Evaluation - Component D (1,396,480) (293,767) (1,690,247) Total project expenditures (62,560,377) (33,925,808) (96,486,185) Less: transfer to letters of credit - - - Less: cash transferred to State Treasury Designated Account (6,581) - (6,581) Closing cash and cash equivalents balance - - - Component A and B were merged starting with 21 August 2017, and became Component A. There are now 3 components: Component A (A + former B), Component B (former C) and Component C (former D). These amounts have been derived by applying the RON/EUR exchange rate as at the time of payment, for the internal payments using NBR exchange rate and for the external payments using auctions exchange rate given by the Bank (Raiffeisen Bank). This statement is to be read in conjunction with the notes to and forming part of the project financial statements set out on pages 11 10 21. Statement of expenditures In EUR Uses of funds Cumulative at January 01, 2019 Cumulative at December 31, - December 31, December 31, 2018 2019 2019 Budgetary pre-financing funds 62,566,958 33,925,808 96,492,766 Letters of credit - - Penalties transferred to State Budget W6,581) - (6,581) Total 62,560,377 33,925,808 96,486,185 Uses of funds - by component Cumulative at Cumulative at December 31, January 01, 2019 - December 31, 2018 December 31, 2019 2019 Component A 58,718,440 33,468,823 92,187,263 Component B, former Component C 2,445,457 163,218 2,608,675 Component C, former Component D 1.396,480 293-767 1 690,247 Total 62,560,377 33,925,808 96,486,185 These amounts have been derived by applying the RON/EUR exchange rate as at the time of payment, for the internal payments using NBR exchange rate and for the external payments using auctions exchange rate given by the Bank (Raiffeisen Bank). This statement is to be read in conjunction with the notes to and forming part of the project financial statements set out on pages 11 to 21. 10i Notes to the project financial statements I General information Loan agreement Romania has received the loan no. 8362-RO in amount of 250 million Euros from the International Bank for Reconstruction and Development ("IBRD") to support the implementation of the Health Sector Reform - Improving Health System Quality and Efficiency Project. The Loan agreement no. 8362 RO between Romania and IBRD was signed at Bucharest on June 17, 2014 and ratified by law no. 179/December 16, 2014. The subsidiary agreement between Ministry of Public Finance ("MoPF") and Ministry of Health - Project Management Unit ("PMU") was signed on March 5, 2015. The Loan Agreement was subsequently modified through Amendments 1 and 2. The PMU implements the Preparation of the Health Sector Reform - Improving Health System Quality and Efficiency Project (the "Project"), which is financed under the Loan Agreement no. 8362 - RO signed between the International Bank for Reconstruction and Development (the "IBRD") and the Government of the Romania on June 17, 2014. The objective of the Project is to improve access to, and quality and efficiency of. public health services in Romania. Designation of borrowed funds The Project is part of the 2014-2020 National Health Strategy and currently consists of the following parts: Part A. Strengthening Health Service Delivery Improving access to and quality of selected life-saving services and screenings by strengthening key hospitals that will become the backbone of the hospital network, and improving the cancer screening network through the provision of goods, works, non-consulting services, consultants' services and training in support of the following activities: (a) Improving life-saving medical services such as medical services in operating rooms, intensive care units, advanced surveillance and treatment units for critical cardiac patients, burn units, radiotherapy units/centers, emergency medical services including telemedicine systems and medical imaging diagnosis services; (b) Performing rehabilitation works for existing medical units, and new construction of four large medical units, including (re)organization of their medical flows: and (c) Improving the cervical cancer screening network by supplying mobile units for cervical cancer screening, and strengthening the technical capacity of regional pathology and cytology laboratories. Part B. Health Sector Governance and Stewardship Improvement Improving sector governance and stewardship of the MOH and other relevant governmental institutions to bridge the gap between policy and practice and to strengthen the capacity of improving the quality of medical care services through the provisions of goods, non-consulting services, consultants' services and training, through the following activities. (a) adapting evidence-based standards and protocols; (b) Strengthening and supporting the implementation of health technology assessments; Strengthening the capacity of the health sector to conduct surveys and studies, and provide advice in formulating evidence-based policies; (c) Supporting selected national health programs to shift focus toward preventive care and promotion of population health services among the Borrower's population; and (d) Strengthening the communications strategy of the MoH to inform the general public on reform programs and expected outcomes. it Part C. Project Management, Monitoring and Evaluation Supporting the MOH and the Project Management Unit ("PMU") in Project management and implementation, including fiduciary tasks, monitoring and evaluation and reporting through the provisions of goods, non- consulting services, consultants' services, training, auditing and incremental operating costs. Loan allocation In compliance with the Loan Agreement concluded on June 17, 2014 and ratified by law no. 179/December 16. 2014, modified through amendments 1 and 2, the components of expenditures financed through IBRD loan proceeds comprise of the following: Code Component Description Amount allocated Amount allocated from the loan_USD from the loan_EUR A Strengthening Health Service Delivery 315,700,000 233,000,000 B Health Sector Governance and Stewardship 13,600,000 10,000,000 Improvement C Project Management, Monitoring and Evaluation 9,500,000 7,000,000 Total project financing 338,800,000 250,000,000 For the purposes of this Schedule: a) the term "foreign expenditures" means: expenditures in the currency of any country other than that of the Borrower for goods or services supplied from the territory of any country other than that of the Borrower; b) the term "local expenditures" means: expenditures in the currency of the Borrower or for goods or services supplied from the territory of the Borrower; c) the term "Incremental Operating Costs" means: expenditures incurred by the PMU, on account of Project implementation, including: * salaries of the staff (other than civil servants) of the PMU- * office supplies and equipment (office rent, equipment and fumiture; office rehabilitation; office consumables; office equipment); * fuel and vehicles; * communication expenditures and travel expenditures of the PMU staff (including mobile phones, telephone lines, fax, internet); * domestic and abroad travel expenditures including dai:y allowance and accommodation * office software; * advertising and translation services * bank charges * operating, maintenance and insurance costs for vehicles and office equipment d) the term "Statement of Expenditures" means: expense reports used by the Borrower to forward to the IBRD the application for reimbursement of payments already made. e) the term "State Treasury Account" means: a bank account opened at the State Treasury of Bucharest where PMU is receiving the requested money from the Ministry of Public Finances. The Ministry of Public Finance advances the required amounts for the implementation of the Project and withdraws amounts from the IBRD based on application for disbursement of payments already made. The legal address of the Ministry of Health, Romania - Project Management Unit ('PMU') is Cristian Popisteanu Ent Sector 1, Bucharest, Romania, fiscal code 15852060. The average number of the PMU's staff in 2019 was 7 (2018: 7). 1, 2 Significant accounting policies 2.1 Basis of preparation The project financial statements were prepared in accordance with the accrual basis of accounting as well as the World Bank guidelines and the relevant points of the Loan IBRD 8362 - RO. Significant accounting policies are disclosed below. 2.2 Functional and presentation currency The national currency of Romania is RON, which is also the functional currency of the Project since this currency best reflects the economic substance of the underlying events and transactions of the Project. These project financial statements are presented in EUR (presentation currency), as this is the currency of the Loan and the main beneficiary of this audit report is IBRD. In preparing the project financial statements, transactions in currencies other than EUR are recorded at the rates of exchange defined by the National Bank of Romania prevailing on the dates of the transactions. These amounts have been derived by applying the RON/EUR exchange rate as at the time of payment, for the internal payments using NBR exchange rate and for the external payments using auctions exchange rate given by the Raiffeisen Bank Romania ("the Bank"). Any exchange rate differences are recognized in the statement of the Project sources and uses of funds. 2.3 Project financing Project expenditures are pre-funded from the State Budget, and then the eligible expenses are reimbursed by IBRD through loan 8362-RO. PMU would use pre-financing from State Budget funds and then the MoPF would get reimbursed from the loan using the reimbursement method for eligible Project payments. The Treasury makes the monthly budgetary openings as requested, and the Project would receive its allocations under title number 65 in the Treasury system. IBRD loan funds would reimburse the Project eligible expenses pre-financed from the State Budget funds. The Borrower would submit withdrawal applications for the eligible expenditures. The supporting documentation for disbursements would include summary sheets and statement of expenditures. No designated account would be used. 2.4 Project expenses The Project expenses are recognized on the accrual basis of accounting. The accumulated Project expenses are disclosed in the Statement of funds received and uses of funds and Summary of funds received and uses of funds by Project activities. 2.5 Non-current and other current assets Non-current assets are recognized at acquisition cost under equipment category or inventories. Following the.r accounting transfer to the beneficiaries on the basis of the unpaid transfer minute. they are recognized as costs (after all documents have been submitted by the vendor), and the Acceptance Certificate has been issued by the MoH, according to contract stipulations. 2.6 Liabilities i) Recording the loan The loan will be recorded as a use of funds as the withdrawals take place. The entire amount of the loan will not appear as a debt element in the accounting of the Project Management Units. ii) Acquisition of goods and services The acquisition of goods and services is recorded as assets and expenditures respectively at the time of the payment, and is allocated between the different sub-projects and activities to which they refer. The invoices for 13 goods and services not paid at the time of the financial reporting are shown as liability items and are reported as uses of funds at the date of payment. 2.7 Funding PMU does not record the loan amounts received from the IBRD, this being done at MoPF level. Please see 2.3 "Project financing'. 2.8 Use of funds Using of funds represents the amounts paid for the purpose of the Project by the PMU, funds pre-financed by the Ministry of Public Finances. 3. Closing date of the Project The closing date of the Project was defined as 15 December 2020. 4. Non-current assets and other current assets As at December 31, 2019, PMU has not transferred all the medical equipment in inventories to beneficiaries. Out of the total assets of EUR 15,288,494 the amount of EUR 12,272,690 relates to equipment and EUR 385,477 are advances for non-current assets. 5. Accounts payable In EUR December 31, 2019 ELEKTA LIMITED 1,364,860 GENERAL ELECTRIC MEDICAL SYSTEMS 262,760 TBS GROUP S.P.A. 240,840 MIDANNE INVEST GRUP SRL 85,011 TEHNO ELECTRO MEDICAL COMPANY SRL 29,386 LINET spot. S.R.O. 26,884 KRAL MEDICAL SOLUTIONS SRL 20,966 Others 71,118 2,101,825 The exchange rate used for translating the dosing balance is the one published by the National Bank of Romania. On 31 December 2019, 1 EUR = 4.7793 RON. 6. Advances for non-current assets In EUR December 31, 2019 GENERAL ELECTRIC MEDICAL SYSTEMS ROMANIA SRL 131,264 TRACTEBEL ENGINEERING S.A. 55,800 POLITECNICA INGEGNERIA ED ARCHITETTURA SOC. COOP. MODENA SUCURSALA BUCURESTI 132,310 3TI PROGETTI ITALIA INGEGNERIA INTEGRATA S.P.A. SUCURSALA BUCURESTI 66,103 385,477 7. Other current liabilities Other current liabilities include social charges of EUR relating to employees salary payments, VAT and other taxes. 8. Bank accounts used within the project, statement of designed account All the funds are received through the State Treasury Account. The internal payments are done through this account and for the external payments the funds are transferred to the bank account from Raiffeisen Bank. Based on the Order of the Public Finance Ministry no 2004/2013, starting with January 1, 2014 the Project Management Unit represents a unit within the Ministry of Health in relation to the Treasury account and will only use the following treasury account for the reimbursable funds: Account No. RO 08 TREZ 23A6 6010 0650 1OX Depository Bank State Treasury Branch Treasury Activity and Public Accounting of the Bucharest Municipality Address No. 6-8, Splaiul Unirii, 4th District, 040032 Related loan/credit Loan no. 8362 - RO, Loan 22943-RO Account Currency RON State treasury account as at 31 December 2019 IBRD EIB audited Total Opening balance January 1, 2018 - - Cash receipts from MoPF for funds approved by - - funds providers Cash receipts from MoPF as GOR contribution - 950,574 950,574 Other funds received from MoFP: - pre-financing for costs to be supported from IBRD 45,269,730 - 45,269,730 funds 2019 - other - - Total cash receipts 2018 45,269,730 950,574 46,220,304 Total payments from the State Treasury Account (45,269,730) (950,574) (46,220,304) Closing balance December 31, 2018 - - Opening balance January 1, 2019 - - Cash receipts from MoPF for funds approved by - - funds providers Cash receipts from MoPF as GOR contribution - - Other funds received from MoFP: - 778,233 778,233 - pre-financing for costs to be supported from IBRD 33,925,808 - 33,925,808 funds 2018 - other - - Total cash receipts 2019 33,925,808 778,233 34,704,041 Total payments from the State Treasury Account (33,925,808) (778,233) (34,704,041) Closing balance December 31, 2019 - - Project with EIB was audited by Moore Stephens and they issued qualified opinion in relation to the litigation with VAMED STANDORTENTWICKLUNG und ENGINEERING GMBH & CO. 9. Legislation and fiscal environment in Romania The legislation and fiscal environment in Romania and their implementation into practice change frequently and are subject to different interpretations by various Ministries of the Government. Over recent years, Romania has undergone substantial legal and economic changes. Therefore it is not possible to estimate what changes may occur or the resulting effect of any such changes on the Project development or future results of its development, 15 10. Subsequent events The withdrawal application No.14 of EUR 7,077,952 has been disbursed from lBRD in 2020 for expenses related to period 01.11.2019-31.01.2020. In May 2020, the World Bank representatives have performed a virtual implementation support visit. According to the Aide-memoire dated May 21, 2020, although still rated "moderately unsatisfactory", the project has made significant progress in the implementation of key activities, including the provision of new medical equipment and training, which is improving the availability and quality of health care services in participating facilities. The main agreement reached during the visit mentioned above was to restructure the Project to strengthen the Government's response to the COVID-19 outbreak by (i) adding a component on COVID-19; (ii) aligning the Project's results framework with this new priority; and (iii) allocating to the new component funds for activities which can be completed by the Project's closing date of December 15, 2020. Also, the Aide-memoire, mentions that if the bidding documents for the Timisoara burn center are ready for publication on July 1, 2020, the partial extension of the Project's closing date to allow for the completion of civil works will be done. Any other resources unused by December 15, 2020 will be cancelled at that time. World Bank representatives recommend the cancellation through the proposed restructuring of the funds that were not allocated to activities which could realistically be completed by December 15, 2020 or to the Timisoara burn center. 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