INTEGRATED SAFEGUARDS DATA SHEET RESTRUCTURING STAGE Note: This ISDS will be considered effective only upon approval of the project restructuring Public Disclosure Copy Report No.: ISDSR15947 Date ISDS Prepared/Updated: 12-Nov-2015 Date ISDS Approved/Disclosed: 12-Nov-2015 I. BASIC INFORMATION 1. Basic Project Data Country: Nigeria Project ID: P102119 Project Name: Nigeria HIV/AIDS Program Development Project II (P102119) Task Team Enias Baganizi Leader(s): Estimated 02-Dec-2008 Estimated 16-Jun-2009 Appraisal Date: Board Date: Managing Unit: GHN07 Lending Specific Investment Loan Instrument: Sector: Other social services (53%), Health (27%), Public administration- Health (20%) Theme: HIV/AIDS (61%), Social Safety Nets/Social Assistance & Social Care Services (17%), Participation and civic engagement (12%), Tubercu losis (10%) Is this project processed under OP 8.50 (Emergency Recovery) or OP 8.00 (Rapid Response to Crises and No Emergencies)? Public Disclosure Copy Financing (in USD Million) Total Project Cost: 230.00 Total Bank Financing: 225.00 Financing Gap: 0.00 Financing Source Amount BORROWER/RECIPIENT 5.00 International Development Association (IDA) 225.00 Total 230.00 Environmental B - Partial Assessment Category: Is this a Yes Repeater project? 2. Current Project Development Objectives The objective of the Project is reducing the risk of HIV infections by scaling up prevention interventions and increasing access to HIV counseling, testing, car e and support services Page 1 of 6 Proposed New PDO (from Restructuring Paper) The objective of the Project is reducing the risk of HIV infections by scaling up prevention interventions and increasing access to HIV counseling, testing, car e Public Disclosure Copy and support services 3. Project Description The indicative total cost of Project II is estimated at US$ 225.00 million. The overall institutional architecture of the project will remain the same with operations being coordinated by NACA at the Federal level and the SACAs at the State level. Data from theNational HIV/AIDS Reproductive and Health Survey, 2012 indicates that the HIV epidemic in Nigeria is a mixed epidemic, with disparities between states, local governments within states and among different populations. Most At Risk Populations (MARPs) which include female sex workers, men who have sex with other men and injective drug users are among the most affected populations which also serve as a bridge population with the general population. Because of the complexity of the epidemic in Nigeria, the project will scale-up both interventions targeting high risk groups and interventions aimed at the general population. Moving forward, the project will emphasize (i) HIV counseling and testing, (ii) combination prevention for key populations, (iii) scaling-up Prevention of Mother to Child Transmission (PMTCT) through public and private health sector; and (iv) strengthening documentation of results. Component 1: Expanding public sector response: The project is now financing four line ministries to deliver services to support the achievement of the PDO: (i) Ministry of Health to support priority interventions to scale up HCT and PMTCT services; combination prevention interventions for MARPS and the general population; and support to surveys to track progress of the national program (ii) Ministry of Youth and Sport to concentrate efforts on peer education, social mobilization of in and out of school youth, (iii) Ministry of Education to scale up Family Life and HIV Education (FLHE) and other in-school interventions, and (iv) Ministry of Women Affairs will work with Public Disclosure Copy Orphan and Vulnerable Children (OVC) and their care givers, income generation activities (IGA) activities for People Living With HIV/AIDS (PLWHA), and demand creation for PMTCT services. The Government agreed to allocate at least 70% of the public sector response resources to the health sector. Component 2: Expanding civil & private sector engagement and response through the HIV/AIDS Fund (HAF). This component is designed to support the civil society response to HIVIAIDS through a system of providing grants to NGOs, contracting with private health providers for a limited set of HIV-related services and contracting with implementing partners to work with the private sector in selected states. The epidemic appraisals and other assessment conducted in-country at sub-national level has supported the availability of data to design prevention programs to better target, locate and work with high risk groups. This has improved state level HIV response and currently 546 NGOs have been issued grants and are delivering services. The project will continue to support strategic expansion of civil society activities to promote HIV counseling and testing (HCT), scale-up PMTCT, behavior change communication (BCC), condom social marketing and universal precautions, increase support to people living with HIV/AIDS (PLWHA), orphan and vulnerable children (OVC) as highlighted in national guidelines. The states are encouraged to work with other development partners to deliver on the national strategic plan. Component 3: Strengthening mechanisms for project coordination and management. Considerable Page 2 of 6 work has gone into building the institutional capacity of the public and private sector to address the epidemic. Financial management mechanisms established under Project 1 are adequate, as are procurement mechanisms. This component will continue this effort, with the specific objectives of: Public Disclosure Copy • Improving project governance and strengthening institutional capacity for government agencies and civil society organizations. • Strengthening and expanding implementation of an M&E system by (i) improving the tracking of resources and results at the all levels, and (ii) facilitating the demonstration of results with selected evaluations or impact analysis. The national surveys completed between 2007 and 2012 will provide excellent baseline date to monitor the impact of future activities. • Developing solid coordination mechanisms for technical and financial commitment by all partners, including standardized implementation guidelines and joint financing agreements where possible. Enhancing linkages between government agencies, civil society and the private sector for effective coordination and program delivery, and to promote sustainability. 4. Project location and salient physical characteristics relevant to the safeguard analysis (if known) National 5. Environmental and Social Safeguards Specialists Africa Eshogba Olojoba (GENDR) Amos Abu (GENDR) Chukwudi H. Okafor (GSURR) Michael Gboyega Ilesanmi (GSURR) Warren Waters (GSURR) Public Disclosure Copy 6. Safeguard Policies Triggered? Explanation (Optional) Environmental Yes Assessment OP/BP 4.01 Natural Habitats OP/BP No 4.04 Forests OP/BP 4.36 No Pest Management OP 4.09 No Physical Cultural No Resources OP/BP 4.11 Indigenous Peoples OP/ No BP 4.10 Involuntary Resettlement No OP/BP 4.12 Safety of Dams OP/BP No 4.37 Projects on International No Waterways OP/BP 7.50 Page 3 of 6 Projects in Disputed No Areas OP/BP 7.60 Public Disclosure Copy II. Key Safeguard Policy Issues and Their Management A. Summary of Key Safeguard Issues 1. Describe any safeguard issues and impacts associated with the Restructured project. Identify and describe any potential large scale, significant and/or irreversible impacts: The project will generate some hazardous medical waste in HIV/AIDS testing and treatment centers. In addition, the project is also anticipated to involve the renovation of old buildings, construction of new ones and other minor civil works to enhance the quality of HIV/AIDS service delivery. The potential environmental and social impacts of sub-projects will be small-scale and site-specific; and thus easily remediable typical of category B projects. The project at the inception prepared an Environmental and Social Management Framework (ESMF) for the renovation of old buildings, construction of new ones and other minor civil works to enhance the quality of HIV/ AIDS service delivery. However, the safeguard audit report prepared for the project showed that there was no subproject that carried out such activities and as such no ESMP had been prepared. The same situation is anticipated in the restructured project. The safeguard audit report concluded that the existing and potential issues can be mitigated and as such a safeguard section plan has been developed with a budget. No long term adverse impacts were identified nor anticipated. This project will not fund activities that would cause an adverse effect on the environment or any form of land acquisition or restriction of access to sources of livelihoods. The national MWMP and project specific medical waste management plan will continue to provide guidance on how the medical waste generated would be managed. The project will target vulnerable communities and marginalized groups including women, PLWHAs, etc. The project will (i) support outreach activities to remove the stigma of HIV/AIDs, (ii) identify and fund NGOs working with marginalized groups, (iii) provide Public Disclosure Copy an opportunity for broad consultation at the state and national levels on project goals and results. 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area: No long-term adverse impact is anticipated. 3. Describe any project alternatives (if relevant) considered to help avoid or minimize adverse impacts. N.A. 4. Describe measures taken by the borrower to address safeguard policy issues. Provide an assessment of borrower capacity to plan and implement the measures described. A national medical waste management plan was prepared in consultation with all stakeholders. The plan was disclosed in country and at the Bank InfoShop. The National Health Waste Management Plan was disclosed in-country from April 19 to May 21, 2007. This projectwill be guided by this overarching national plan. The borrower has also prepared and disclosed a project specific medical waste management plan (MWMP). It supports: (i) raising public awareness on the dangers to public health as a result of exposure to medical wastes (ii) segregation, evacuation, treatment and final disposal of medical wastes resulting from the implementation of project activities (iii) choice of technologies for treatment and disposal of medical wastes, (iv) provision of personal protection equipment and disinfectants and (v) capacity building for medical waste management. An Environmental and Social Management Framework (ESMF) for the renovation Page 4 of 6 of old buildings, construction of new ones and other minor civil works has also been prepared. In addition, a safeguard audit report was prepared for the project to assess the status of implementation of the earlier instruments (ESMF & MWMP) prepared and developed specific Public Disclosure Copy actions for implementation. The two reports (ESMF & MWMP) were reviewed and final versions disclosed in country and at the Banks Infoshop. The safeguard audit report will be disclosed on November 12, 2015 All of the activities related to the health care waste management plan will be implemented by the Ministry of Health. Its existing capacity for ensuring compliance with safeguard policies is rather weak, but the safeguard audit report includes capacity building with an orientation already done for NACA staff. Other capacity building activities will include training of safeguard focal persons for NACA, SACA, LACA and HCFs staff in addition to CSOs working with Most At Risk Populations. In addition, NACA and SACAs have designated environment and social specialists who will be responsible for following up safeguards issues when they arise during project implementation. A letter of commitment to implement all the actions contained in the budgeted safeguard action plan was issued by NACA to the Bank. Enhanced support and guidance would be provided by the safeguards specialists in the team from the Bank. NACA and SACAs have agreed put in place beneficiary feedback and grievance redress mechanisms as identified during a joint Bank/NACA supervision mission. The Bank will support the project to develop a working framework for the grievance redress and beneficiary feedback mechanism. After which, a capacity building workshop for safeguards focal persons will be organized and the mechanism developed and adapted to what currently exists. NACA and SACA formal redress grievance mechanism system will (i) provide information about project implementation; (ii) enhance responsiveness to citizens’ needs; (iii) provide a forum for resolving grievances and disputes at the lowest level; (iv) resolve disputes relatively quickly before they escalate to an unmanageable level; (v) help to win the trust and confidence of community members in the project and creating productive relationships between the parties and (vi) ensure equitable and fair distribution of benefits, costs, and risks. Public Disclosure Copy 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. The existing medical waste management plan was prepared using extensive consultation with stakeholders throughout the country. Both the project specific MWMP and ESMF were prepared after a series of consultation with the public, private sector and CSOs. These safeguards instruments have been disclosed in-country and at the Info Shop. In addition, the safeguards audit report was prepared in consultation with the relevant stakeholders and will be disclosed on November 12, 2015. B. Disclosure Requirements Environmental Assessment/Audit/Management Plan/Other Date of receipt by the Bank 11-Nov-2015 Date of submission to InfoShop 16-Nov-2015 For category A projects, date of distributing the Executive //// Summary of the EA to the Executive Directors "In country" Disclosure Nigeria 13-Nov-2015 Comments: Page 5 of 6 If the project triggers the Pest Management and/or Physical Cultural Resources policies, the respective issues are to be addressed and disclosed as part of the Environmental Assessment/ Audit/or EMP. Public Disclosure Copy If in-country disclosure of any of the above documents is not expected, please explain why: C. Compliance Monitoring Indicators at the Corporate Level OP/BP/GP 4.01 - Environment Assessment Does the project require a stand-alone EA (including EMP) Yes [ ] No [ ] NA [ ] report? The World Bank Policy on Disclosure of Information Have relevant safeguard policies documents been sent to the Yes [ ] No [ ] NA [ ] World Bank's Infoshop? Have relevant documents been disclosed in-country in a public Yes [ ] No [ ] NA [ ] place in a form and language that are understandable and accessible to project-affected groups and local NGOs? All Safeguard Policies Have satisfactory calendar, budget and clear institutional Yes [ ] No [ ] NA [ ] responsibilities been prepared for the implementation of measures related to safeguard policies? Have costs related to safeguard policy measures been included Yes [ ] No [ ] NA [ ] in the project cost? Does the Monitoring and Evaluation system of the project Yes [ ] No [ ] NA [ ] include the monitoring of safeguard impacts and measures related to safeguard policies? Have satisfactory implementation arrangements been agreed Yes [ ] No [ ] NA [ ] Public Disclosure Copy with the borrower and the same been adequately reflected in the project legal documents? III. APPROVALS Task Team Leader(s): Name: Enias Baganizi Approved By Safeguards Advisor: Name: Johanna van Tilburg (SA) Date: 12-Nov-2015 Practice Manager/ Name: Trina S. Haque (PMGR) Date: 12-Nov-2015 Manager: Page 6 of 6