The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) Combined Project Information Documents / Integrated Safeguards Datasheet (PID/ISDS) Appraisal Stage | Date Prepared/Updated: 09-Nov-2021 | Report No: PIDISDSA31911 Nov 02, 2021 Page 1 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) BASIC INFORMATION OPS_TABLE_BASIC_DATA A. Basic Project Data Country Project ID Project Name Parent Project ID (if any) Western Africa P176647 First Additional Financing P159040 to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) Parent Project Name Region Estimated Appraisal Date Estimated Board Date Regional Disease Surveillance AFRICA WEST 16-Dec-2021 24-Feb-2022 Systems Enhancement (REDISSE) Phase II Practice Area (Lead) Financing Instrument Borrower(s) Implementing Agency Health, Nutrition & Population Investment Project Federal Republic of West African Health Financing Nigeria, Republic of Togo, Organization (WAHO), Republic of Liberia, MINISTRY OF PUBLIC Republic of Guinea Bissau HEALTH (MINSAP) OF GUINEA BISSAU, MINISTRY OF HEALTH (MOH) OF LIBERIA, NIGERIA CENTER FOR DISEASE CONTROL (NCDC), MINISTRY OF HEALTH (MOH) OF TOGO Proposed Development Objective(s) Parent The PDOs are : (i) to strengthen national and regional cross-sectoral capacity for collaborative disease surveillance and epidemic preparedness in West Africa, thereby addressing systemic weaknesses within the animal and human health systems that hinder effective disease surveillance and response; and (ii) in the event of an Eligible Emergency, to provide immediate and effective response to said Eligible Emergency. Components Component 1: Surveillance and Information Systems Component 2: Strengthening of Laboratory Capacity Component 3: Preparedness and Emergency Response Component 4: Human Resource Management for Effective Disease Surveillance and Epidemic Preparedness Component 5: Institutional Capacity Building, Project Management, Coordination and Advocacy Nov 02, 2021 Page 2 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) PROJECT FINANCING DATA (US$, Millions) SUMMARY -NewFin1 Total Project Cost 20.50 Total Financing 20.50 of which IBRD/IDA 20.50 Financing Gap 0.00 DETAILS -NewFinEnh1 World Bank Group Financing International Development Association (IDA) 20.50 IDA Credit 20.50 Environmental Assessment Category B-Partial Assessment Decision The review did authorize the team to appraise and negotiate Nov 02, 2021 Page 3 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) B. Introduction and Context 1. The Regional Disease Surveillance Systems Enhancement (REDISSE) Program is an interdependent Series of Projects (iSOP) to strengthen national, regional and cross-sectoral capacity for integrated disease surveillance and response in West and Central Africa. The REDISSE Program was developed jointly by the Health and the Agriculture Global Practices with One health (OH) approach to ensure that the human-animal-environment interface is addressed in strengthening of West and Central Africa’s disease surveillance systems. The REDISSE Program has two objectives: 1) to address systemic weaknesses within the animal and human health systems that hinder effective cross sectoral and cross border collaboration for disease surveillance and response; and 2) in the event of an eligible emergency, to provide immediate and effective response to said eligible emergency. 2. REDISSE Phase 2 (REDISSE 2) was approved by the Executive Directors on March 1, 2017 for an amount of US$147 million equivalent to support the regional disease surveillance and response systems in West Africa. This amount includes an IDA credit of US$140 million equivalent and an IDA grant of US$7 million equivalent. The effectiveness dates for REDISSE 2 varied from country to country, July 27, 2017 for Togo, September 21, 2017 for Guinea Bissau, November 1, 2017 for Liberia, and February 13, 2018 for Nigeria. The closing date of the project is August 31, 2023. REDISSE 2 provides financing1 to the countries of Guinea- Bissau, Liberia, Nigeria, and Togo. 3. In February 2020, the project was restructured. This was a Level 2 restructuring that resulted in (i) formalization of the reallocation of US$2.5 million from Sub-components 1.1, 1.2, and 1.3 to Sub-component 3.3 in Nigeria as a result of the activation of the Contingent Emergency Response (CERC) on April 6, 2018 for a major outbreak of Lassa fever; and (ii) revision of the results framework to incorporate new, more reliable, baseline data for project indicators based on actual Joint External Evaluation (JEE) scores; elimination of inconsistencies between the regional and country targets; removal of indicators that were no longer valid; addition of new indicators to monitor gender disparities in access to training opportunities and reflecting CERC activation impact indicators. 4. In March 2020, a CERC activation of 8.0 million to respond to COVID-19 drew resources from REDISSE 2 – Liberia. There was no restructuring since the reallocation of funds between components, for Liberia and amendment to the legal agreement was done at the same time as the CERC activation. This was done on the basis that all conditions precedent for activation had been met. The funds were reallocated from the Credit No. IDA-59690-LB disbursement categories 1 and 2 to the CERC category 3 to address the most urgent needs. C. Proposed Development Objective(s) Original PDO 5. The PDOs are : (i) to strengthen national and regional cross-sectoral capacity for collaborative disease surveillance and epidemic preparedness in West Africa, thereby addressing systemic weaknesses within the animal and human health systems that hinder effective disease surveillance and response; and (ii) in the event of an Eligible 1The funding for REDISSE 2 is allocated as follows: US$21 million equivalent for Guinea Bissau; US$15 million equivalent for Liberia; US$90 million equivalent for Nigeria; and US$21 million equivalent for Togo. Nov 02, 2021 Page 4 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) Emergency, to provide immediate and effective response to said Eligible Emergency. Current PDO 6. No change. 7. There is a clear and urgent need for AF for the REDISSE 2, to Liberia and Togo. The AF should replenish funds reallocated to respond COVID-19 in order to achieve the PDO. D. Project Description 8. In early February 2020 it was agreed that COVID-19 preparedness and response activities could be integrated into the Annual Work Plan and Budgets (AWPBs) and procurement plans financed by the project; or the clients could choose to activate the CERC of the project to reallocate resources to the COVID-19 response. Consequently, REDISSE provided the first response in Africa to country requests for financing to prepare for the COVID-19 pandemic. Support was expedited with in-place financing and rapid disbursement. This gave a “jumpstart� advantage to REDISSE countries and WAHO in addressing the COVID-19 threat. As the first novel coronavirus infections emerged on the continent, REDISSE project resources were increasingly called upon to finance countries’ evolving COVID-19 plans. The REDISSE program had allocated over US$163.52 million to the COVID-19 response in West and Central Africa. 9. The reallocated funding to COVID-19 response hampers implementation of project activities both nationally and regionally. The total allocation to COVID-19 response from REDISSE 2 countries amounts to US$64.50 million, or 43.9% of the envelope. This being the case, only a few of the REDISSE countries in West Africa will be able to resume the activities that have been placed on hold during the current crisis and continue to finance essential capacity building activities for the full project period. E. Implementation 10. REDISSE 2 has been under implementation since August 2017, during which it has strengthened disease surveillance and response systems in Guinea-Bissau, Liberia, Nigeria, and Togo (participating countries) and strengthened regional level collaboration (information exchange), coordinating (regional policies and technical strategies) and resource sharing (training institutions and reference laboratories) among ECOWAS member states and Mauritania. There is clear evidence of progress at both regional and country level. 11. REDISSE 2 has been performing in a Moderately Satisfactory (MS) manner for the overall Project Development Objective (PDO) and Implementation Progress (IP). The MS rating reflects the low disbursement rate, a reflection of the difficulties encountered working with three different ministries in all countries participating in REDISSE 2. 12. Despite initial delays in project start up activities and slow disbursement at the country level in the initial months, as well as the delay in project implementation due to COVID-19, the implementation of activities and the disbursement rate have accelerated in the past year. As of October 20, 2021, 51 percent have been disbursed. 67 percent of the IDA funding for Liberia (Credit N. 5969) and 53 percent of the IDA funding for Togo (Credit N. 5967 - D1700) have been disbursed, which are higher than originally projected and accelerating due to the requirements of the COVID-19 response. An additional US$20.5 million (US$15 million for Liberia and US$5.5 for Nov 02, 2021 Page 5 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) Togo) is needed to support the project activities until the end of the REDISSE Phase 2 project, on August 31, 2023, bringing the total for project activities to US$167.5 million. 13. The Financial Management was rated moderately unsatisfactory at the archived Portfolio and Risk Management (PRIMA) in June 2021. 14. Procurement is currently rated Satisfactory based on the findings of the Procurement Revision recorded at the Procurement Risk Assessment Management System (P-RAMS) on February 23, 2021. 15. The AF project will not lead to the realization of new activities. Indeed, the original funding under REDISSE II is insufficient for completion of REDISSE project activities through August 31, 2023 due to financing gap resulting from reallocation of funds to the COVID-19 response. For Liberia, the AF will replenish the funds used for COVID- 19 and to support completion of activities under all components of the project. For Togo, the AF will replenish the funds used for COVID-19 and to support completion of activities under components 1, 2, 3 and 5 of the project. Thus, no new Operational Policies have been triggered for AF activities and category B is maintained due to potential negative impacts of the project related to the rehabilitation/upgrading of existing medical and other facilities, generation of infectious medical and animal waste and usage of pesticides. The two policies triggered (OP 4.01 and OP 4.09) with the parent project remain applicable to the AF. The safeguard documents already produced for the parent project, namely the Health Care Waste Management Plan (HCWMP), the Integrated Pest and Vector Management Plan (IPVMP), and the Environmental and Social Management Framework (ESMF), will be maintained for the AF and revised as necessary to take into account certain AF activities. The revised ESMF shall ensure project affected communities are identified and consulted, with appropriate social risk mitigation measures included, including those related to Sexual Exploitation and Abuse/Sexual Harassment (SEA/SH) and those related to labor influx which can increase the risks related to COVID-19 transmission and other communicable diseases, including sexually transmitted infections/diseases. The revised ESMF shall be cleared by the Bank prior to the start of project activities. 16. As of October 20, 2021, Liberia has spent a total of US$10.74 million out of the total committed amount of US$15 million under the IDA financing. The proposed AF for Liberia, in the amount of US$15 million, will be from the IDA National PBA (US$5 million) and IDA Regional Integration (US$10 million) and will cover the completion of the planned activities under all components. 17. As of October 20, 2021, Togo has spent a total of US$11.13 million out of the total committed amount of US$21 million under the IDA financing. The proposed AF for Togo, in the amount of US$5.5 million, will be from the IDA National PBA (US$1.83 million) and IDA Regional Integration (US$3.67 million) and will cover the completion of the planned activities under components 1, 2, 3 and 5. . F. Project location and Salient physical characteristics relevant to the safeguard analysis (if known) This project is a part of the REDISSE Program, which, as mentioned in Section B1 above, is a interdependent projects. The second project in the series (REDISSE II) is extending the program to Guinea Bissau, Liberia, Nigeria and Togo. Activities with a physical footprint includes upgrading of laboratory networking facilities, strengthening capacities to prepare for impending epidemics in humans and animals and to respond Nov 02, 2021 Page 6 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) effectively to disease outbreak threat, surveillance, AMR and insecticide resistance monitoring and mapping. While some of these project activities have low to moderate environmental risks, the project will also strengthen the capacity of client governments to successfully manage environmental and social impacts in the event of a infectious disease outbreak among human and/or animals. The physical locations and specific details of the proposed project interventions in the four countries are not as yet known. G. Environmental and Social Safeguards Specialists on the Team Olukayode O. Taiwo, Social Specialist Komlan Kpotor, Environmental Specialist Gina Cosentino, Social Specialist Lucky Erhaze, Environmental Specialist Zinnah S Mulbah, Environmental Specialist Akhilesh Ranjan, Social Specialist Sophie Lo Diop, Environmental Specialist Papa Ansoumana Moustapha Mane, Social Specialist SAFEGUARD POLICIES THAT MIGHT APPLY SAFEGUARD _TBL Safeguard Policies Triggered? Explanation (Optional) Environmental Assessment OP/BP 4.01 Yes Performance Standards for Private Sector No Activities OP/BP 4.03 Natural Habitats OP/BP 4.04 No Forests OP/BP 4.36 No Pest Management OP 4.09 Yes Physical Cultural Resources OP/BP 4.11 No Indigenous Peoples OP/BP 4.10 No Involuntary Resettlement OP/BP 4.12 No Safety of Dams OP/BP 4.37 No Projects on International Waterways No OP/BP 7.50 Projects in Disputed Areas OP/BP 7.60 No Nov 02, 2021 Page 7 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) KEY SAFEGUARD POLICY ISSUES AND THEIR MANAGEMENT OPS_SAFEGUARD_SUMMARY_TBL A. Summary of Key Safeguard Issues 1. Describe any safeguard issues and impacts associated with the proposed project. Identify and describe any potential large scale, significant and/or irreversible impacts: The project activities related to enhancement of surveillance of animal and human health and improvement of laboratories have some social and environmental risks. The impacts of such impacts however are expected to moderate and mostly site specific, with no significant or long-term negative impacts, if well managed. The potential environmental impacts are related to i) construction of laboratory structures (including indiscriminate disposal of construction waste, noise and temporary disruption of access of community; pollution of soil and water through misuse of chemical and their indiscriminate disposal; iii) insufficient attention to occupational health and safety of community and workers, lab technicians etc.); iv) ongoing operations of healthcare facilities and laboratories resulting in generation of infectious waste which needs to be managed to reduce potential health risks and v) management of environmental impacts during epidemics to prevent further spread of disease through poor infection control and inadequate waste management practices. These environmental impacts can also have concomitant impacts on communities and can dispropriately impact vulnerable groups and individuals. In addition, the presence of labor influx can exacerbate the transmission of communicable diseases, including COVID-19 and sexually transmitted diseases and risks related SEA/SH. 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area: The potential impacts especially long-term are related to increased risks to public health due to uncontrolled spread of infectious diseases or increase in rates of hospital acquired infections. Poorly disposed chemicals also have the potential for polluting land and water, which have longer term impacts on public health, 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. Each country has prepared Environmental and Social Management Frameworks (ESMF) which addresses the construction and occupational health related issues related to rehabilitation and construction of laboratories. A Healthcare Waste Management Plan (HCWMP) has also been prepared to institutionalize systems for segregation, treatment and disposal of infectious waste. Integrated Vector and Pesticide Management Plan (IVPMP) have been prepared by each country for sound management of theuse and disposal of chemicals, improved knowledge or awareness and use of Personal Protective Equipment (PPE) for occupational safety. 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. Nov 02, 2021 Page 8 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) OPS_SAFEGUARD_DISCLOSURE_TBL B. Disclosure Requirements (N.B. The sections below appear only if corresponding safeguard policy is triggered) OPS_EA_DISCLOSURE_TABLE Environmental Assessment/Audit/Management Plan/Other For category A projects, date of Date of receipt by the Bank Date of submission for disclosure distributing the Executive Summary of the EA to the Executive Directors "In country" Disclosure OPS_ PM_D ISCLOSURE_TAB LE Pest Management Plan Was the document disclosed prior to appraisal? Date of receipt by the Bank Date of submission for disclosure Yes "In country" Disclosure OPS_COMPLIANCE_INDICATOR_TBL C. Compliance Monitoring Indicators at the Corporate Level (to be filled in when the ISDS is finalized by the project decision meeting) (N.B. The sections below appear only if corresponding safeguard policy is triggered) OPS_EA_COMP_TABLE OPS_ PM_COM P_TABLE OPS_ PDI_ COMP_TAB LE OPS_ALL_COMP_TABLE Nov 02, 2021 Page 9 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) CONTACT POINT World Bank Andy Chi Tembon Senior Health Specialist Noel Chisaka Senior Health Specialist Yemdaogo Tougma Economist, Health Borrower/Client/Recipient Federal Republic of Nigeria Republic of Togo Republic of Liberia Republic of Guinea Bissau Implementing Agencies West African Health Organization (WAHO) Stanley Okolo Prof. wahooas@wahooas.org MINISTRY OF PUBLIC HEALTH (MINSAP) OF GUINEA BISSAU Ilda Mateus dos Santos Nov 02, 2021 Page 10 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) Economist ildamateus6@gmail.com MINISTRY OF HEALTH (MOH) OF LIBERIA Bernice Dahn Minister of Health info@moh.gov.lr NIGERIA CENTER FOR DISEASE CONTROL (NCDC) Chikwe Ihekweazu Chief Executive officer Chikwe.Ihekweazu@ncdc.gov.ng MINISTRY OF HEALTH (MOH) OF TOGO Machikourou SALAMI Program Coordinator salami_machikourou@yahoo.fr FOR MORE INFORMATION CONTACT The World Bank 1818 H Street, NW Washington, D.C. 20433 Telephone: (202) 473-1000 Web: http://www.worldbank.org/projects APPROVAL Andy Chi Tembon Task Team Leader(s): Noel Chisaka Yemdaogo Tougma Approved By Safeguards Advisor: Nathalie S. Munzberg 13-Dec-2021 Practice Manager/Manager: Magnus Lindelow 14-Dec-2021 Country Director: Boutheina Guermazi 21-Dec-2021 Nov 02, 2021 Page 11 of 12 The World Bank First Additional Financing to the Regional Disease Surveillance Systems Enhancement Project in West Africa, Phase II (REDISSE II) (P176647) Nov 02, 2021 Page 12 of 12