The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) EASTERN AND SOUTHERN AFRICA | Eastern and Southern Africa | IBRD/IDA | Investment Project Financing (IPF) | FY 2023 | Seq No: 5 | Archived on 03-Feb-2025 | ISR03144 Implementing Agencies: Africa Centres for Disease Control and Prevention 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 21-Jul-2022) Enhance the capacity of Africa Centres for Disease Control and Prevention (Africa CDC) to support AU Member States in preventing, detecting, and responding to current and future public health threats. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name COVID-19 Response:(Cost 2,000,000.00) Enhancing Africa CDC’s technical and programmatic functions to support AU Member States’ preparedness capacities:(Cost 78,000,000.00) Strengthening Africa CDC’s institutional capacity and operational structure:(Cost 20,000,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Feb 03, 2025 Page 1 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions The Project is reaching its mid-term point, with expenditures reaching 22.4% of the total envelope of US$100 million. While implementation progress was stagnant during the first semester of CY2024, the Africa CDC and its Project Implementation Unit have considerably increased the speed of implementation of activities under the project, evidenced by both disbursements during FY25 and progress on achieving the targets of both PDO Indicators and Intermediate Results Indicators. The Annual Work Plan and Budget for the year 2025 has been already submitted and approved by the World Bank, with an estimated disbursement of US$45 million. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 04 - 02 Aug Proposed Rating 21 Jul 2022 2024 Political and Governance Moderate Substantial Substantial Macroeconomic Low Low Low Sector Strategies and Policies Low Low Low Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Low Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Overall Low Substantial Substantial Feb 03, 2025 Page 2 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes People recruited in the Africa Volunteers Health Corps roster at RCC level Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0.00 Jul/2022 0.00 03-May-2024 19 11-Nov-2024 2,500.00 Jul/2027 Number of people recruited Comments on Recruitment process started in the second semester of 2024. Nineteen (19) recruited and in the Africa Volunteers achieving targets onboarded and an additional 340 interviews have been conducted. The Africa CDC has Health Corps roster at RCC strengthened its recruitment capacities, so the process is scaled-up and targets are met by level (Number) (Number) the end of the Project. Percentage of females 0.00 0.00 21 50.00 recruited in the Africa Comments on Gender disaggregation of the indicator. Volunteers Health achieving targets Corps roster at RCC level (Percentage) Percentage of people 0.00 0.00 52 40.00 recruited in the Africa Comments on Geographic dissagregation of the indicator to ensure a proper and comprehensive Volunteers Health achieving targets geographic distribution in the continent. The geographic dissagregation follows the World Corps roster at RCC Bank's regional grouping of countries. West and Central African countries are: Benin, Burkina level from West and Faso, Cabo Verde, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Central African Equatorial Guinea, Gabon, Gambia, Ghana, Guinea,uinea-Bissau, Liberia, Mali, Mauritania, countries Niger, Nigeria, Senegal, Sierra Leone, and Togo (Percentage) Percentage of people 0.00 0.00 43 40.00 recruited in the Africa Comments on Geographic dissagregation of the indicator to ensure a proper and comprehensive Volunteers Health achieving targets geographic distribution in the continent. The geographic dissagregation follows the World Corps roster at RCC Bank's regional grouping of countries. East and South African countries are: Angola, Feb 03, 2025 Page 3 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) level from East and Botswana, Burundi, Comoros, Democratic Republic of the Congo, Eritrea, Eswatini, Ethiopia, South African countries Kenya, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia , Rwanda, São Tomé (Percentage) and Principe, Seychelles, Somalia, South Africa, South Sudan, Sudan, Uganda, United Republic of Tanzania, Zambia, and Zimbabwe. Percentage of people 0.00 0.00 5 20.00 recruited in the Africa Comments on Geographic dissagregation of the indicator to ensure a proper and comprehensive Volunteers Health achieving targets geographic distribution in the continent. The geographic dissagregation follows the World Corps roster at RCC Bank's regional grouping of countries. North African countries are: Algeria, Djibouti, Egypt, level from North Lybia, Morocco, Sawarahi Arab Republic, and Tunisia. African countries (Percentage) People trained under the newly updated Africa Epidemiologic Service (AES) program Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0.00 Jul/2022 0.00 03-May-2024 0.00 11-Nov-2024 45.00 Jul/2027 Number of people trained Comments on The AES program has been operationalized. Ten (10) fellows from 9 MS have been enrolled under the newly updated achieving targets for Epi track (the program lasts 2 years). The online portion of the AES has been rolled out on Africa Epidemiologic Service their LMS (learning management system). The Africa CDC is expecting to scale-up the (AES) program (Number) recruitment of AES fellows so the target is met at the end of the Project. Percentage of females 0.00 0.00 0.00 50.00 trained under the Comments on Female disaggregation of parent indicator newly updated Africa achieving targets Epidemiologic Service (AES) program (Percentage) Biosafety and Biosecurity standards at Laboratory Level Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0.00 Jul/2022 22.00 03-May-2024 1 11-Nov-2024 5.00 Jul/2027 Feb 03, 2025 Page 4 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) Number of laboratories Comments on An Africa CDC framework for biosafety and biosecurity accreditation has been developed. supported to perform a achieving targets Staff from 22 laboratories have been trained on the framework that will be used to assess certification assessment on them. 1 MS (Uganda) has been certified. Minimum Standards for Biosafety and Biosecurity in handling high risk pathogens (Number) Member States supported through the Vaccine Technology and Intellectual Property Transfer Service Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of Member States 0.00 Jul/2022 0.00 03-May-2024 0.00 11-Nov-2024 10.00 Jul/2027 supported through the newly Comments on The framework for supporting Member States in Vaccine Technology and Intellectual established Vaccine achieving targets Property (IP) Transfer Support Service has been developed. However, given the evolving Technology and Intellectual priorities of the Africa CDC and how they would like to streamline the support through the Property (IP) Transfer Project, this indicator will be assessed during MTR to determine its feasibility and relevance Support Service (Number) to this operation. Africa CDC roadmap for becoming an autonomous health body of the AU operationalized Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year No Jul/2022 No 03-May-2024 Yes 11-Nov-2024 Yes Jul/2027 Comments on The roadmap for becoming an autonomous health body of the AU is completed and Africa CDC's roadmap for achieving targets implemented with all the core fiduciary and administrative functions operational. becoming an autonomous In 2023, at its 43th ordinary session the Executive council reviewed and approved the health body of the AU has proposed new structure of Africa CDC through Decision EX.CL/ Dec.1218 (XLIII). in February been operationalized 2024, the AUC submitted its final report called “ the interim report on the operationalization (Yes/No) of Africa CDC - EX.CL/1498 (XLIV) highlighting the fulfillment of all legal, structural and financial aspects of the autonomy of Africa CDC. This report was approved by the Executive Council in February 2024 through Decision EX.CL/Dec.1250(XLIV). The Africa CDC is authorized to enter into financial agreements with other institutions, if operating with its Feb 03, 2025 Page 5 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) own bank account, has designated signatories, is able to receive funds directly into their accounts, can advertise and make HR appointments directly, can advertise and award procurement processes, etc. 6.2 Intermediate Results Indicators by Components COVID-19 Response Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of Member States 0.00 Jul/2022 10.00 03-May-2024 10.00 11-Nov-2024 15.00 Jul/2027 supported to implement Comments on Ten (10) countries were supported. Nov 2024 mission held discussions about eliminating the high-frequency surveys on achieving targets words "high frequency" and "COVID-19" from the indicator to cover vaccine literacy and COVID-19 vaccine literacy hesitancy for any disease given that there are other outbreaks that are now more prominent and hesitancy (Number) than COVID-19 (e.g. Mpox). Therefore, it is expected that this indicator will be either (Number) dropped or modified during after the MTR. Enhancing Africa CDC’s technical and programmatic functions to support AU Member States’ preparedness capacities Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Africa CDC Strategic Plan for No Jul/2022 No 03-May-2024 No 11-Nov-2024 Yes Jul/2027 Endemic and Neglected Comments on Progress ~75%. ACDC has recently finished a 1.5 yr process to develop the plan. The plan has Tropical Diseases 2023-2027 achieving targets been developed but it has not yet been validated by AU Member States. developed and validated by Member States (Yes/No) Africa CDC Strategic Plan for No Jul/2022 No 03-May-2024 No 11-Nov-2024 Yes Jul/2027 Community Health Workers Comments on Progress ~75%. Plan has been developed, but it has not yet been validated by AU Member 2023-2027 developed and achieving targets States validated by Member States (Yes/No) Feb 03, 2025 Page 6 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) Regional action plans to No Jul/2022 No 03-May-2024 No 11-Nov-2024 Yes Jul/2027 respond to mental health Comments on Progress ~80%. 4 out of 5 regional action plans have been developed. 1 is pending. and psychosocial support achieving targets during humanitarian crises and epidemics developed (Yes/No) 0.00 Jul/2022 22.00 03-May-2024 31 11-Nov-2024 5.00 Jul/2027 Number of Member States Comments on Thirty-one (31) MS have been supported with event-based surveillance. 2 MS assisted in that have been capacitated achieving targets developing and launching national event-based surveillance guidelines. Surveillance officers on public health intelligence from 11 MS trained on One Health approach. Since this target has been surpassed, and event-based surveillance discussions are taking place on a clear definition of what “support and technical assistance (Number) received” means or on adjusting the target to be in line with that definition. Africa CDC continental No Jul/2022 Yes 03-May-2024 Yes 11-Nov-2024 Yes Jul/2027 framework for mortality Comments on The drafting and development of the Africa CDC continental framework for mortality surveillance developed and achieving targets surveillance has concluded, and it has been validated by AU Member States. validated (Yes/No) Regional Integrated No Jul/2022 No 03-May-2024 Yes 11-Nov-2024 Yes Jul/2027 Surveillance and Laboratory Comments on The development of the RISLNET framework has concluded, and it has been validated by AU Network (RISLNET) achieving targets Member States. Frameworks for East, West, Central and Southern RCCs have been framework developed and developed and validated. validated by Member States (Yes/No) Number of senior laboratory 0.00 Jul/2022 0.00 03-May-2024 76 11-Nov-2024 42.00 Jul/2027 specialists, directors, and Comments on A first cohort of senior laboratory specialist was trained in 2024 and the amount of trainees quality managers trained achieving targets already surpassed the Project's target. under the in-person Laboratory Leadership Training Programme across the continent (Number) 0.00 0.00 38 40.00 Feb 03, 2025 Page 7 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) Percentage of female Comments on Gender disaggregation of the parent indicator senior laboratory achieving targets specialists, directors, and quality managers trained under the in- person Laboratory Leadership Training Programme across the continent (Percentage) 0.00 Jul/2022 0.00 03-May-2024 40 11-Nov-2024 200.00 Jul/2027 Number of laboratory staff Comments on A first cohort of laboratory staff has been trained at Africa CDC HQ in Addis Ababa. The trained in collecting, curating achieving targets Africa CDC has included in the AWPB 2025 the new cohorts to be trained this calendar year. and managing biological data Conducted hands-on training of laboratory staff how to collect, curate and manage biological using standardized training data using standardized training materials. Have also conducted training on mapping data materials (Number) management and validation and on genomic data curation. Number of regional 0.00 Jul/2022 0.00 03-May-2024 0.00 11-Nov-2024 5.00 Jul/2027 laboratory networks brought Comments on The framework for the development of this activity has been finalized. The specific-country up to full capacity for achieving targets support will be provided this CY and has been included in the AWPB 2025. Therefore, it is zoonotic disease diagnosis expected that this indicator will reflect progress during 2025. and data access. (Number) Number of Member States 0.00 Jul/2022 17.00 03-May-2024 17.00 11-Nov-2024 20.00 Jul/2027 supported to improve Comments on Seventeen (17) MS have been supported to improve their AMR surveillance programs. Africa surveillance of antimicrobial achieving targets CDC also launched a Landmark report highlighting well-defined and evidence-based use and AMR microorganisms proposals that align with Africa's position and needs on AMR containment. The report (Number) outlines specific actions, policies, and initiatives, including recommends investments. Number of Member States 0.00 Jul/2022 6.00 03-May-2024 10 11-Nov-2024 20.00 Jul/2027 supported in performing Comments on Four (4) additional AU Member State have been provided technical assistance by the Africa UHPR/JEE assessments achieving targets CDC for performing Universal Health and Preparedness Reviews (UHPR)/ Joint External (Number) Evaluation (JEE) assessments to evaluate preparedness and health security capacities. Feb 03, 2025 Page 8 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) Additional countries have been included in the AWPB 2025, so that the progressive increase of this indicator continues. Number of Public Health 0.00 Jul/2022 3.00 03-May-2024 8 11-Nov-2024 11.00 Jul/2027 Emergency Operations Comments on Five (5) additional AU Members States' PHEOC have been supported through the project in Centers (PHEOCs) supported achieving targets terms of technical expertise and programmatic assistance and operational functions. with capacity building Additionally, this activity has also been included in the AWPB 2025, so the indicator will (Number) continue to see a cumulative progression. Africa Volunteer Health No Jul/2022 No 03-May-2024 No 11-Nov-2024 Yes Jul/2027 Corps (AVoHC) framework Comments on Framework has been updated and validated but translation and dissemination is pending. In updated and disseminated achieving targets addition, AVoHC induction course manual has been developed. (Yes/No) Number of RCCs operational 0.00 Jul/2022 2.00 03-May-2024 2.00 11-Nov-2024 4.00 Jul/2027 under the newly developed Comments on Achieved at ~85%. The RCCs in the Southern and Eastern Regions are functional based on operational framework achieving targets the operational and administrative framework. Central RCC has 4/5 criteria completed. (Number) Western RCC has 3/5 criteria completed. Number of scholars deployed 0.00 Jul/2022 0.00 03-May-2024 0.00 11-Nov-2024 80.00 Jul/2027 to NPHIs under the Kofi Comments on The framework for the deployment and the identification of Kofi Annan Fellowship Annan Fellowship achieving targets Programme are being identified. The deployment of the scholars has been included in the Programme (Number) AWPB 2025, therefore progress is expected this CY. Percentage of female 0.00 0.00 0.00 50.00 scholars deployed to Comments on Gender disaggregation of parent indicator NPHIs under the Kofi achieving targets Annan Fellowship Programme (Percentage) Africa CDC Workforce No Jul/2022 No 03-May-2024 No 11-Nov-2024 Yes Jul/2027 Development Framework has Comments on A taskforce has been established. Consultations with MS to assess gaps is currently taking been revised and validated achieving targets place. by Member States (Yes/No) Feb 03, 2025 Page 9 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) A module on "gender in No No No Yes preparedness" has Comments on Gender in preparedness has been included in the development of the Africa CDC Workforce been included in the achieving targets Development Framework. Africa CDC Workforce Development Framework (Yes/No) Number of people enrolled 0.00 Jul/2022 12.00 03-May-2024 12.00 11-Nov-2024 120.00 Jul/2027 under the two-year Field Comments on A first cohort has been enrolled under the two-year Field Epidemiologic Training Program Epidemiologic Training achieving targets (FETP). It is expected that this CY, an additional and larger cohort will be enrolled. Program (FETP) from Member States (Number) Percentage of females 0.00 25.00 25.00 40.00 enrolled under the two- Comments on Gender disaggregation of parent indicator year Field achieving targets Epidemiologic Training Program from Member States (Percentage) Number of Africa CDC staff 0.00 Jul/2022 6.00 03-May-2024 27 11-Nov-2024 75.00 Jul/2027 members who have Comments on Several activities were approved during CY 2024 directed at professional training of Africa completed professional achieving targets CDC staff. Additional activities have been included in the AWPB 2025, so the continuous training (Number) increase of the indicator is expected for CY2025. Vaccine technology and No Jul/2022 No 03-May-2024 No 11-Nov-2024 Yes Jul/2027 intellectual property (IP) Comments on The tech transfer enablement unit has not yet been established but there has been progress, transfer support service for achieving targets inc training of African biomanufacturing experts on tech transfer (from Algeria, Egypt, Member States has been Senegal, and South Africa). established (Yes/No) Fill and Finish tech transfers 0.00 Jul/2022 0.00 03-May-2024 0.00 11-Nov-2024 6.00 Jul/2027 between local manufacturers Comments on Given the evolving priorities of the institution and how they have been streamlining and international achieving targets activities under the local and vaccine manufacturing, this indicator might be dropped after manufacturers facilitated by the MTR. Feb 03, 2025 Page 10 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) the Africa CDC Manufacturing Unit (Number) No Jul/2022 No 03-May-2024 No 11-Nov-2024 Yes Jul/2027 Comments on The African Pool Procurement Mechanism (APPM), which includes Vaccines and other health achieving targets commodities, has been established. The design of it is underway (at 80-85%) and the launch Africa Vaccine Procurement is schedule for Q4 of 2025. Progress to date includes: Most of the design elements of the Pooling Mechanism designed APPM are completed including product scope, regulatory requirements, and client interface. and launched (Yes/No) The governance and financing mechanisms of the APPM are under discussion; Engagement with the expert panel conducted; Consultation with Regional Economic Communities conducted; Consultation with Member States is under preparation. Strengthening Africa CDC’s institutional capacity and operational structure Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year No Jul/2022 Yes 03-May-2024 Yes 11-Nov-2024 Yes Jul/2027 Organizational frameworks Comments on The Africa CDC has developed and set in motion its internal organizational frameworks for for operationalizing Africa achieving targets operationalizing its transition into an autonomous health body of the AU. CDC's transition into an The Executive Council Decisions EX.CL/Dec.1106(XXXVII) and EX.CL/Dec.4(XXXVIII) instructed autonomous health body of the African Union Commission to produce a road map and a Framework of Operations, the AU have been developed outlining the financial, legal and structural implications to fully operationalize the Africa CDC (Yes/No) as an autonomous agency of the African Union. Gender-responsive HR No No Yes Yes hiring, retention and Comments on Supplemental indicator on gender approached of the parent indicator which has been promotion processes achieving targets achieved. Gender-responsive HR has been included in the organizational frameworks and are developed and hiring practices in the institution. operationalized as part of the Africa CDC transition into an autonomous health Feb 03, 2025 Page 11 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) body of the AU (Yes/No) No Jul/2022 Yes 03-May-2024 Yes 11-Nov-2024 Yes Jul/2027 Comments on The Division of Partnerships and International Cooperation has been established under the Africa CDC's Partnership Unit achieving targets Directorate of External Relations and Strategic Engagement. This Division's mandate is to: is established and functional Lead and coordinate the Africa CDC’s partnership and collaboration efforts with (Yes/No) international organizations, governments, private sector partners, civil society organizations, and other stakeholders to promote the institution’s goals and objectives. There are 3 units: Partnerships, Resource Mobilization and Grants Management. Strategy and action plan No Jul/2022 No 22-Nov-2022 Yes 11-Nov-2024 Yes Jul/2027 developed for the transition Comments on The Africa CDC has developed the strategy and action plan for the transition of the AU of the AU COVID-19 achieving targets COVID-19 Response Fund into the Africa Epidemic Fund. The draft framework for the AfEF Response Fund into the has been revised. Consultations with legal division are taking place. AfEF will be a trust fund Africa Epidemic Fund with all proper mechanisms of control. (Yes/No) Feb 03, 2025 Page 12 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IDA-E1110 Effective 100.00 98.85 0.00 22.44 76.50 22.68% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-E1110 Effective 21-Jul-2022 12-Sep-2022 26-Oct-2022 31-Jul-2027 31-Jul-2027 Feb 03, 2025 Page 13 of 14 The World Bank Implementation Status & Results Report Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats Project (P178633) 8. KEY DATES Key Events Planned Actual Approval 21-Jul-2022 21-Jul-2022 Effectiveness 26-Oct-2022 26-Oct-2022 Mid-Term Review No. 01 15-May-2025 Operation Closing/Cancellation 31-Jul-2027 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) There are no associated operations Feb 03, 2025 Page 14 of 14