Africa CDC Regional Investment Financing Project (P167916) and the Africa Centres for Disease Control Support Program to Combat Current & Future Public Health Threats (P178633) Implementation Support Mission November 4th-11th, 2024 AIDE MEMOIRE I. INTRODUCTION 1. An Implementation Support Mission (ISM) for both the Africa CDC Regional Investment Financing Project (P167916) and the Africa Centres for Disease Control Support Program to Combat Current and Future Public Health Threats (P178633) took place during November 4-11, 2024, in Addis Ababa, Ethiopia. The Mission’s main objectives were to: (a) review the status of project implementation against the 2024 annual workplan; (b) discuss preparation of the 2025 annual workplans; (c) discuss options to accelerate the rate of project implementation; (d) discuss activities to be financed by the projects to support the response to the Mpox outbreak; and (e) strengthen coordination with development partners supporting the Africa CDC.1 2. The Mission team would like to express its gratitude to H.E. Dr. Jean Kaseya, Director General (DG) of Africa CDC, for his support and continued commitment to elevating the role of Africa CDC. The team congratulates the DG for selecting high-quality experts to perform the technical work. Additionally, the team appreciates the support provided by Dr. Raji Tajudeen, Acting Deputy Director General, along with Africa CDC’s Heads of Division and staff for their ongoing efforts in strengthening the technical and institutional capacities of Africa CDC. The Mission also extends sincere appreciation to Mr. Nobel Cubahiro, Interim Project Coordinator, for his support until the appointment of the incoming PIU Coordinator, Dr. Michael Olugbile. The Mission team welcomes the new PIU Coordinator and anticipates working closely with him. The Mission’s findings and key agreed actions were discussed with H.E. Dr. Jean Kaseya, DG of Africa CDC at the wrap-up meeting on Monday, November 11, 2024. II. PROJECT DATA AND RATINGS Table 1: Key Project Data and Ratings Project Data Africa Centres for Disease Control Africa CDC Regional Investment Support Program to Combat Financing Project (P167916) Grant 1 Current & Future Public Health Threats (P178633) Grant 2 Original Project Amount US$ 10 M US$ 100 M Total disbursement US$ 4.3 M US$ 22.4 M Disbursement during US$ 0 US$ 14.3 M FY25 1 A complete list of participants met by the Mission is in Annex 5. 1 Closing Date December 31, 2025 July 31, 2027 Project Ratings Africa Centres for Disease Control Support Program to Combat Current & Future Public Health Threats (P178633) Grant 2 Previous (ISR4-08.2024) Current Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Project Management Moderately Satisfactory Satisfactory Procurement Moderately Satisfactory Moderately Satisfactory Financial Management Unsatisfactory Moderately Unsatisfactory Monitoring and Evaluation Satisfactory Satisfactory Environmental and Social Safeguards Moderately Satisfactory Moderately Satisfactory Component Ratings Component 1 Moderately Satisfactory Moderately Satisfactory Component 2 Moderately Satisfactory Moderately Satisfactory Component 3 Moderately Unsatisfactory Satisfactory III. IMPLEMENTATION PROGRESS AND KEY FINDINGS: 3. Project P167916 or Grant 1 has been effective since May 2020, with disbursements to the Africa CDC totaling US$4.31M out of the US$10M allocated to the regional institution out of the total Project envelope (US$250M). During the previous mission of Project P178633 and subsequent discussions, it was agreed that at least US$5M would be focused on strengthening Africa CDC’s public health assets to complete stage 1 of operationalizing the BSL3 laboratory (the construction of which has been already finalized). This will allow for synergies with the other implementing entities (national institutes of public health of Ethiopia and Zambia). The Annual Work Plan and Budget (AWPB) of 2025 for the Africa CDC allocation of this project has been updated to include these investments. 4. Project P178633 or Grant 2 has been effective since October 2022, with disbursements totaling US$22.4M out of a total financing of US$100M. Project progress towards achievement of the PDO continues as Moderately Satisfactory, however, the Overall Implementation rating has been upgraded from Moderately Unsatisfactory to Moderately Satisfactory. While there were delays in the implementation of the AWPB of 2024 during the first 5 months of the calendar year, implementation has accelerated since the last ISM (May 2024) with significant progress in many of the key activities that contribute to the PDO (see details below). 315 activities have been approved in the 2024 AWBP across 23 business units (technical and administrative units), out of which 115 (37%) have been completed and 84 (27%) are ongoing. This represents a total of US$16.6M of expenditures and commitments as of mid-November. ACDC plans to frontload implementation of big-ticket items during the first 6 months of CY2025. 2 5. Under Component 32 there has been significant progress in the process of autonomy, which is reflected in a new, larger organizational structure, with several units upgraded to divisions and the creation and staffing of 10 new business units, which now includes a functional Division of Partnerships and International Cooperation (IRI29). ACDC is already exercising core functions under its autonomous status (PDO10) in 6 main functional areas established in the roadmap to operationalize the autonomy: (i) Governance and Legal (e.g. ability to sign financial agreements with donors); (ii) Finance (e.g. establishment of own bank account); (iii) HR (e.g. ability to publish and make appointments); (iv) Procurement; (e.g. ability to advertise and award procurement processes); (v) Management of information systems (e.g. acquisition of software licenses); and (vi) Office and Operations. At the same time, the transition and rapid expansion of the organization has also resulted in some challenges, most notably the shortages with regards to collaboration across business units with overlapping mandates. The establishment of the new Planning, Reporting & Accountability Division will be key in ensuring synergies across units. In addition, the Strategy and action plan for the transition of the AU COVID-19 Response Fund into the Africa Epidemic Fund have been developed (IRI30). 6. The PIU has been significantly strengthened and reconstituted since the last Mission, now staffed with a Project Coordinator, Procurement Specialist, Procurement and Disbursement Officer, Finance Expert, Project Management Expert, E&S Expert, IT Expert, and Administrative Assistant. Only the M&E Expert remains pending as the incumbent will not be able to join the PIU until mid-2025. The process to select the next best candidate is ongoing. In the meantime, M&E functions are being well managed between the PIU and the Planning, Reporting and Accountability (PRA) Division, which monitors performance indicators for the entire institution (including those associated with grants), including through an institution-wide quarterly review meeting. The Project Management rating has been upgraded from Moderately Satisfactory to Satisfactory. 7. The mission had discussions with ACDC and other partners about efforts to integrate the PIU within the Africa CDC structure over the medium term and to expand its role to manage additional projects in addition to the World Bank-financed portfolio. A concept note for the transition to an integrated and expanded PIU has been developed. CEPI and Gavi are conducting a capacity assessment, and the Bank team is in discussions with both partners to identify areas where the PIU could be further strengthened to undertake the expanded role. 8. Component 23 has the largest share of the project funds and the highest potential impact of improving continental health security and shows substantial progress. Several IRIs already achieved their end of project targets and many others are well advanced. For example, the continental framework for mortality surveillance (IRI6) and the Regional Integrated Surveillance and Laboratory Network (RISLNET) framework (IRI7) have been developed and validated (IRI6). The Strategic Plan for Endemic and Neglected Tropical Diseases 2023-2027 (IRI2) and the Strategic Plan for Community Health Workers 2023- 2027 (IRI3) have been developed and are scheduled to be validated before the end of the calendar year. The Regional action plans to respond to mental health and psychosocial support during humanitarian crises and epidemics (IRI4) have been developed for 4 out of the 5 regions. In addition, 17 out of a target of 20 MS have been supported to improve surveillance of antimicrobial use and AMR microorganisms (IRI12) and 8 out of a target of 11 Public Health Emergency Operations 2 Strengthening Africa CDC’s institutional capacity and operational structure 3 Enhancing Africa CDC’s technical and programmatic functions to support AU Member States’ preparedness capacities 3 Centers (PHEOCs) have been supported with capacity building (IRI14). With regards to the Number of RCCs operational under the newly developed operational framework (IRI16), while 2 out of a target of 4 are fully operational, one has 4/5 criteria completed and one has 3/5 criteria completed. The target for the number of MS that have been capacitated on public health intelligence and event-based surveillance (IRI5) has been surpassed (31/5), therefore the Bank is in discussions regarding the functional definition of that indicator and the need to adjust the end of project target. Finally, the African Pool Procurement Mechanism (APPM), which includes Vaccines and other health commodities, has been established. The design is underway. Most of the design elements of the APPM are completed including product scope, regulatory requirements, and client interface. The governance and financing mechanisms of the APPM are under discussion. It is expected that the APPM will be launched (IRI26) toward the end of 2025. A detailed status of the Results Framework is provided in Annex 1. 9. Activities under Component 14 have continued but with an emphasis on Mpox, which is the current Public Health Emergency of Continental Security (PHECS)5 in Africa, declared as such on August 13, 2024. An incident manager for the emergency was appointed and a Mpox Continental Preparedness and Response Plan for Africa was developed, together with the WHO. The Mission initiated discussions with ACDC on the need to adjust the component to make it comprehensive of other epidemics, considering COVID-19 has been determined by WHO as an ongoing health issue which no longer constitutes a public health emergency of international concern. 10. Human resources: A key aspect of this project is the support to strengthening human resources, which was one of the most prominent aspects in the discussions leading to its preparation. The Mission stressed the need to closely monitor the number of technical and non-technical staff appointments in relation to the implications for the project’s budget per component and the sustainability of these positions in the future. There is a need to identify mechanisms to enhance the sustainability of these positions once the project is closed. 11. Procurement: The Mission noted several challenges common to Grant 1 and Grant 2 that impacted the performance of planned activities and slowed the procurement process, which require management attention: (i) discrepancy on the procurement performance reported by PIU and what can be seen in the system, as the STEP system has not been regularly updated with regards to completed and signed contracts; (ii) absence of dedicated expert to maintain STEP up-to-date and procurement performance and streamline procurement record-keeping; (iii) delays in procurement activities over the past two- years due to the leadership transition and development of their new Strategic Plan. To address these challenges, the Mission recommended the following: (i) recruitment of a dedicated consultant to ensure proper procurement record-keeping and regular updates in STEP for future contracts during project implementation, facilitating timely post-procurement reviews; (ii) urge for a more proactive collaboration with business units to define procurement needs in-line with the PDO; and (iii) submit final Terms of Reference (ToR) and technical specifications to the Bank before the Procurement Plan submission in STEP, ensuring Bank comments are addressed to minimize delays and cancellation of planned activities (iv) finalize updating STEP for already completed and signed contracts so that WB can conduct FY25 PPR. In addition, the Mission discussed and agreed that the financing for the procurement of laboratory equipment with estimated amount of US$8.00M, will be divided under both projects. Grant I (P167916) will cover US$5.70M, while Grant II (P178633) will finance the remaining US$2.30M. A detailed status of procurement aspects is provided in Annex 2. The Procurement performance rating for the project remains Moderately Satisfactory. 4 COVID-19 Response 5 under Article 3, Paragraph F of the Africa CDC Statutes 4 12. Financial Management (FM): There are FM issues that require attention to ensure that both projects financial management arrangements work optimally to provide reasonable assurances that Bank proceeds are being used for the intended purposes and FM reports can be used in a timely manner to monitor the project. These issues include: a) Interim Financial Reports (IFR’s): the Interim Financial Reports (IFRs) for the quarters ending on June 30, 2024, December 31, 2023, and March 31, 2024, were submitted with delays of three months, four months and 1.5 months, respectively. However, with the recruitment of the Financial Management Specialist for the PIU, Q3 IFR was prepared and submitted on in a timely manner. External Audits: the 2023 external audit reports have been submitted with a delay of four months. The auditors provided unmodified opinion on the financial statements of both grants. Furthermore, the Management Letters that report on internal control weaknesses have not been submitted along with the Audit reports. These should be submitted by December 15, 2024. To avoid similar delays, the auditors for the 2024 external audit must be recruited by December 31, 2024. b) Low Disbursement and Implementation Bottlenecks: for Grant 1, there is an undisbursed fund balance of US$ 5.77M with only one year remaining for implementation. This resource's use for eligible expenses should be considered. The budget utilization in FY 2024 up to the third quarter is 24%. For Grant 2, since the last mission, additional disbursement of US$ 14.3M (22.6% disbursement) has been made. However, expenditures incurred in 2024 (up to Q3) is only US$ 4.9M. The budget utilization in FY 2024 up to the third quarter is 15%. Project implementation must accelerate by addressing procurement bottlenecks. c) Questionable expenditures: there are questionable expenditures of US$ 23,514.1 and US$ 39,556 under Grant 1 and Grant 2 respectively. Necessary explanation/documents should be provided by December 10, 2024. d) Interfund Borrowing: interfund borrowing is noted and such practice should be avoided. The 2024 Q4 IFR (due on February 14, 2025) should show that all interfund borrowings are cleared. The Bank will review and provide guidance on the request from ACDC to open another project/designated bank account to avoid interfund borrowing by December 31, 2024. The mission appreciates the engagement made with the Office of Internal Oversight (OIO) at AUC with firm commitment to commence the internal audit of the project in December 2024 while also including the projects in their 2025 annual workplan. This should be followed up to ensure execution as planned. 13. The FM rating has been upgraded to Moderately Unsatisfactory in view of the recruitment of finance officer, submission of the 2024 Q3 IFR in a timely manner, and engagement with OIO to plan for the internal audit review. To further improve the FM aspects and rating for the projects, IFRs should be submitted in a timely manner, the 2024 external audit report should be completed in a timely manner (report due by June 30, 2025), adequate explanation should be provided for the questionable expenditures, the Grant 1 remaining resource should be utilized for planned activities, budget utilization should improve under both grants, and interfund borrowing should be addressed. 14. Environmental and Social (E&S) dimensions: The Mission identified the following issues for Grant 1 and 2: (i) E&S Expert and ESCP Monitoring: the Mission welcomed the onboarding of the E&S expert to support Africa CDC's PIU and emphasized close monitoring of E&S considerations in project activities, ensuring adherence to ESCP exclusion criteria for high-risk procurements; (ii) Annual Work Plan Review: Africa CDC was advised to screen the AWPBs to identify risks and measures as needed, and report progress; (iii) Labor and Working Conditions: the PIU should integrate E&S and occupational health and safety measures into work plans, TORs, and procedures, and ensure proper implementation of the SEP, LMP, and update Grievance Mechanisms (GMs); (iv) Laboratory Equipment Procurement: due diligence on laboratory equipment procurement must document available 5 technologies and management systems, with a Waste Management Plan for chemical handling (under Grant 1); (v) Capacity Building: Africa CDC agreed to develop a training plan and allocate the necessary budget in the 2025 AWPB; (vi) Reporting and Incident Management: timely E&S progress reporting and incident management should align with ESCP timelines. The detailed E&S Report can be found in Annex 4. The Environment and Social performance rating for the project remains Moderately Satisfactory. 15. Finally, the Mission discussed the possibility of having the Mid Term Review Mission in April or May of 2025. IV. NEXT STEPS AND AGREED ACTIONS Table 2: Summary of Agreed Actions No. Actions Due Date Responsible 1 Bi-weekly meetings to discuss implementation progress and Continuous WB Team, PIU support. 2 Submission of an overview of the HR recruitment status, February 28, 2025 PIU process, and pipeline Procurement 3 Recruit a dedicated consultant to update activities in STEP December 10, 2024 PIU 4 Update STEP for already completed and signed contracts and December 20 for PIU continue updating for all planned activities already completed contracts and ongoing for others 5 Share results of PPR Report with Africa CDC Before next WB Procurement Mission (WB) 6 Prioritize procurement needs by business units that contribute Ongoing PIU to the PDO 7 Facilitate proactive collaboration between the PIU, user Ongoing PIU department, and technical team to expedite planned activities, ensuring clear communication, regular check-ins, and swift issue resolution for timely execution 8 Recruit additional support on procurement for the Directorate December 31, 2024 PIU of Administration to handle operational procurement Financial Management 9 Submit the FY 23 external audit Management Letter December 15, 2024 AUC Finance Directorate 10 Provide explanation for the questionable expenditure of US$ December 10, 2024 Africa CDC 39,556 Directorate of Finance 12 Monitor budget execution regularly, report variance analysis Ongoing, quarterly AUC, Africa in quarterly IFRs, and address bottlenecks CDC 13 Clear the interfund borrowing, cease such practices, and 2024 Q4 IFR (due Feb AUC Directorate reflect it in the Q4 CY2024 IFR. 14, 2025) of Finance 14 Provide guidance on the opening of new designated/project December 31, 2024 FM (WB) account outside of Ethiopia to resolve the cause of the interfund borrowing 15 Ensure that the Office of Internal Oversight (OI) conducts February 15, 2025 AUC Directorate internal audit on the FY23 and FY24 accounts and submits an of Finance, Africa internal audit report to the Bank. CDC 6 16 Ensure external auditors are recruited for the FY24 audit to December 31, 2024 AUC Directorate ensure audit report is submitted on time of Finance Environmental and Social (E&S) 17 Review AWPB 2024 & 2025 and related ToRs to screen for Starting Nov 2024, PIU eligibility and other E & S considerations against ESCP ongoing during FY 25 measures 18 Submit E&S report capturing progress against the measures January 15, 2025 PIU in the ESCP 19 Share Grievance Mechanism (GM) guidelines to address December 31, 2024 PIU project related E&S issues 20 Identify and document the available technology and December 31, 2024 Africa CDC management systems for the Africa CDC laboratory's E&S risk management 21 Ensure the screening and preparation and implementation of January 30, 2024 Africa CDC laboratory chemical handling and Waste Management Plan (under Grant 1) Table 3. Status of Agreements from the previous Mission No. Actions Due Date Responsible Status Submit a revised AWPB 2024 with the level details Done satisfactory to the World Bank, reflecting realistic 1 May 18, 2024 Africa CDC timelines, and clarifying the status of activities (delayed, ongoing, completed). Review and provide a full No Objection to the revised World Bank Done 2 May 25, 2024 version of the AWPB 2024. team 3 Submit a first draft of the AWPB 2025. July 31, 2024 Africa CDC Done Africa CDC Continuous Hold quarterly meetings with the Heads of Divisions and PIU 4 technical teams to discuss implementation progress and Continuous World Bank challenges. team 5 Submit the 2023 Implementation Progress Report May 17, 2024 Africa CDC Done Recruitment of the following PIU positions yet to be Done filled: Project Coordinator (Permanent Position of Senior 6 Jun,20, 2024 Africa CDC Staff), Monitoring and Evaluation (permanent position); and E&S Specialist. 7 Recruitment of supplementary positions in the PIU. June 30, 2024 Africa CDC Ongoing Procurement Continue to undertake procurement in line with the World Continuous 8 Continuous Africa CDC Bank Procurement Regulations Update the PPSD and upload the approved procurement Done Africa CDC 9 activities in STEP for the Bank’s no objection before June 15, 2024 initiating activities Africa CDC Continuous 10 Utilize Bank’s direct payment procedure Continuous Africa CDC Not yet done 11 Update STEP with all procurement process data June 30, 2024 Africa CDC Done 12 Bring on board additional procurement support staff June 30, 2024 Africa CDC/ Continuous Submit all TORs through STEP for Bank’s review and no 13 Continuous World Bank objection Team 7 Financial Management AUC Done 14 Submit the IFR for the quarter ended December 31, 2023 May 15, 2024 Directorate of Finance Monitor budget execution regularly, report variance Ongoing, AUC, Africa Ongoing 15 analysis in quarterly IFRs, and address bottlenecks quarterly CDC AUC Not yet done 2024 1st Q 16 Clear the interfund borrowing and cease such practices Directorate of IFR Finance Directorate of Done 17 Finalize the recruitment of additional finance officer June 30, 2024 Finance, Africa CDC Ensure Office of Internal Oversight (OIO) is aware of the Done, audit legal covenant regarding the internal audit requirement report Internal audit 2024AUC (submitting internal audit reports covering six months expected in report Directorate of 18 period within 45 days of the end of the six months) and early 2025 submission - Finance, that they include the project in their work plan to review August 15, Africa CDC the project transactions. The audit report for the six- months of FY 24 should be submitted to the Bank. Ensure external auditors are recruited and the audit AUC Done but 19 conducted timely to ensure audit report is submitted on June 30, 2024 Directorate of report delayed time Finance 8 Annex 1: Results Framework PDO Indicators End Baseline Date: Target No. Indicator Name 18-Jul- 11 Nov Comments/Progress towards end target 31-Jul- 2022 2024 2027 People recruited in the Africa Volunteers Health Corps roster at RCC level Number of people recruited in the Africa Volunteers Health Corps 19 recruited and onboarded and an additional 340 interviews PDO 1 AVoHC roster at RCC level (Number) (Number) 0 19 2,500 have been conducted Percentage of females recruited in the Africa Volunteers Health Corps PDO 2 roster at RCC level (Percentage) 0 21 50 Percentage of people recruited in the Africa Volunteers Health Corps roster at RCC level from West and Central African countries PDO 3 (Percentage) 0 52 40 Percentage of people recruited in the Africa Volunteers Health Corps PDO 4 roster at RCC level from East and South African countries (Percentage) 0 43 40 Percentage of people recruited in the Africa Volunteers Health Corps PDO 5 roster at RCC level from North African countries (Percentage) 0 5 20 People trained under the newly updated Africa Epidemiologic Service (AES) program The AES program has been operationalized. 10 fellows from 9 MS have been enrolled for Epi track (the program lasts 2 Number of people trained under the newly updated Africa years). The online portion of the AES has been rolled out on PDO 6 Epidemiologic Service (AES) program (Number) 0 0 45 their LMS (learning management system) Percentage of females trained under the newly updated Africa PDO 7 Epidemiologic Service (AES) program (Percentage) 0 0 50 Biosafety and Biosecurity standards at Laboratory Level An Africa CDC framework for biosafety and biosecurity Number of laboratories supported to perform a certification assessment accreditation has been developed. Staff from 22 laboratories on Minimum Standards for Biosafety and Biosecurity in handling high have been trained on the framework that will be used to assess PDO 8 risk pathogens (Number) 0 1 5 them. 1 MS (Uganda) has been certified. Member States supported through the Vaccine Technology and Intellectual Property Transfer Service Number of Member States supported through the newly established Vaccine Technology and Intellectual Property (IP) Transfer Support PDO 9 Service (Number) 0 0 10 Africa CDC roadmap for becoming an autonomous health body of the AU operationalized 9 In 2023, at its 43th ordinary session the Executive council reviewed and approved the proposed new structure of Africa CDC through Decision EX.CL/ Dec.1218 (XLIII). in February 2024, the AUC submitted its final report called “ the interim report on the operationalization 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 has a governing structure, is authorized to enter into financial agreements with other institutions, if operating with its own bank account, has designated signatories, is able to receive funds directly into their PDO Africa CDC's roadmap for becoming an autonomous health body of the accounts, can advertise and make HR appointments directly, 10 AU has been operationalized (Yes/No) No Yes Yes can advertise and award procurement processes, etc. Intermediate Results Indicators End Baseline Date: Target No. Indicator Name 18-Jul- 11 Nov Comments/ Progress towards end target 31-Jul- 2022 2024 2027 Component 1: COVID-19 Response 10 countries were supported. Nov 2024 mission held discussions about eliminating the words "high frequency" and "COVID-19" from the indicator to cover vaccine literacy and Number of Member States supported to implement high frequency hesitancy for any disease given that there are other outbreaks IRI 1 surveys on COVID-19 vaccine literacy and hesitancy (Number) 0 10 15 that are now more prominent than COVID-19 (e.g. Mpox) Component 2: Enhancing Africa CDCs Technical and Programmatic Functions to Support AU Member States Progress ~75%. ACDC has recently finished a 1.5 yr process Africa CDC Strategic Plan for Endemic and Neglected Tropical to develop the plan. The plan has been developed but not Diseases 2023-2027 developed and validated by Member States validated yet. Validation is scheduled to happen Nov 27-29, IRI 2 (Yes/No) No No Yes 2024 Africa CDC Strategic Plan for Community Health Workers 2023- 2027 Progress ~75%. Plan has been developed, being validated end IRI 3 developed and validated by Member States (Yes/No) No No Yes Nov 2024 Regional action plans to respond to mental health and psychosocial Progress ~80%. 4 out of 5 regional action plans have been IRI 4 support during humanitarian crises and epidemics developed (Yes/No) No No Yes developed. 1 is pending. 10 31 MS have been supported with event-based surveillance. 2 MS assisted in developing and launching national event-based surveillance guidelines. Surveillance officers from 11 MS trained on One Health approach. Since this indicator has been surpassed, discussions are taking place on a clear definition of Number of Member States that have been capacitated on public health what “support and technical assistance received” means and IRI 5 intelligence and event-based surveillance (Number) 0 31 5 on adjusting the target to be in line with that definition. Continental framework has been developed and validated. 4 MS (Burkina Faso, Uganda, Cameroon and Zambia) have adopted the framework. 6 MS has also been supported to develop national action plans for mortality surveillance. ACDC has also developed a Africa CDC Operational Guide for system assessments and integration of mortality Africa CDC continental framework for mortality surveillance developed surveillance data analysis at the national level and has trained IRI 6 and validated (Yes/No) No Yes Yes 5 MS on its use. Regional Integrated Surveillance and Laboratory Network (RISLNET) Frameworks for East, West, Central and Southern RCCs have IRI 7 framework developed and validated by Member States (Yes/No) No Yes Yes been developed and validated Number of senior laboratory specialists, directors, and quality managers trained under the in-person Laboratory Leadership Training Programme Training on laboratory QMS and leadership training have IRI 8 across the continent (Number) 0 76 42 taken place in Ghana and Senegal Percentage of female senior laboratory specialists, directors, and quality managers trained under the in-person Laboratory Leadership IRI 9 Training Programme across the continent (Percentage) 0 38 40 Conducted hands-on training of laboratory staff how to collect, curate and manage biological data using standardized Number of laboratory staff trained in collecting, curating and managing training materials. Have also conducted training on mapping IRI 10 biological data using standardized training materials (Number) 0 40 200 data management and validation and on genomic data curation Number of regional laboratory networks brought up to full capacity for IRI 11 zoonotic disease diagnosis and data access (Number) 0 0 5 17 MS have been supported to improve their AMR surveillance programs. Africa CDC also launched a Landmark report highlighting well-defined and evidence-based proposals that align with Africa's position and needs on AMR Number of Member States supported to improve surveillance of containment. The report outlines specific actions, policies, and IRI 12 antimicrobial use and AMR microorganisms (Number) 0 17 20 initiatives, including recommends investments. Number of Member States supported in performing UHPR/JEE IRI 13 assessments (Number) 0 10 20 10 MS supported with JEEs Number of Public Health Emergency Operations Centers (PHEOCs) Latest MS supported with capacity building include Liberia, IRI 14 supported with capacity building (Number) 0 8 11 Madagascar, CAR, Mozambique, Zambia 11 Framework has been updated and validated but translation and Africa Volunteer Health Corps (AVoHC) framework updated and dissemination is pending. In addition, AVoHC induction IRI 15 disseminated (Yes/No) No No Yes course manual has been developed. Achieved at 85%. The RCCs in the Southern and Eastern Regions are functional based on the operational and Number of RCCs operational under the newly developed operational administrative framework. Central RCC has 4/5 criteria IRI 16 framework (Number) 0 2 4 completed. Western RCC has 3/5 criteria completed. The online portion of the Kofi Annan Fellowship Programme Number of scholars deployed to NPHIs under the Kofi Annan has been rolled out on their LMS (learning management IRI 17 Fellowship Programme (Number) 0 0 80 system) Percentage of female scholars deployed to NPHIs under the Kofi Annan IRI 18 Fellowship Programme (Percentage) 0 0 50 Africa CDC Workforce Development Framework has been revised and A taskforce has been established. Consultations with MS to IRI 19 validated by Member States (Yes/No) No No Yes assess gaps is currently taking place. A module on "gender in preparedness" has been included in the Africa IRI 20 CDC Workforce Development Framework (Yes/No) No No Yes Number of people enrolled under the two-year Field Epidemiologic IRI 21 Training Program (FETP) from Member States (Number) 0 12 120 Percentage of females enrolled under the two-year Field Epidemiologic IRI 22 Training Program from Member States (Percentage) 0 25 40 Number of Africa CDC staff members who have completed IRI 23 professional training (Number) 0 27 75 The tech transfer enablement unit has not yet been established but there has been progress, inc training of African Vaccine technology and intellectual property (IP) transfer support biomanufacturing experts on tech transfer (from Algeria, IRI 24 service for Member States has been established (Yes/No) No No Yes Egypt, Senegal, and South Africa) Fill and Finish tech transfers between local manufacturers and international manufacturers facilitated by the Africa CDC IRI 25 Manufacturing Unit (Number) 0 0 6 The African Pool Procurement Mechanism (APPM), which includes Vaccines and other health commodities, has been established. The design of it is underway (at 80-85%) and the launch is schedule for Q4 of 2025. Progress to date includes: Most of the design elements of the APPM are completed including product scope, regulatory requirements, and client interface. The governance and financing mechanisms of the APPM are under discussion; Engagement with the expert panel conducted; Consultation with Regional Economic Africa Vaccine Procurement Pooling Mechanism designed and Communities conducted; Consultation with Member States is IRI 26 launched (Yes/No) No No Yes under preparation. 12 Component 3: Strengthening Africa CDC's Institutional Capacity and Operational Structure The Executive Council Decisions EX.CL/Dec.1106(XXXVII) and EX.CL/Dec.4(XXXVIII) instructed the African Union Commission to produce a road map and a Framework of Organizational frameworks for operationalizing Africa CDC's transition Operations, outlining the financial, legal and structural into an autonomous health body of the AU have been developed implications to fully operationalize the Africa CDC as an IRI 27 (Yes/No) No Yes Yes autonomous agency of the African Union. Gender-responsive HR hiring, retention and promotion processes are developed and operationalized as part of the Africa CDC transition into IRI 28 an autonomous health body of the AU (Yes/No) No Yes Yes The Division of Partnerships and International Cooperation has been established under the Directorate of External Relations and Strategic Engagement. This Division's mandate is to: Lead and coordinate the Africa CDC’s partnership and collaboration efforts with international organizations, governments, private sector partners, civil society organizations, and other stakeholders to promote the institution’s goals and objectives. There are 3 units: IRI 29 Africa CDC's Partnership Unit is established and functional (Yes/No) No Yes Yes Partnerships, Resource Mobilization and Grants Management. A strategy and action plan have been developed. The draft framework for the AfEF has been revised. Consultations with Strategy and action plan developed for the transition of the AU COVID- legal division are taking place. AfEF will be a trust fund with IRI 30 19 Response Fund into the Africa Epidemic Fund (Yes/No) No Yes Yes all proper mechanisms of control. 13 Annex 2: Procurement The Mission assessed the performance of the planned activities and agreed actions of previous mission for the two projects: Grant I (P167916) and Grant II (P178633). For Grant I (P167916), 29 procurement activities approved through STEP, with an estimated amount of US$6.49M, representing 65% of the total financing. The performance in terms of amount is 36% of the planned activities and 41% in terms of number of contracts. For Grant II (P178633), 53 procurement activities approved through STEP, with an estimated amount of US$14.77M, which accounts for 15% of the project financing. This is notably lower for the project implemented for two years compared to total financing. The performance in terms of amount is 14% of the total estimated amount and 19% in terms of number of planned activities. Below is the actual status of procurement activities reported by Africa CDC for projects during the support mission. Completed Under Pending Cancelled Procurement Activities Implementation Implementation 29 activities 12 activities with No No 17 activities P167916 $6.49M contract amount of $4.15M $2.34M (36%) 53 activities 10 activities with 16 activities with 9 activities with 18 activities P178633 $14.77M contract value of estimated amount estimated amount $2.84M $2.09M (14%) of $6.60M of $3.24M The Mission discussed and agreed that the financing for the procurement of laboratory equipment with estimated amount of US$8.00M, will be divided under both projects. Grant I (P167916) will cover US$5.70M, while Grant II (P178633) will finance the remaining US$2.30M. The Procurement Plans for this activity for both projects in the STEP system have been updated and will be submitted to the Bank once the exact amount available under Grant I is confirmed. Besides, a detailed discussion took place between Africa CDC and the World Bank team regarding the bidding document for the procurement of laboratory equipment. Following this discussion, Africa CDC has revised the bidding document and submitted it to the Bank for final review and approval. The Mission acknowledged that most of the actions agreed upon during the previous mission have been successfully implemented. However, it also identified challenges that impacted the performance of the planned activities. The Mission observed a discrepancy between the performance reported by Africa CDC and the progress extracted from STEP, with the performance reported by Africa CDC being notably good. Currently, STEP does not reflect any completed and signed contracts, primarily due to infrequent updates for all signed and completed contracts. The PIU indicated that most documentation for these completed contracts are ready for updating in STEP; however, Africa CDC indicated that regular follow-up and updating of STEP with procurement records requires a dedicated person as it was in the case in previous years and in the case of the AUC. Otherwise, the Procurement Specialist will be overwhelmed, which might be hindering this process. To enhance efficiency and accuracy, the mission recommends that the Africa CDC recruit a dedicated consultant focused on regularly updating STEP for both projects. This consultant should aim to complete the updates for already finalized contracts by November 30, 2024. Additionally, the consultant will ensure proper procurement record keeping and regular updates for future contracts during the project 14 implementation period, thereby preventing discrepancies in performance reporting and facilitating timely post-procurement reviews by the Bank. The Mission was informed that the Bank plans to conduct the Post-Procurement Review (PPR) starting from 1st December, based on the data and information uploaded in STEP. Therefore, it is essential to complete the updates before the PPR begins. The Bank will finalize the PPR report and share with the Africa CDC before the next mission. For both projects, majority of the planned activities are of small value contracts and will undergo a Post- Procurement Review, except two contracts: the Procurement of Data Center Equipment and the Procurement of Laboratory Equipment, which are under prior review contracts. The mission observed that the procurement plan is approved for only 14.77% of the total financing for Grant II, despite the project being in its second year. The Mission identified that the initiation of procurement activities has not progressed effectively over the past almost two years, related to the leadership transition and development of their new Strategic Plan. Africa CDC is required to move forward as per the approved Procurement Plan. To address these issues, the Mission recommends that the project office collaborate proactively with the respective business units to clearly define the procurement needs associated with the project PDO. This approach aims to ensure that procurement activities are implemented before the next mission. The Mission also noted that the PIU is required to submit the Terms of Reference (ToR) and technical specifications to the Bank for review and approval before the Procurement Plan is submitted through STEP. Once the ToR and technical specifications are agreed upon by the Bank, the activities will be uploaded into STEP. This arrangement aims to streamline communication between the Bank and PIU, thereby minimizing delays and cancellations of planned activities, ultimately enhancing overall performance. Africa CDC reported that since the implementation of these project, the Supply Chain Division has issued over 400 purchase orders related to operational procurement and over a thousand purchase orders related to travel, totaling more than USD 5 million. These procurements are essential for the efficient and effective execution of operational activities. The division is currently tasked with procuring various goods, consultancy services, and various operational services. To enhance procurement processes, the Mission has agreed to recruit one consultant to support operational procurement activities, including accommodation, conference packages, venue hire, transportation services, interpretation equipment services, and other related services. 15 Annex 3: Financial Management Grant 1 – P167916 Based on the observation of the mission, there are important aspects that require the project management’s attention to ensure that project financial management arrangements properly support project implementation and provide reasonable assurance that Bank proceeds are being used for the intended purposes and that reports produced by the system can be relied upon to monitor the project. Additional finance officer has been recruited under the other World-Bank financed project (P176883). However, issues that require follow-up and action include: i) the project’s Interim Financial Reports (IFRs) for the quarters ended June 30, 2024, December 31, 2023, and March 31, 2024, have been submitted with a delay of three months, four months, and two months respectively. The IFR for the quarter ended September 30, 2024, has been submitted in a timely manner; ii) the 2023 external audit report has been submitted with a delay of more than four months. The auditors provided unmodified audit opinion on the financial statements. The accompanying Management Letter has not been submitted. This should be submitted to the Bank by December 15, 2024. In addition, to ensure the 2024 external audit is completed in a timely manner, the recruitment of auditors should be completed by December 31, 2024; iii) questionable expenditures of USD 3,187.50 have been noted in the previous supervision mission and necessary explanation has not been provided to date. In addition, for DSA paid (USD 20,326.60) in relation to training expenditures reviewed in November 2021 FM supervision, attendance sheets/other relevant supporting document have not been provided to date. The necessary explanation/documents should be provided by December 10, 2024, for both issues; iv) there is undisbursed fund balance with the Bank which amounts to USD 5.77 million though only a year is left for project implementation. Use of this resource for eligible expenditures should be given due attention; v) interfund borrowing is noted and such practice should be avoided. The 2024 4th quarter IFR (due on February 14, 2025) should show that all interfund borrowings are cleared; and vi) internal audit review has not been conducted on the project’s accounts. The project has communicated with the Office of Internal Oversight (OIO) and agreed on the process to conduct the audit of the project accounts. Hence, the internal audit report for 2024 should be submitted to the Bank by February 15, 2025. The FM rating is upgraded to Moderately Unsatisfactory in view of the recruitment of finance officer, submission of the 2024 Q3 IFR in a timely manner, and engagement with OIO to plan for the internal audit review. Action Plan Agreed Action Responsible party Timeframe Submit the 2023 external audit Management Letter AUC Directorate of December 15, Finance 2024 Provide explanation/documentation for the ACDC finance December 10, questionable expenditure of USD 3,187.50 and DSA directorate 2024 payment of USD 20,326.60 (attendance sheets/other relevant document) Monitor budget execution regularly, report variance AUC, Africa CDC Ongoing, analysis in quarterly IFRs, and address bottlenecks quarterly Clear the interfund borrowing, cease such practices, and reflect it AUC Directorate of 2024 4th Q in the Q4 2024 IFR. Finance IFR(due February 14, 2025) Ensure Office of Internal Oversight (OIO) conducts AUC Directorate of February 15, internal audit on the 2024 accounts and submit Finance, Africa 2025 internal audit report to the Bank. CDC 16 Ensure external auditors are recruited for the 2024 AUC Directorate of December 31, audit to ensure audit report is submitted on time Finance 2024 Grant 2 – P178633 Based on the observation of the mission, there are important aspects that require the project management’s attention to ensure that project financial management arrangements properly support project implementation and provide reasonable assurance that Bank proceeds are being used for the intended purposes and that reports produced by the system can be relied upon to monitor the project. The project has recruited additional finance officer for the project. However, issues that require follow-up and action include: i) the project’s Interim Financial Reports (IFRs) for the quarters ended June 30, 2024, December 31, 2023, and March 31, 2024, have been submitted with a delay of three months, four months and one and half month respectively. The IFR for the quarter ended September 30, 2024, has been submitted in a timely manner; ii) the 2023 external audit report has been submitted with a delay of more than four months. The auditors provided unmodified audit opinion on the financial statements. The accompanying Management Letter has not been submitted. This should be submitted to the Bank by December 15, 2024. In addition, to ensure the 2024 external audit is completed in a timely manner, the recruitment of auditors should be completed by December 31, 2024; iii) questionable expenditures of USD 39,556 have been noted in the previous supervision mission and necessary explanation has not been provided to date. This should be provided by December 10, 2024; iv) expenditure incurred in 2024 (up to the second quarter) is only USD 2.4 million. Project implementation should improve in the remaining months of 2024 by addressing bottlenecks; v) interfund borrowing is noted and such practice should be avoided. The 2024 4th quarter IFR (due on February 14, 2025) should show that all interfund borrowings are cleared. The Bank will review the request of the project to open another project/designated bank account to avoid interfund borrowing. The Bank will provide guidance on this by December 20, 2024; and vi) internal audit review has not been conducted on the project’s accounts. The project has communicated with the Office of Internal Oversight (OIO) and agreed on the process to cover the audit of the 2023 and 2024 accounts. Hence, the internal audit report covering these periods should be submitted to the Bank by February 15, 2025. The FM rating is upgraded to Moderately Unsatisfactory in view of the recruitment of finance officer, submission of the 2024 Q3 IFR in a timely manner, and engagement with OIO to plan for the internal audit review. Action Plan Agreed Action Responsible party Timeframe Submit the FY 23 external audit Management Letter AUC Directorate of December 15, Finance 2024 Provide explanation for the questionable expenditure of ACDC financeDecember 10, USD 39,556 directorate 2024 Monitor budget execution regularly, report variance AUC, Africa CDC Ongoing, analysis in quarterly IFRs, and address bottlenecks quarterly Clear the interfund borrowing and cease such practices AUC Directorate of 2024 4th Q Finance IFR (due on February 14, 2025) Ensure Office of Internal Oversight (OIO) conducts AUC Directorate of February 15, internal audit on the FY 23 and 24 accounts and submit Finance, Africa CDC 2025 internal audit report to the Bank. 17 Ensure external auditors are recruited for the FY 2024 AUC Directorate of December 31, audit to ensure audit report is submitted on time Finance 2024 18 Annex 4: Environmental & Social Dimensions The Mission noted that the long-awaited E&S expert is on board to support the Africa CDC PIU. The mission team reviewed the status of the Environmental and Social Commitment Plan (ESCP) implementation and advised the PIU to continue the close follow up on E&S requirements consideration in project financed technical assistance (TA) and other project activities as well as implementation of other measures in the ESCP. Further, the mission team advised the PIU to apply the exclusion criteria indicated in the ESCP and avoid any procurement that has significant E&S risks and impacts including procurement of laboratory chemicals and reagents. Africa CDC has also been informed to review the annual work plan, do retrospective screening for eligibility, identify measures as appropriate, and share the outcome with the Bank team as part of the project progress report against the ESCP measures. To ensure project compliance on labor and working conditions, the Bank team advised the Africa CDC PIU to ensure the preparation, inclusion, and adoption of adequate E&S considerations and occupational health and safety aspects into, annual work plans, TORs, and standard operational procedures. Further, the team advised the PIU to review the project documents including the Stakeholder Engagement Plan (SEP) and Labor Management Procedure (LMP) and ensure that the project activities including the Grievance Mechanism (GM) are properly implemented. The Mission team also advised the PIU to share the latest guiding procedure or GM guideline to address project related E&S issues by end of December 2024. Following the AWPB 2025 proposed to procure laboratory equipment to support the Africa CDC laboratory, the Mission team emphasized the need to do internal due diligence to identify and document the available technology and management system to ensure E&S risk management. Thus, PIU will share the due diligence report by the end of December 2024. The Bank team will also provide a checklist for the due diligence and additional guidance in the process. Furthermore, ACDC shall ensure the screening, preparation and implementation of laboratory chemical handling and Waste Management Plan for activities that are related with the procurement of equipment and laboratory reagents & chemicals purchase for the ACDC lab under (P167916 Grant 1) by January 30, 2024. Regarding capacity building the Africa CDC team has agreed to develop a training plan and ensure that the required budget is allocated in the AWPB for 2025 implementation. The Mission team also advised Africa CDC to ensure timely reporting for E&S progress and inform E&S incidents as per the timeline indicated in the ESCP. 19 Annex 5: List of Participants Africa CDC Leadership H.E. Dr. Jean Kaseya Director General Dr. Raji Tajudeen Ag. DDG Dr. Balde Bilguissou Chief of Staff Mame Niang Technical Advisor Africa CDC Business Units Disease Control and Prevention & Health Promotion Mohammed Abdulaziz Head of Division Serge Batcho Unit Lead, Maternal and Sexual and Reproductive Health Awoke Lakew National Coordinator, Disease Control and Prevention Sangwoo Tak Technical Officer, Disease Control and Prevention Emergency Preparedness and Response Wessam Mankuola Head of Division Yabsira Yienhalem Technical Officer, National Public Health Institute Radjabu Bigirimana Technical Officer, Emergency, Preparedness and Response Edouard Nkunzimana Technical Officer Mathew Tut Moses Kol Operation Officer Laboratory Diagnostics and Systems Yenew Kabede Ag Director Laboratory Systems Abebaw Kabede Sr. Technical Officer for Genomics Idosie Kenfack Sr. Technical Officer for Biosafety Yao Atrah Sr. Technical Officer for Laboratory Aytenew Ashenafi Sr. Program Manager Surveillance and Disease Intelligence Merawi Aragaw Head of Division Bekure Tamirat Unit Lead, Health Informatics Kyeng Mercy Unit Lead, Epidemic Intelligence Emily Atuheire Unit Lead, Surveillance Yewande Alimi Unit Lead, One Health Festo Mazuguni Unit Lead, Epidemiology and Biostatistics Bethelhem Tibebu Technical Officer for Surveillance Bamtura Moses Sr. Technical Officer Digital Solutions Mallion Kangume Coordinator, Cross Border Surveillance Julie Nanyongo Analyst, Event Based Surveillance Communication and Public Information Margaret Edwin Director of Communication and Public Information Ndahafa Nakwafila Senior Communication Team Lead Coordinator Wilson Johwa Senior Communication Officer Addis Miraf Communication Officer 20 Lilian Ndong Nang Risk Communication and Community engagement Specialist Health Systems Strengthening and Public Health Institutes Raji Tajudeen Head of Division Haftom Taame Principal Technical Officer, National Public Health Institutes Bonheaur Dounebaine Sr. Technical Officer, Workforce Development Adam Terefe Technical Officer, Learning and Monitoring System Tiruneh Baye Technical Officer, Workforce Development Fai Karl Senior Technical Officer, National Public Health Institutes Farha Abdalla Technical Officer, National Public Health Institutes Health Economics and Financing Sumaiyah Docrat Ag. Head; Principal Health Economist Elias Asfaw Health Economist Josephine Gakii Gatua Health Economist Paulina Afra Ofori-Adu Senior Health Financing Officer External Relations and Strategic Engagement Claudia Shilmani Director Nobel Cubahiro Senior Advisor, Partnerships and Grants Management Africa CDC Regional Coordinating Centers (RCCs) Herlinda Temba Regional Director, RCC Western, Nigeria Mazyanga Lucy Mazaba Regional Director, RCC Eastern, Kenya Apollinaire Kima Technical Officer M&E, RCC Central, Gabon Lul Pout Riek Regional Director, RCC Southern, Zambia Brice Bicaba Regional Director, RCC Northern, Egypt Judith Kose Otieno Regional Programme Lead, Eastern RCC Diana Nyole Technical Officer Planning, Eastern RCC Science for Science and Innovation Elvis Temfack Head of Division, R&D, and Clinical Trials Local Manufacturing for Health Commodities Abebe Genetu Bayih Ag. Lead Yared Yiegezu Zegiorgis Senior Analyst, Vaccine Value Chain and Tech Transfer Wesley Ronoh Lead, Market Shaping Sandra Haile Brugger Lead, Access to Finance Fasika Mekete Alemu Senior Technical Expert, Products and Market Primary Healthcare Landry Tsague Senior Advisor to DG James Guwani Head, Div of Comm Health Syst and Integ Service Delivery Thaddee Niyoyitungir Lead, Div of Comm Health Syst and Integ Service Delivery Reiche Massengo Tech Officer, Div of Comm Health Syst and Integ Service Del Senga Sembuche Principal Officer, Div of Child Health and Immunization Ebba Secka Senior Technical Officer, Division of Maternal Health 21 Digital Health, Health Information Systems, and Data Governance Cyril Syck Advisor, Digital Strategy Patrick Kasiama Advisor, Digital Health, AI & IT Judith Nguimfack Specialist, Principal Delivery Finance Omar Rakib Director Florence Nviri Head, Financial Manager Division Belay Worku Geda Consultant, Financial Management Administration Michel IRIE Bi Director Daudi Mkoma Head, Human Resources Management (HR Division) Tesfaye Hailemichael Senior Procurement Officer, Supply Chain Division Catherine Garba Senior Administrator, Facilities Division Nacer Adamou Senior IT Officer, Management Information Systems Noline Okech Supply Chain Officer, Supply Chain Division Dennis Kibiye Senior System Officer, Management Information Systems Michael Mekbib Sileshi Digital Officer, Management Information Systems Planning, Reporting and Accountability Justin Maeda Ag. Head of Division, Planning, Reporting & Accountability John Ojo Senior Officer, Monitoring and Evaluation Christine Ngwawe Officer, Monitoring and Evaluation Walter Ouma Onditi Consultant, M&E Legal Bethlehem Arega Acting Head Sheila Koburungi Senior Compliance Officer Brave Hanunka Legal Officer Fortunate Mutesi Legal Officer Isaac Zulu Compliance Officer Project Implementation Unit (PIU) Michael Olugbile Project Coordinator Zemenu Asnake Procurement Specialist Ziphele Innocencia Radebe Procurement and Disbursement Officer Danilo Fernando Correia da Silva Environmental and Social Safeguards Expert Pistis Kabwa Manzila Project Management Expert World Bank Fernando Montenegro Torres Sr. Economist and Task Team Leader Rocio Schmunis Sr. Health Specialist and Co-Task Team Leader Deo Ndikumana Sr. Operations Officer, AFWRI Luis Osorio-Florez Health Specialist (Virtual) Tseganeh Amsalu Guracha Sr. Health Specialist 22 Mogesie Ayele Sr. Procurement Specialist Mekdim Hailu Yemane Financial Management Specialist Feben Demissie Hailemeskel Social Development Specialist Selam Tarkeghn Neda Environmental Engineer Nohra Eugenia Posada Consultant African Union Commission (AUC) Patrick Abdoulaye Man'ke World Bank Projects Portfolio Coordinator 23