The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) Haiti COVID-19 Response (P173811) LATIN AMERICA AND CARIBBEAN | Haiti | IBRD/IDA | Investment Project Financing (IPF) | FY 2020 | Seq No: 9 | Archived on 06-Feb-2025 | ISR03116 Implementing Agencies: Ministry of Public Health and the Population, UNITE DE GESTION DE PROJET (UGP) 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 02-Apr-2020) To respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Haiti. Has the Development Objective been changed since Board Approval of the Project Objective? Yes Current Development Objective (Approved as part of Additional Financing package Seq. 1 on 23-May-2022) To respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Haiti. 2. COMPONENTS Name Component 1: Emergency COVID-19 Response:(Cost 40,500,000.00) Component 2: Health System Strengthening:(Cost 12,000,000.00) Component 3: Implementation Management and Monitoring and Evaluation:(Cost 2,500,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Moderately Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating High Substantial Feb 06, 2025 Page 1 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions In 2024, the Project has increased its focus on supporting the country’s core health system functions and emerging needs. In the last year, the Project has supported epidemiological surveillance and response to COVID-19, cholera, and other infectious diseases, with a particular focus on the new and expanding internally displaced population camps across the country, as the number of internally displaced people continues to increase as a result of insecurity and violence. The Project has also provided five key hospitals and regional laboratories with autonomous energy supply based on solar solutions in the northern and southern peninsulas. To respond to the growing needs in the metropolitan area, the Project is also supporting two main hospitals to maintain critical emergency, maternal, and laboratory services with an estimated coverage of 1.5 million people. Support to Ministry of Health's immunization activities across the country continues in order to reduce the risk of further outbreaks of vaccine-preventable diseases. 4.2 MPA Program Development Objective Original MPA Program Development Objective (Approved as part of (Seq. ) package on ) Current MPA Program Development Objective (Approved as part of (Seq. ) package on ) 4.3 Multiphase Programmatic Approach (MPA) Status (Public Disclosure) COVID-19 MPA Sustained progress continues to be made under the SPRP Program, including under the MPA. Disbursements have been affected by: (i) the processing of refunds to the project accounts, which in the past months has increased at this late stage of project implementation, and (ii) fluctuations between the SDRs and Euros against the US dollar for operations denominated in SDRs and Euros. In addition, disbursements have been affected by the pausing of disbursements in Afghanistan and Myanmar. While the parent project in Afghanistan ($100.4) million will close on June 30, 2025 (as of mid-January 2025, only $77.66 million has been disbursed). In terms of Myanmar, which closed in August 2023, there was an undisbursed balance of over $42 million, which was finally canceled in late November. Delay in the cancellation had been a result of an exchange rate loss issue which was resolved. Only Bangladesh has low disbursements - 65 percent of commitments. The credit closed on December 31, 2024, and the expected cancellation of undisbursed funds ($33.0 as of today) did not materialize as the Bank did not receive the request from the Government to cancel undisbursed funds before the closing date. As of January 20, 2025, disbursements under the MPA are $4,039 million or 98 percent of commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations or disbursements under PEF grants as commitments do not include PEF Grants. Disbursements in mid-November 2024 were $4,020 million. Fifty-eight (58) operations had closed by June 30, 2024, and ten operations closed on December 31, 2024. As of today, there are 29 operations with closing dates in CY25 with 17 closing by June 2025 and the remaining 12 by December 2025. Feb 06, 2025 Page 2 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) As with the Mid Term Review (MTR) issued on March 25, 2023, no individual ICR is required for COVID-19 MPA operations. Only one Global ICR will be prepared upon completion of the SPRP COVID-19 MPA Program, which closes on December 31, 2025. The Global ICR will be informed by final ISRs packages prepared by country operations’ teams. A template for the final ISR package was issued by OPCS on March 21, 2023. Final ISR packages include a Summary Project Assessment – Annex 1, Borrower’s Evaluation – Annex 2, which is optional, and the final ISR. So far, forty-eight (48) final ISR packages have been prepared; several others are under preparation. Out of the 48, two were prepared during the last two weeks of last CY (Liberia and Moldova) and two during the first two weeks of January (Indonesia and Fiji). Of the ten operations that closed on December 31, 2024, the ones with the lowest disbursements are Niger at 83 percent, Zambia at 79 percent, and Mozambique at 77 percent (combined parent projects and AFs). Disbursements' applications under the first two operations are continuing to be processed during the disbursement grace period. In the case of Niger, because rehabilitation works were completed by early December and payments/disbursements are likely to be reflected by the end of January/early February. As for Zambia, several payments are to be made in the coming weeks for goods and services delivered before the closing date. The situation in Mozambique is less clear. As of January 20, 2025, sixty-eight (66) operations or 78 percent of projects approved are fully disbursed, four have reached 98-99 percent, and nine have reached 92-97 percent. All MPA projects in AFW, ECA, and MNA are fully disbursed. Disbursements for the other four regions are: (i) EAP and LAC 98 percent, (ii) SAR 96 percent, and (iii) AFE 92 percent. The projects are benefitting about 4.01 billion people or 50 percent of the global population. When countries with AF-V operations are counted, the projects are benefitting about 4.26 billion or 54 percent of the global population. This is because some countries that do not have a parent project have AF-V operations. All projects approved are disbursing. Retroactive Financing (RF) continues to represent 19 percent of total disbursements. SAR has the highest percentage of RF at 37 percent, followed by ECA at 18 percent. Direct Payment (DP) disbursements represent 22 percent. EAP has the highest level of DP disbursements at 79 percent, followed by AFW at 39 percent. Disbursements to UN agencies represent 13 percent. IDA continues to represent 40 percent while IBRD represents 60 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts by counterparts and Bank teams have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations which have supported vaccine procurement and deployment efforts. COVID-19 MPA AF-V Considerable efforts are being made to accelerate the implementation of AF operations and the SPRP Program in general. As in the previous month, acceleration of implementation of AF-V operations has continued. Total disbursements as of January 20, 2025, amount to US$7.18 billion or 87 percent of overall commitments ($8.24 billion). Disbursements in mid- December were $7.15 billion. EAP has the highest percentage of disbursements at 98 percent, followed by ECA at 96 percent, LAC at 95 percent, MNA at 91 percent, SAR at 89 percent, AFW at 84% percent, and AFE at 77 percent. In the case of AFE, disbursements are likely to accelerate in the coming weeks with civil works contracts being completed under the Uganda operation, whose closing date was extended to June 30, 2025. AFW disbursements are likely to increase considerably as disbursements under the: (i) Niger operation should become fully disbursed with the procurement of equipment delivered and installed in the selected facilities and works completed by the closing date of December 31, 2024, and (ii) Zambia operation which good and services were delivered and installed by the closing date. As of January 20, 2025, there are 114 Bank-financed operations (including MPA-V operations) to support vaccine procurement and rollout in 78 countries amounting to $8.24 billion. 121 operations had been approved amounting to Feb 06, 2025 Page 3 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) $10.1 billion, but five operations were cancelled: (i) Costa Rica loan ($120 million), (ii) Peru loan ($500 million), (iii) Gabon loan ($12 million) - the loan agreement lapsed, (iv) Philippines AF2 loan of $300 million, and (v) Guinea credit of $25.44 million. Also, a couple of TFs were cancelled. The Afghanistan operation commitment of $113 million was reduced to $60 million. Many operations have processed partial cancellations, thereby decreasing the overall commitments in the past months. Also, when operations close, undisbursed funds are returned to the Bank and small adjustments to commitments are made causing overall commitments to be reduced. In the past several months, partial cancellations amounting to $1,171 million have been processed under 28 operations (MPA and AF operations). Out of the $1,171 million cancelled, $771 million were from IDA and $400 million from IBRD. Partial cancellations have been mainly a result of evolving needs in countries given the stage of the pandemia and donations of vaccines, which reduced the need for IBRD/IDA funds for their purchase. Guidance was issued on July 7, 2023, under an Email from the Global HNP Director, which provided direction for the use of undisbursed funds under COVID-19 operations. Thanks to this guidance, the restructurings have allowed in some cases adding as an activity under Component 1 for the procurement of Routine Immunization vaccines as the program for immunization in most countries suffered as funds and human resources were redirected to finance the pandemic. Of the 114 approved operations: (i) 65 are in Africa – 32 in AFE and 33 in AFW; (ii) 10 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 8 in Middle East and North Africa; and (vi) 9 in South Asia. The 114 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Thirty-two (32) operations are being implemented in Fragile and Conflict-affected situations. IDA represents 45 percent and IBRD 55 percent of disbursements. Eighteen (18) operations are fully disbursed (Argentina, Cambodia, El Salvador AF1 and AF2, Honduras, Indonesia, Iraq, Jordan, Nigeria, Panama, ROC F1 and AF2, S. Sudan AF2, Sri Lanka AF-V 1, Tunisia, Ukraine AF-V 3, West Bank and Gaza, and Zimbabwe). Forty (40) operations have disbursed 90%+ and sixteen (16) operations have disbursed 80%+. All 114 operations approved are disbursing. Retroactive Financing (RF) continues to represent 34 percent of overall commitments. ECA and SAR have the highest level of RF at 68 percent, LAC at 50 percent, AFE at 29 percent, and MNA at 28 percent. Disbursements to UN agencies represent 23 percent of overall disbursements, while Direct Payment represents 18 percent of disbursements. As with the COVID-19 MPA operations, streamlined procedures, delegated approval, wide use of Bank Facilitated Procurement (BFP), coupled with flexible project design, and intensified efforts from counterparts and Bank staff, have contributed to the rapid design, processing, and implementation of AF-V operations. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 08 - 31 Jul Proposed Rating 02 Apr 2020 2024 Political and Governance High High High Macroeconomic Substantial Substantial Substantial Feb 06, 2025 Page 4 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) Sector Strategies and Policies Substantial High Substantial Technical Design of Project or Program Substantial Substantial Moderate Institutional Capacity for Implementation and Substantial High High Sustainability Fiduciary Substantial High High Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Overall High High Substantial Feb 06, 2025 Page 5 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Emergency COVID-19 Response Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Suspected cases of COVID-19 0.00 Apr/2020 100.00 11-Jun-2024 100.00 31-Dec-2024 90.00 Nov/2025 cases reported and Comments on As of December 31st 2024, 100% of reported cases are investigated, according to the DELR( investigated based on achieving targets Directorate of Epidemiology, Laboratories and Research) database. national guidelines (Percentage) Country has activated their 0.00 Mar/2020 11.00 11-Jun-2024 11.00 31-Dec-2024 11.00 May/2023 public health Emergency Comments on The target was achieved for this indicator. However, as COVID-19 does not represent a Operations Centre or a achieving targets health emergency at the moment, no coordination meetings have been held in 2024. coordination mechanism for COVID-19 (Number) Health System Strengthening Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of designated 0.00 Mar/2020 28.00 11-Jun-2024 28.00 31-Dec-2024 3.00 Mar/2024 laboratories with diagnostic Comments on As of December 31st 2024, 28 laboratories have been consistently performing PCR testing equipment, test kits, and achieving targets for COVID-19. reagents for diseases with mandatory immediate notification per MSPP norms (Number) 5.00 Nov/2023 5.00 11-Jun-2024 5.00 31-Dec-2024 8.00 Nov/2025 Feb 06, 2025 Page 6 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) Health care facilities with a Comments on Solar systems for two facilities are expected to be complete by June 2025 and the third one functional solar powered achieving targets by September 2025. system (Number) 6.2 Intermediate Results Indicators by Components Component 1: Emergency COVID-19 Response Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Individuals reached with 0.00 Mar/2020 4,545,684.00 11-Jun-2024 4,872,337.00 31-Dec-2024 6,000,000.00 Nov/2025 tailored information (e.g., Comments on Communication activities were implemented by the MSPP to reach people with tailored individuals and decision achieving targets information on COVID-19, prevention of cholera and promotion of routine vaccination. The makers in different sectors — overall security environment continue to slow down community outreach activities, in travel and tourism, food and particular in the metropolitan area. agriculture, healthcare workers and businesses . . .) (Number) 50.00 Nov/2023 100.00 11-Jun-2024 100 31-Dec-2024 100.00 Nov/2025 Call centers collecting citizen Comments on All the call centers are in place collecting the population's feedbacks and complaints about feedback on COVID-19 achieving targets COVID-19 vaccines and vaccination in general. Between July 2024 and December 2024, 342 vaccination, which are people have contacted or have been contacted by those teams and 16 cases of ESAVI have functional (Percentage) been detected through the same period. Component 2: Health System Strengthening Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 35.63 Mar/2020 100.00 11-Jun-2024 100.00 31-Dec-2024 100.00 Nov/2025 Feb 06, 2025 Page 7 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) Specimens of diseases with Comments on 100% of received samples have been tested within WHO Standard Time despite issues with mandatory immediate achieving targets fuel shortage, roadblock and reginal air traffic. notification submitted for laboratory testing confirmed within WHO standard time at reference laboratories supported by the project (Percentage) 0.00 Nov/2023 34.50 11-Jun-2024 39.00 31-Dec-2024 70.00 Nov/2025 Health facilities reporting Comments on As of December 31st 2024, data collected from the information system by UEP, show that 39 essential vaccination supplies achieving targets % of health facilities offering immunization services have effectively reported their essential data (Percentage) immunization supplies management data using the Logistics Management Information System. Medical waste incinerators 0.00 Nov/2023 0.00 11-Jun-2024 0.00 31-Dec-2024 4.00 Nov/2025 meeting WHO standards Comments on Four Incinerators have been procured but are pending customs clearance before installation. functional in a public health achieving targets facility (Number) Cholera alerts and outbreaks 40.00 Nov/2023 50.00 11-Jun-2024 93.00 31-Dec-2024 100.00 Nov/2025 investigated and acted on by Comments on All the mobile teams have been in place since August 2024. mobile rapid response teams achieving targets As of December 31st, 2024, the teams have investigated and responded to 93% of the within 48 hours of onset Cholera alerts and outbreaks, including those in displacement camps. (Percentage) 0 Jan/2024 0.94 31-Dec-2024 1 Nov/2025 Renewable energy capacity Comments on This is a new corporate scorecard indicator introduced via an Omnibus Amendment, enabled (Megawatt) CRI achieving targets measuring the renewable energy generated by the solar panels procured and installed under the Project. Feb 06, 2025 Page 8 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) 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-E0620 Effective 35.00 33.16 0.00 20.91 12.73 62.15% IDA-D6010 Effective 20.00 19.38 0.00 19.60 0.43 97.85% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-D6010 Effective 02-Apr-2020 03-Apr-2020 15-Apr-2020 30-Mar-2024 30-Nov-2025 Feb 06, 2025 Page 9 of 10 The World Bank Implementation Status & Results Report Haiti COVID-19 Response (P173811) IDA-E0620 Effective 23-May-2022 04-Aug-2022 31-Oct-2022 30-Mar-2024 30-Nov-2025 8. KEY DATES Key Events Planned Actual Approval 02-Apr-2020 02-Apr-2020 Effectiveness 15-Apr-2020 15-Apr-2020 Mid-Term Review No. 01 11-Jul-2022 11-Jul-2022 Operation Closing/Cancellation 30-Nov-2025 9. RESTRUCTURING HISTORY Restructuring Level 2 Approved on 22-Feb-2024 10. ASSOCIATED OPERATION(S) There are no associated operations Feb 06, 2025 Page 10 of 10