The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) EASTERN AND SOUTHERN AFRICA | Eastern and Southern Africa | IBRD/IDA | Investment Project Financing (IPF) | FY 2024 | Seq No: 3 | Archived on 11-Feb-2025 | ISR02415 Implementing Agencies: Democratic Republic of Sao Tome and Principe - Ministry of Health (MOH), East, Central and Southern Africa Health Community (ECSA-HC), Federal Democratic Republic of Ethiopia - Ministry of Health (MOH), Intergovernmental Authority on Development (IGAD), Kenya BioVax Institute, Republic of Kenya - Ministry of Health (MOH) 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 29-Sep-2023) The Development Objective (DO) is to strengthen health system resilience and multisectoral preparedness and response to health emergencies in Eastern and Southern Africa. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Strengthening the Preparedness and Resilience of Regional & National Health Systems to Manage Health Emergencies:(Cost 250,200,000.00) Improving early detection of and response to HEs through a multisectoral approach:(Cost 80,700,000.00) Program Management:(Cost 28,100,000.00) Contingent Emergency Response Component (CERC):(Cost 0.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Feb 11, 2025 Page 1 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) Overall Risk Rating Substantial Substantial 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions The performance of the Program remains satisfactory with all countries and regional entities under Phase 1 (Ethiopia, Kenya, Sao Tome and Principe, the East, Central and Southern Africa Health Community [ECSA-HC] and the Intergovernmental Authority on Development [IGAD]) now effective. Five projects have been added to the Program under phases 2 (Democratic Republic of Congo), 3 (Burundi), 4 (Rwanda), 5 (Malawi) and 6 (Zambia). Given the high demand for participation in the Program, the World Bank approved an Additional Financing (AF) for US$0.5 billion on May 24, 2024. This AF brings the total financing envelope to US$1.5 billion. The AF provides an opportunity to support up to six additional countries. A regional launch for the Program was held in Nairobi, Kenya on May 15, 2024 and was attended by delegations from all participating entities, and the Regional Advisory Committee (RAC) for the Program was constituted. The RAC met again in Addis Ababa in November 2024. 4.2 MPA Program Development Objective Original MPA Program Development Objective (Approved as part of Approval (Seq. 2) package on 04-Apr-2024) The MPA Program Development Objective (PrDO) is to strengthen health system resilience and multisectoral preparedness and response to health emergencies in Eastern and Southern Africa. Current MPA Program Development Objective (Approved as part of (Seq. ) package on ) The MPA Program Development Objective (PrDO) is to strengthen health system resilience and multisectoral preparedness and response to health emergencies in Eastern and Southern Africa. 4.3 Multiphase Programmatic Approach (MPA) Status (Public Disclosure) The AFE MPA Program was approved by the World Bank's Board of Executive Directors on September 29, 2023, for an original envelope of US$1 billion. As of January 31, 2025, a total of 8 countries and 2 regional entities have been approved under the Program. Both regional entities (ECSA-HC and IGAD) and five countries have become effective (Burundi, Ethiopia, Kenya, Rwanda, Sao Tome and Principe [STP], and Zambia). Additional Financing of US$500 million was approved in March 2024, paving the way for the inclusion of as many as six additional countries in subsequent phases of the Program. Annual Work Plans are under development for FY26 in synchronization each country's planning cycle. Implementation has commenced, with a total of US$42.24 million disbursed across Ethiopia, STP, Zambia, ECSA-HC, and IGAD. Effectiveness is expected to be completed for Malawi in February 2025 and DRC by the end of March 2025. Two Regional Advisory Committee meetings have been held so far, in Nairobi (May 2024) and Addis Ababa (November 2024), and six communities of practice have been established. Feb 11, 2025 Page 2 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 02 - 20 Jun Proposed Rating 29 Sep 2023 2024 Political and Governance Substantial Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Substantial Substantial Substantial Overall Substantial Substantial Substantial Feb 11, 2025 Page 3 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes To strengthen health system resilience & multisectoral preparedness & response to HEs AFE Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Countries reaching an 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 average score of 3.5 in at Comments on MPA: The target is 0 in Year 1; results are not yet due. least 3 JEE core capacity achieving targets areas in each axis (Prevent, Detect, and Respond) (Percentage) Countries where 60% of 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 health events met all three 7- Comments on MPA: The target is 0 for the first two years. 1-7 targets (Percentage) achieving targets Countries where 80% of 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 project-supported Comments on MPA: The target is 0 in the first two years. Laboratories which will participate have been laboratories have achieved a achieving targets identified. 3-star rating or higher during a SLIPTA audit (Percentage) Countries that have signed 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 protocols to promote cross Comments on MPA: The target for the first year is 0. border response achieving targets (Percentage) 6.2 Intermediate Results Indicators by Components Feb 11, 2025 Page 4 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) Strengthening the Preparedness and Resilience of Regional & National Health Systems to Manage Health Emergencies Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Countries that have 0.00 Sep/2023 0 01-Jun-2024 40 15-Dec-2024 100.00 Mar/2030 developed or updated a Comments on STP and Ethiopia have completed this in 2024. multisectoral National Action achieving targets Plan for Health Security. Note: The denominator is currently 5 countries for which data is available. (Percentage) Countries that have 0.00 Sep/2023 0 01-Jun-2024 20 15-Dec-2024 100.00 Mar/2030 conducted a multisectoral Comments on Ethiopia has conducted a simulation exercise in November 2024. simulation exercise, or an achieving targets intra- or after-action review (within WHO-recommended timelines) for a health emergency that has occurred (Percentage) Countries that have at least 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 one field epidemiologist who has completed a minimum 1- year program in at least 90% of 1st-level administrative divisions (e.g. province) (Percentage) Countries where at 0.00 0 0 66.00 least 30% of field epidemiologists who have completed a minimum 1-year program at the 1st- Feb 11, 2025 Page 5 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) level administrative region are female. (Percentage) Countries that have 0.00 Sep/2023 0 01-Jun-2024 20 15-Dec-2024 66.00 Mar/2030 established an incident Comments on Established in STP. management system and achieving targets have designated at least 1 health official in 90% of 2nd- level administrative divisions (e.g. district) to serve as incident manager. (Percentage) Countries where at 0.00 0 20 66.00 least 40% of incident Comments on Achieved in STP. managers at the achieving targets second-level administrative division are female. (Percentage) Countries with a national 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 multi sectoral action plan for One Health that is costed and financed (Percentage) Countries that have national 0 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66 Mar/2030 clinical case management guidelines for priority health events, and these guidelines are being implemented at the national level with project support (Percentage) Feb 11, 2025 Page 6 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) Improving early detection of and response to HEs through a multisectoral approach Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Countries that have trained 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 at least 1 health official in at least 90% of second-level administrative divisions (e.g. district) on IDSR (Percentage) Countries where at 0.00 0 0 66.00 least 40% of IDSR trainees are female. (Percentage) People receiving quality 0 Sep/2023 4,500 15-Dec-2024 22,500 Mar/2030 health, nutrition, and Comments on As the MPA program focuses enhancing systems capacity and not service delivery, this population services (Number achieving targets indicator is being compiled solely for STP, which includes immunization activities which are of people) CRI being tracked. People receiving quality 0 Sep/2023 4,500 15-Dec-2024 22,500 Mar/2030 health, nutrition, and population services – Youth (Number of people) CRI People receiving quality 0 Sep/2023 2,200 15-Dec-2024 11,250 Mar/2030 health, nutrition, and population services – Female (Number of people) CRI 0.00 Sep/2023 0 01-Jun-2024 20 15-Dec-2024 66.00 Mar/2030 Feb 11, 2025 Page 7 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) Countries with at least 1 Comments on STP has achieved this in 2024. trained and functional rapid achieving targets response team in at least 90% of first-level administrative divisions (e.g. province) (Percentage) Countries where an essential 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 100.00 Mar/2030 health services package is newly approved or revised, including non-communicable diseases, mental health, and maternal and reproductive health services. (Percentage) Countries that have 0.00 Sep/2023 0 01-Jun-2024 20 15-Dec-2024 100.00 Mar/2030 developed a RCCE plan and Comments on STP has achieved this in 2024. standard operating achieving targets procedure which applies to both routine and emergency contexts, and accounts for gender dimensions of RCCE (Percentage) Countries that have achieved 0.00 Sep/2023 0 01-Jun-2024 0 15-Dec-2024 66.00 Mar/2030 Level 4 of Joint External Evaluation indicator R5.3 ("Community Engagement") (Percentage) Points of entry supported per 0 Sep/2023 0 01-Jun-2024 4 15-Dec-2024 4 Mar/2030 country to develop Public Comments on Points of entry have been supported in Ethiopia and Kenya Health Emergency achieving targets Feb 11, 2025 Page 8 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) Contingency Plans (Number) Feb 11, 2025 Page 9 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) 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-E2290 Effective 195.00 193.85 0.00 27.10 166.75 13.98% IDA-E2280 Effective 9.00 8.82 0.00 3.52 5.35 39.70% IDA-E2270 Effective 20.00 19.60 0.00 3.51 16.17 17.84% IDA-E2260 Effective 15.00 14.96 0.00 3.11 11.82 20.82% IDA-74050 Effective 120.00 114.78 0.00 0.00 114.78 0% Feb 11, 2025 Page 10 of 11 The World Bank Implementation Status & Results Report Health Emergency Preparedness, Response and Resilience Program Using the Multiphase Programmatic Approach (P180127) 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-74050 Effective 29-Sep-2023 03-Jan-2024 27-Nov-2024 31-Dec-2028 31-Dec-2028 IDA-E2260 Effective 29-Sep-2023 07-Dec-2023 06-Mar-2024 31-Mar-2030 31-Mar-2030 IDA-E2270 Effective 29-Sep-2023 24-Oct-2023 17-Jan-2024 31-Mar-2030 31-Mar-2030 IDA-E2280 Effective 29-Sep-2023 26-Oct-2023 23-Jan-2024 31-Mar-2030 31-Mar-2030 IDA-E2290 Effective 29-Sep-2023 12-Dec-2023 11-Mar-2024 31-Mar-2030 31-Mar-2030 8. KEY DATES Key Events Planned Actual Approval 29-Sep-2023 29-Sep-2023 Effectiveness 17-Jan-2024 17-Jan-2024 Mid-Term Review No. 01 14-Apr-2027 Operation Closing/Cancellation 31-Mar-2030 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) There are no associated operations Feb 11, 2025 Page 11 of 11