FOR OFFICIAL USE ONLY Report No: PPHI00468 INTERNATIONAL DEVELOPMENT ASSOCIATION PROJECT PAPER ON A PROPOSED GRANT IN THE AMOUNT OF US$ 4.00 MILLION TO THE FOOD AND AGRICULTURAL ORGANIZATION FOR A SAR CAPACITY BUILDING FOR PANDEMIC PREVENTION, PREPAREDNESS, AND RESPONSE (PPR) WITH ONE HEALTH APPROACH {DATE} Health, Nutrition & Population Other CURRENCY EQUIVALENTS (Exchange Rate Effective {Mar 12, 2024}) Currency Unit = = US$1 FISCAL YEAR January 1 - December 31 Regional Vice President: Martin Raiser Regional Director: Nicole Klingen Country Director: Abdoulaye Seck Practice Manager: Feng Zhao Task Team Leader(s): Shiyong Wang, Deepika Eranjanie Attygalle, Amadou Ba The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) ABBREVIATIONS AND ACRONYMS AI Artificial Intelligence AMR Antimicrobial Resistance Bay of Bengal Initiative for Multi-Sectoral Technical and Economic BIMSTEC Cooperation DAH Development Assistance for Health EOC-NET Regional Emergency Operation Center Network EMDE Emerging Market and Developing Economy FAO Food and Agricultural Organization GHSI Global Health Security Index IHR International Health Regulations JEE Joint External Evaluation MDB Multilateral Development Bank NAPHS National Action Plan for Health Security NCDs Non-Communicable Diseases OECD Organization for Economic Cooperation and Development OH One Health PA Paris Alignment PMU Project Management Unit POM project operations manual PPR Prevention, Preparedness and Response RICE Regional Integration, Cooperation, and Engagement SAARC South Asia Association for Cooperation SASEC South Asia Subregional Eco SEARHEF South-East Asia Regional Health Emergency Fund SimEX Simulation and Exercise SPAR States Parties Self-Assessment Annual Report (SPAR) SEARO South-East Regional Office, WHO UNEP United Nations Environmental Program USAID United States Agency for International Development WOAH World Organization for Animal Health WHO World Health Organization @#&OPS~Doctype~OPS^dynamics@padsgbasicinformation#doctemplate BASIC INFORMATION Project Beneficiary(ies) Operation Name i The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) SAR Capacity Building for Pandemic Prevention, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Preparedness, and Response (PPR) with One Health Lanka approach Financing Instrument Classification Investment Project Financing (IPF) Small Grants Approval Date Closing Date Environmental and Social Risk Classification 17-Jan-2025 31-Dec-2026 Low Approval Authority Bank/IFC Collaboration CD Decision No Proposed Development Objective(s) To strengthen collaboration on and the capacity for pandemic prevention, preparedness, and response with One Health approaches in selected South Asian countries. Components Component Name Cost (US$) Improved regional and sectoral collaboration through strategic planning for 800,000.00 pandemic PPR Enhanced collaboration and capacity for pandemic PPR through shared 2,700,000.00 learning and regional platforms Strengthened project management and capacity of regional entities for 500,000.00 pandemic PPR @#&OPS~Doctype~OPS^dynamics@padborrower#doctemplate Organizations Borrower: Food and Agriculture Organization Contact Title Telephone No. Email Jiaoqun Shi Country representative 8801755594497 jiaoqun.shi@fao.org Implementing Agency: Food and Agricultural Organization Contact Title Telephone No. Email Eric Brum Program Manager 8801730001245 eric.brum@fao.org @#&OPS~Doctype~OPS^dynamics@padfinancingsummary#doctemplate PROJECT FINANCING DATA (US$, Millions) ii The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Maximizing Finance for Development Is this an MFD-Enabling Project (MFD-EP)? No Is this project Private Capital Enabling (PCE)? No SUMMARY Total Operation Cost 4.00 Total Financing 4.00 Financing Gap 0.00 DETAILS Non-World Bank Group Financing Trust Funds 4.00 Health Emergency Preparedness and Response Multi-Donor Trust 4.00 @#&OPS~Doctype~OPS^dynamics@paddisbursementprojection#doctemplate Expected Disbursements (US$, Millions) WB Fiscal Year 2025 2026 2027 Annual 0.50 1.80 0.30 Cumulative 0.50 2.30 2.60 @#&OPS~Doctype~OPS^dynamics@padsgprocessing#doctemplate FINANCING & IMPLEMENTATION MODALITIES Situations of Urgent Need of Assistance or Capacity Constraints [ ] Fragile State(s) [ ] Fragile within a non-fragile Country [✓] Small State(s) [ ] Conflict [ ] Responding to Natural or Man-made Disaster Other Situations [ ] Financial Intermediaries (FI) [ ] Series of Projects (SOP) [ ] Performance-Based Conditions (PBCs) [ ] Contingent Emergency Response Component (CERC) [✓] Alternative Procurement Arrangements (APA) [ ] Hands-on Expanded Implementation Support (HEIS) Practice Area (Lead) Health, Nutrition & Population iii The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Contributing Practice Areas Agriculture and Food; Environment, Natural Resources & the Blue Economy @#&OPS~Doctype~OPS^dynamics@padrisk#doctemplate OVERALL RISK RATING Risk Category Rating Overall ⚫ Substantial @#&OPS~Doctype~OPS^dynamics@padcompliance#doctemplate POLICY COMPLIANCE Policy Does the project depart from the CPF in content or in other significant respects? [ ] Yes [✓] No Does the project require any waivers of Bank policies? [ ] Yes [✓] No ENVIRONMENTAL AND SOCIAL Environmental and Social Standards Relevance Given its Context at the Time of Appraisal E & S Standards Relevance ESS 1: Assessment and Management of Environmental and Social Risks and Relevant Impacts ESS 10: Stakeholder Engagement and Information Disclosure Relevant ESS 2: Labor and Working Conditions Relevant iv The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) ESS 3: Resource Efficiency and Pollution Prevention and Management Relevant ESS 4: Community Health and Safety Not Currently Relevant ESS 5: Land Acquisition, Restrictions on Land Use and Involuntary Resettlement Not Currently Relevant ESS 6: Biodiversity Conservation and Sustainable Management of Living Natural Not Currently Relevant Resources ESS 7: Indigenous Peoples/Sub-Saharan African Historically Underserved Not Currently Relevant Traditional Local Communities ESS 8: Cultural Heritage Not Currently Relevant ESS 9: Financial Intermediaries Not Currently Relevant NOTE: For further information regarding the World Bank’s due diligence assessment of the Project’s potential environmental and social risks and impacts, please refer to the Project’s Appraisal Environmental and Social Review Summary (ESRS). @#&OPS~Doctype~OPS^dynamics@padlegalcovenants#doctemplate LEGAL Legal Covenants Sections and Description @#&OPS~Doctype~OPS^dynamics@padconditions#doctemplate Conditions Type Citation Description Financing Source @#&OPS~Doctype~OPS^dynamics@padteam#doctemplate PROJECT TEAM Bank Staff Specialization in this Name Role Unit operation Shiyong Wang Team Leader(ADM Responsible) HSAHP Amadou Ba Team Leader animal health SSAA1 Financial Management Specialist(ADM Md. Didarul Islam ESAG1 Responsible) Md Kamruzzaman Procurement Specialist(ADM Responsible) ESARU Iqbal Ahmed Environmental Specialist(ADM Responsible) SSAE2 Shanek Mario Fernando Social Specialist(ADM Responsible) ESF SSAS1 Shabbir Ahsan Social Specialist social specialist SSAS1 v The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Elsa Suzanne Gilberte Le Counsel Bangladesh CL LEGAS Groumellec Tasfia Kamal Team Member project assistance SACBD Rajagopala Raghavan Team Member WFA WFACS Satish Kumar Shivakumar Team Member WFA WFACS Adiam Berhane Demeke Team Member HSAHP Yinan Zhang Team Member Regional Coordination SARRE Di Dong Team Member Health Economics HSAHP Mamata Ghimire Team Member Country Engagement HSAHP Ali Saeed Mirza Team Member IHR HSAHP Bulathge Bhakthi Team Member Project Management LEGIA Anuruddhika Abeysooriya Mazhar Farid Team Member Lawyer SAR tasks LEGAS John C. Keyser Team Member Animal Health SSAA1 Anna Koziel Team Member human health HSAHP D Mudiyanselage Athula Team Member animal health SSAA1 Hemanthasiri Senaratne Udage Arachchige Priyanka disaster risk Team Member ISAU1 Kumari Dissanayake management Phoebe M. Folger Team Member Operations HSAHP Lung Duy Vu Team Member Surge Capacity HSAHN Atia Hossain Team Member HSAHP Animal Health and Joachim Vandercasteelen Team Member SSAA1 Agriculture Specialist Anupam Joshi Team Member Environmental Specialist SSAE1 Suresh Kunhi Mohammed Team Member Public Health HHNGE Md Istiak Sobhan Team Member Environmental Specialist SSAE2 Kajali Paintal Goswami Team Member HHNGE Junko Funahashi Team Member Legal LEGAS vi The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) PEOPLE'S REPUBLIC OF BANGLADESH, KINGDOM OF BHUTAN, REPUBLIC OF THE UNION OF MYANMAR, NEPAL, DEMOCRATIC SOCIALIST REPUBLIC OF SRI LANKA, REPUBLIC OF INDIA, KINGDOM OF THAILAND SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach Contents I. STRATEGIC CONTEXT .................................................................................................................. 1 II. PROJECT DEVELOPMENT OBJECTIVES ......................................................................................... 4 III. PROJECT DESCRIPTION ............................................................................................................... 4 IV. IMPLEMENTATION ..................................................................................................................... 5 V. KEY RISKS .................................................................................................................................. 7 VI. APPRAISAL SUMMARY ............................................................................................................... 7 VII. WORLD BANK GRIEVANCE REDRESS ......................................................................................... 11 VIII. RESULTS FRAMEWORK AND MONITORING ............................................................................... 13 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) I. STRATEGIC CONTEXT A. Regional Context 1. In 2024-25, at just under six percent, the South Asia Region (SAR) is expected to grow faster than any other emerging market and developing economy (EMDE) region. However, for all countries, this will represent a slowdown from pre-pandemic averages. A few potential adverse events could derail this outlook, including risks related to fragile fiscal positions. An urgent policy priority for the region is, therefore, to manage and reduce fiscal risks. Over the longer term, the policy priority is to accelerate growth and job creation in a sustainable manner. 2. Growing recognition of cross-border connectivity and trade benefits has built the momentum for regional cooperation in South Asia. A more integrated SAR would boost growth, cut costs, create jobs, and open new markets. The eastern sub-region of Bangladesh, Bhutan, India, and Nepal has made progress in sub-regional cooperation, with investment and connectivity opportunities emerging in energy, transport, and trade. The region is also confronting intensifying transboundary climate challenges that require cross-border cooperation to address and enhance resilience. B. Sectoral and Institutional Context 3. Strengthening pandemic prevention, preparedness, and response (PPR) and One Health (OH) approaches are paramount for reducing fiscal risks and fostering sustainable growth in South Asia, a region globally recognized as a hot spot for emerging infectious diseases, including those with pandemic potential . With a population reaching 1.8 billion, the region is undergoing rapid urbanization and overcrowding, strained service delivery, land-use change, and environmental degradation and pollution. Countries are increasingly interconnected and dependent on intra-regional trade, which enables frequent cross-border movements of animals and people. Together, these factors elevate the risk for increased frequency and severity of public health emergencies. 4. Improved pandemic PPR and OH approaches are also critical to building climate resilience in the region. Several South Asian countries are among the most countries vulnerable to climate change due to their high exposure to climate hazards and limited capacity to adapt to its effects. Climate change is expected to exacerbate the prevalence or modify the geographic distribution of climate-sensitive diseases. Warming temperatures, changing rainfall patterns, and degraded ecosystems create more favorable conditions for food and water insecurity, extreme heat exposure, and transmission sites for zoonotic, waterborne, and vector-borne diseases. Climate hazards and disasters can also disrupt health services by damaging facilities and creating barriers to accessing care. As such, the World Health Organization (WHO) South-East Asia Regional Strategic Roadmap for Health Security and Health System Resilience for Emergencies recommends that member states build national capacity to understand climate change effects on health and adapt to climate impacts. 5. Today’s evolving disease landscape highlights the imperative of bolstering health system resilience to address complex health threats. Health systems are becoming overwhelmed as they see a sharp rise in non-communicable diseases (NCDs), while concurrently managing the region’s legacy infectious diseases. The prevalence of emerging infectious diseases among animals is also increasing due to inadequate animal health systems, overuse of antibiotics, poor waste management, and limited access to veterinary care. Dengue, chikungunya, Nipah virus, Japanese encephalitis, avian influenza, enteric fever, polio, antimicrobial resistance (AMR), and a range of food-borne illnesses are a few of the priority emerging and remerging infectious disease challenges affecting the region. Experiences from COVID-19 illustrate the profound toll of pandemics and the need for robust health systems and effective regional cooperation to mitigate multidimensional health threats. 6. The capacity in the region varies, yet common vulnerabilities exist for pandemic PPR. As measured by the 2021 Global Health Security Index (GHSI), only India and Bhutan scored above the global average score of 38.9 in the SAR. The Page 1 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Joint External Evaluations (JEE) on International Health Regulations (IHR) core capacity revealed common gaps across SAR countries, including for zoonotic disease and AMR management, medical countermeasures and personnel deployment, risk communication, food safety, case-based investigation, emergency preparedness, and response operations. 7. There is strong global political momentum to support pandemic PPR. A global treaty for pandemic PPR has been under development to ensure equity in access to essential tools to prevent pandemics and provide health care for all people. During the recent SAR Conference on Improving Pandemic PPR with One Health Approach, the countries in the region acknowledged the needs to build national capacity and set up regional pandemic PPR mechanisms. Novel financing mechanisms such as the Pandemic Fund and the Health Emergency Preparedness and Response (HEPR) trust fund have been set up since the COVID-19 pandemic. The former was established to ensure fair pandemic PPR financing in low and middle-income countries, focusing on the development of infectious disease surveillance, human resource for health and laboratory system. The HEPR was set up in June 2020 by the World Bank to support eligible countries and territories to improve their capacities to prepare for, prevent, respond to, and mitigate the impact of epidemics. It was set up as a flexible mechanism to provide catalytic, upfront, and rapid financing at times when other funding sources are unavailable for health emergency preparedness and to fill specific gaps in health emergency responses. 8. The WHO Strategy Roadmap on Health Security and Health System Resilience for Emergencies (2023-2027) outlines strategic aims to reinforce health security and system resilience in SAR . Key among these objectives is the strengthening of regional collaboration through (i) the establishment of a Regional Health Emergency Council for decision-making on various coordination issues such as vaccine implementation, trade and travel measures; (ii) enhancement of national and regional alert systems; (iii) the creation of networks for information sharing and risk assessment; (iv) setting up a Regional Emergency Operation Center Network (EOC-NET) that conducts regular capacity building through training and simulation and exercise (SimEx); (v) integrated laboratory networks for diagnostics and genomic surveillance, and (vi) strengthened collaboration on the production, procurement, and distribution of drugs, consumables, and vaccines. 9. Utilizing an OH approach to meet health security and system resilience goals is imperative because the drivers of pandemics are multisectoral. Addressing emerging infectious diseases at the source, including the drivers for their emergence, spillover, and spread, needs expertise and capacity from the environmental and animal health sectors. Up to two-thirds of emerging or reemerging infectious diseases are zoonotic in origin, which necessitates integrated surveillance systems in humans, wildlife, and livestock. Moreover, safeguarding the environment and intervening environmental determinants of health—such as water and sanitation, pollution, food security, and climate impacts— is beyond the purview of human health sector. In SAR, numerous stakeholders across sectors including governments, non- governmental organizations, the private sector, United States Agency for International Development (USAID), multilateral development banks (MDBs), such as the Asian Development Bank (ADB) and WB, as well as the Quadripartite partners comprising UN agencies i.e., WHO, United Nations Environment Programme (UNEP), Food and Agriculture Organization (FAO), and World Organization for Animal Health (WOAH), have been working on developing a harmonized One Health strategy for tackling health security challenges through adopting the global One Health Joint Plan of Action (2022 to 2026). 10. The challenge for containing infectious diseases within national borders is daunting in an increasingly interconnected world. Infectious diseases can be transmitted from their geographic origins without notice. A regional approach not only promises efficiency gains and harmonized pandemic PPR-related policies but also fosters shared resources, expertise, and information on infectious disease outbreaks. 11. While regional collaboration is crucial for pandemic PPR and OH goals, it remains insufficient in South Asia. Unlike other regions, SAR has limited established functioning regional platforms for coordinated infectious disease surveillance, prevention, and response. The most prominent regional entities include the South Asia Association for Cooperation (SAARC), the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC: Bangladesh, Page 2 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Bhutan, India, Sri Lanka, Nepal, Myanmar, Thailand), and the Bangladesh, Bhutan, India, Nepal Initiative (BBIN). Examples of regional collaborations on health security agenda include (i) in collaboration with the ADB, and FAO), the SAARC worked on a capacity building project to improve epidemiology and information sharing on transboundary animal diseases in the region from 2014 to 2018, (ii) In 2016, the South-East Asia Regional Health Emergency Fund (SEARHEF) was set up at the WHO Southeast Asia Regional Office (SEARO) to catalyze interventions that are prioritized in the National Action Plans for Health Security (NAPHS), (iii) the SAARC member states created a COVID-19 Emergency Fund to mitigate the pandemic's impact, and (iv) India donated COVID-19 vaccines to neighboring countries, demonstrating solidarity for addressing public health crises in the region. However, many of these initiatives have been ad hoc with limited sustainability. 12. Several regional structures/entities have been assessed for their potential to lead and sustain regional pandemic PPR initiatives in SAR. These include SAARC, BIMSTEC, South Asia Subregional Economic Cooperation (SASEC), WHO SEARO, FAO, and the BBIN Initiatives (refer to Annex 1 on comparison among the regional structures). The BIMSTEC stood out to be uniquely suited for coordinating regional health security, offering comparative advantages of navigating complex geopolitics and ensuring regional ownership through member-driven governance. The BIMSTEC Secretariat has established a Public Health Expert Group comprising senior officials from health ministries among its member countries to lead the health security agenda. It has developed and ratified the Plan of Action on Public Health (2023-2025) aiming to bolster the regional human and animal health systems, use an ecological perspective for disease prevention and preparedness, and ensure a unified response to public health emergencies through a OH framework among member states. Further, the BIMSTEC willingly offers opportunities to engage non-members in the region. For instance, Pakistan and Maldives were observers and cooperating partners in regional pandemic PPR discussions held by BIMSTEC in July 2023. The FAO has also been identified as another key player because of its records of promoting regional coordination and collaboration on infectious diseases prevention and control, its expertise on One Health and its experience in working with the WB and the ADB as well as its presence in all countries. 13. The World Bank engagement approach for pandemic PPR in SAR: The World Bank has been working with regional entities, including the BIMSTEC Secretariat, OH quadripartite partners, ADB and participating countries to improve pandemic PPR under three interlinked phases. • Phase 1 (October 2022 to September 2024): aims to improve the knowledge base for policymakers on the regional context in terms of pandemic PPR and OH, advocate for and sustain political support for pandemic PPR. • Phase 2 (February 2024 to December 2026): aims to strengthen strategic planning for pandemic PPR and OH in SAR. Action plans to establish a regional collaboration mechanism and/or regional OH implementation structure will be developed and selected regional mechanisms on pandemic PPR and OH will be launched. This project will support Phase 2. • Phase 3 (2026 or later): aims to implement priority activities for strengthening regional and country pandemic PPR and OH capacities, establish governance and implementation structures, regional mechanisms and/or platforms for pandemic PPR and OH. C. Higher Level Objectives to which the Project Contributes 14. The proposed operation is consistent with the South Asia Regional Integration, Cooperation, and Engagement (SA RICE) approach, the Paris Agreement, and Country Partnership Frameworks in the region. The operation is expected to contribute to regional and country priorities of reducing social vulnerabilities, building health system resilience, and ultimately, increasing human capital through improving health outcomes [6.7]. The objectives are aligned with SAR countries’ Nationally Determined Contributions (NDCs) under the Paris Agreement by contributing to adaptation targets by increasing health system resiliency to climate-sensitive diseases and strengthening early warning systems. Page 3 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) 15. The operation responds to the World Bank’s evolution roadmap for delivering public goods through Global Challenge Programs (GCPs) that aim to reverse negative trends for people and the planet. Decades of development gains have been threatened by overlapping global shocks since 2020, including COVID-19, multiple wars, and the ongoing climate crisis. This operation aligns with the “Pandemic Prevention and Preparedness� GCP. It contributes to other GCPs including “Climate Change Adaptation and Mitigation� (e.g., by enhancing climate and health resilience and integrating climate data into early warning systems); “Food and Nutrition Security� (e.g., by improving management of environmental factors and disease outbreaks in the agriculture sector); “Enabling Digitalization� (e.g., by improved digital management early warning systems and data sharing); and “Protecting Biodiversity and Nature� (e.g., by taking One Health approaches for improved pandemic PPR capacities). II. PROJECT DEVELOPMENT OBJECTIVES A. Project Development Objective 16. To strengthen collaboration on and the capacity for pandemic prevention, preparedness, and response with One Health approaches in selected South Asian countries. B. Project Beneficiaries 17. The direct beneficiaries of the capacity-building and technical assistance include the BIMSTEC Secretariat and the member countries. Other direct beneficiaries include health professionals working for the health, agriculture, livestock, environment, forestry, climate change and disaster management sectors among BIMSTEC member states. Indirect beneficiaries include the general populations in the region through public health benefits from enhanced health system and climate resilience. C. PDO-Level Results Indicators 18. The achievement of PDO will be measured by the following four indicators: a. Plans or roadmaps developed and endorsed for the establishment of at least two regional pandemic PPR mechanisms by the BIMSTEC members (Number). (Collaboration) b. At least one regional pandemic PPR mechanism launched to help collaboration and cooperation among BIMSTEC member states (Number). (Collaboration and Capacity) c. Enhanced BIMSTEC's capacity for effective coordination measured by (i) BIMSTEC staff trained on project management, including FM, PM and ESF; and (ii) progress reviews conducted on the regional Plan of Action on Public Health and Animal Health (Y/N). (Capacity) III. PROJECT DESCRIPTION A. Project Components 19. The project comprises of three components with the activities aligned with objectives for strengthened regional integration, collaboration, and capacity for improved PPR. 20. Component 1: Improved regional and sectoral collaboration through strategic planning for pandemic PPR (US$800,000). This component aims to bolster strategic planning for the establishment of regional mechanisms and advancing OH agenda in selected countries. The three key activities include (i) conducting OH profiling and investment case development in India, Nepal, and the third country, (ii) conducting the assessments on (a) prioritization and mapping of the diseases at human and animal interface and with outbreak potential, and (b) coordination mechanisms on Page 4 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) transboundary infectious diseases at points of entry, and (iii) supporting the development of strategic roadmaps for the establishment of at least two out of four following regional mechanisms: (a) early warning and surveillance, (b) stockpiling, (c) surge capacity for public health emergencies, and (d) pandemic PPR financing. 21. Component 2: Enhanced collaboration and capacity for pandemic PPR through shared learning and regional platforms (US$2,700,000). This component aims to pilot selected regional platforms that facilitate expertise and information sharing. The main activities comprise: (i) exploring the establishment of a regional infectious/zoonotic disease early warning and surveillance observatory, either a virtual or physical entity, that works on (a) regional infectious disease forecasting and projection by using big data and artificial intelligence (AI); (b) facilitating the sharing of expertise on and the capacity for managing infectious disease outbreaks and their risk factors; (c) capacity building for regional infectious disease early warning and surveillance; and (d) guiding the evaluation of surveillance systems, (ii) identifying potential regional centers of excellence on pandemic PPR and OH and support at least one regional center of excellence facilitating cross learning and capacity building in the regional with the needed laboratory equipment, supplies, computers and software and (iii) conducting senior policy seminars and simulations to formulate or harmonize policies, regional governance and coordination structures for such as (a) infectious disease early warning and surveillance and (b) public and animal health measures at the point of entries (PoEs). 22. Component 3: Strengthened project management and capacity of regional entities for pandemic PPR (US$500,000). This component is focused on project management and strengthening the BIMSTEC Secretariat’s capacities of joint planning, policy development and harmonization, and M&E for regional pandemic PPR initiatives. The key activities encompass (i) conducting project management and monitoring and evaluation, (ii) capacity building of project management for the BIMSTEC Secretariat, and (iii) knowledge management, exchange and dissemination. B. Project Cost and Financing Project Components Project cost Trust Funds Counterpart Funding Total Costs Total Project Costs 4,000,000 4,000,000 0 Total Financing Required IV. IMPLEMENTATION A. Institutional and Implementation Arrangements 23. The FAO Bangladesh Country Office based in Dhaka will be the primary implementing agency with a Project Management Unit (PMU). The FAO has expertise and experience in health emergency prevention, preparedness, and response. It will be responsible for implementing activities under all components and provide technical assistance to ensure the establishment of a functioning BIMSTEC Project Management Office (PMO). The FAO Bangladesh Office will be supported by its regional office based in Bangkok and its headquarters in Rome. Page 5 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) 24. Within the BIMSTEC Secretariat, a PMO will be set up with a minimum staff comprising a project coordinator, 1 or 2 project officers with health background, 1 procurement officer, 1 financial management officer and 1 environment and social officer. They will learn from the PMU peers by shadowing and on the job training. A Project Advisory Committee (PAC), comprising senior public health officials from the BIMSTEC public health expert group and the FAO representatives of Bangladesh and the Regional Office, will be established to provide strategic guidance, and solve outstanding issues during the project implementation. 25. In the selected countries for OH profiling and investment plan development, or any assessments, the national One Health coordination platforms will be engaged and strengthened under the project to ensure effective coordination and collaboration among different sectors involved in One Health initiatives. Besides, the country based One Health coordination mechanisms will help identification of RCoEs to be supported under the project. The RCOEs identified and supported will handle promoting learning, exchange, and capacity building among participating countries. Figure 1: Project implementation arrangements. B. Results Monitoring and Evaluation 26. The FAO Bangladesh Office and will be responsible for project monitoring and evaluation. Semi-annual project implementation progress reports will be compiled by the PMU, in coordination with the BIMSTEC Secretariat, before communicating to the World Bank. As an activity of capacity for the BIMSTEC Secretariat, a Project Operations Manual (PoM) will be developed and followed by the Project PMU and BIMSTEC PMO. In the PoM, a section on project M&E specifying M&E requirements, data source, collection and verification, and frequency of reporting will be specified. 27. Three key results areas to be monitored and evaluated under the project include (i) improved coordination among the BIMSTEC members in the region on health emergency and/or pandemic prevention, preparedness and response, (ii) improved regional capacity in terms of strategic planning and selected technical areas such as infectious disease early warning, rapid response, risk assessment, or other identified regional priorities, and (iii) the BIMSTEC Secretariat’s project management capacity. 28. The World Bank task team will conduct project implementation and support missions every six months. C. Sustainability 29. As in the earlier sections of this document, the WB has developed three staged engagement strategies. This project is a part of the second stage. It serves as a proof of concept for potential investments and support from the MDBs like World Bank in the future. The region is the only sub-continent that does not have any functioning and routine coordination mechanisms for health emergencies or pandemic PPR. This operation aims to change this status quo by strengthening an existing regionally owned entity’s capacity to sustain pandemic PPR functions. Page 6 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) 30. The need for improving regional pandemic PPR is strong. Some countries have expressed their strong interest in joining a regional possible project on pandemic PPR through One Health approach in the SAR. A few countries have either won or applied for the support form Pandemic Fund or have pandemic PPR related component under their new health system strengthening projects. Further information can be found in Paragraph 39. 31. Under the project, it is expected that at least action plans/roadmaps for regional pandemic PPR mechanisms to be developed, and the capacity for coordination, selected technical areas to be improved, one regional center of excellence set up. All these will continue to benefit the region beyond the lifecycle of the project. V. KEY RISKS A. Overall Risk Rating and Explanation of Key Risks 32. The overall risk for the project is rated as substantial based on the low institutional capacity for regional collaboration and lack of good track record in regional coordination, collaboration, or integration. The political and sector risks are rated as moderate and environmental and social risk is rated low. 33. Institutional capacity risk: Substantial. The project will partially depend on the BIMSTEC Secretariat to coordinate the member states on advancing pandemic PPR policies, with the support from the Public Health Expert Group. The BIMSTEC Secretariat has limited capacity in project management and suffers from heavy process. 34. Mitigation measures include (i) FAO will be the main agency for implementing key technical activities under the project, and provide support to the BIMSTEC Secretariat, (ii) countries in the region will be mobilized and supported to exercise their technical leadership in one or more technical thematic areas through the approach of establishment of RCoEs. VI. APPRAISAL SUMMARY A. Technical, Economic and Financial Analysis 35. Countries must be ready for future pandemics since they will be inevitable. The annual probability of a pandemic ranges from 0.15% to 4%. One analysis estimates that the probability for another pandemic like COVID-19 in the next 25 years could be 47% to 57%. However, none of the countries in the region are adequately prepared for the next pandemic as shown by the Joint External Evaluation (JEE), States Parties Self-Assessment Annual Report (SPAR), GHSI assessment which collectively measure the countries capacity for the implementation of the IHR. 36. Pandemics can cause social and economic havocs. The COVID-19 pandemic is set to cost the global economy US$13.8 trillion through 2024 (IMF, 2022). In the SAR and part of the Southeast Asia Region, the BIMSTEC member states suffered from insurmountable human capital losses due to COVID-19 pandemic. By March 21, 2024, the BIMSTEC members reported more than 54 million COVID-19 cases, and 646,028 deaths, in addition to the excess deaths due to other causes during the pandemic. These losses would be huge in case they could be monetarized. Besides, due to stringent disease control polices, the economies in these countries were set on pause or to recession (Figure 1). Country Unemployment Rate (%) Real GDP Growth (%) 2020 Change since 2019 2020 Change since 2019 Bangladesh 5.3 20.45% 3.4 -56.96% Bhutan 5.0 85.19% -10.2 -275.86% India 7.9 21.54% -5.8 -248.72% Myanmar 1.5 275.00% -9 -236.36% Page 7 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Nepal 13.1 23.58% -2.4 -135.82% Sri Lanka 7.9 68.09% -4.6 -2200.00% Thailand 1.1 57.14% -6.1 -390.48% Figure 1: Total unemployment (% of total labor force) and rate of change of real GDP in the selected BIMSTEC Members. Source: retrieved on April 2 at https://data.worldbank.org/indicator. 37. Surveillance on and interventions against infectious diseases have externalities beyond the health sector. The development of early warning and surveillance for infectious disease is a public good. Moreover, spending on infectious disease surveillance can be cost effective, or even cost saving. For instance, between 1994 and 2009, it was estimated that the PulseNet, a surveillance system for foodborne diseases, reduced the number of illnesses from Salmonella by 266,522, from Escherichia coli (E. coli) by 9,489, and from Listeria monocytogenes by 56. This reduced medical and productivity costs by USD507 million. Direct effects from improved recalls additionally reduced illnesses from E. coli by 2,819 and Salmonella by 16,994, which further reduced costs with USD37 million. Annual costs for PulseNet to public health agencies were $7.3 million, representing a more than fivefold return on investment. 38. Countries tend to under-spend on disease prevention and control. For low-income countries in 2020, average per- person assistance for pandemic preparedness was USD0·04, for the COVID-19 health response was USD4, and for total development assistance for health (DAH) was USD141. According to an analysis in the Organization for Economic Cooperation and Development (OECD) countries, the willingness to pay for disease surveillance was 264 Euros per year, or roughly 5% of total health spending. However, countries spent only 0.002% to 0.9% of total health expenditures to the disease surveillance and control programs at the time of the investigation was conducted2. The financing for regional pandemic PPR mechanisms is more disagreeable since there has been limited investment on building sustainable and critical regional mechanisms in South Asia Region. One of examples was the USD2 million spent on the regional collaboration on One Health supported by the ADB, with a trust fund from Japan between 2014 to 2018. 39. This project complements the other ongoing investment in the region. For instance, Bhutan and Nepal have secured the support from the Pandemic Fund under Round 1. Bangladesh, Pakistan and Sri Lanka are bidding for the possible support under the Pandemic Fund Round 2. Improving primary health care system’s pandemic PPR will be one of the foci under the health sector programs supported by the WB in Bangladesh, Nepal and Sri Lanka. India has a sizeable investment in strengthening its public health and veterinary services. However, all the afore-mentioned investments have been or will be focused on the improvement in the national human and animal health systems. 40. By augmenting the efforts on improving the national core IHR and PVS capacity and improving health systems resilience, a regional approach for pandemic PPR can result in improved efficiency and equity in terms of stockpiling and procurement, disease early warning, and R&D. Countries can benefit from shared resources for, expertise in, information on and lessons learnt from infectious disease prevention and control. B. Fiduciary 41. Accounts and Audits: FAO will use the UN’s Financial Regulations for project accounting and reporting. FAO will: (i) maintain a financial management system, including records and accounts, adequate to reflect the transactions related to the activities, in accordance with the requirements of the UN Financial Regulations; (ii) maintain a separate ledger account (Grant Control Account) in their books to record the financial transactions of this project; (iii) prepare, on a six� month basis, interim unaudited financial reports (IFRs), in accordance with the UN Financial Regulations, the FMFA, and 1 Micah, A. E., Bhangdia, K., Cogswell, I. E., Lasher, D., Lidral-Porter, B., Maddison, E. R., ... & Hlongwa, M. M. (2023). Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026. The Lancet Global Health, 11(3), e385-e413. 2 Himmler S, van Exel J, Perry-Duxbury M, et al. Willingness to pay for an early warning system for infectious diseases. Eur J Health Econ 2020; 21:763–73. 10.1007/s10198-020-01171-2. Page 8 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) the FAO standard format (Project Status Report) generated directly from the FAO system and as will be stated in the Disbursement and Financial information Letter (DFIL). The IFRs will be provided to the World Bank no later than 90 days after the end of each six-month period. 42. The Grant Control Account will be subject exclusively to the internal and external audit arrangements applicable to FAO as set out in the UN’s Financial Regulations and the FMFA. FAO will make their externally audited financial statements and accompanying reports of their external auditors on their financial statements publicly available on their website. FAO will keep all records evidencing all expenditures in respect of which withdrawals from the Grant Control Account were made, in accordance with its regulations, rules, policies, and procedures relating to retention of records. 43. Final Financial Report. FAO shall issue the Final Financial Report signed by an authorized official. The Final Financial Report will be issued within three (3) months of the project closing date. If the Final Financial Report indicates a balance of funds in favor of the Bank, the Bank will provide relevant payment instructions to FAO to process the refund. FAO shall transfer the refund within thirty (30) calendar days of its receipt of the payment instructions. 44. Internal controls: To ensure proper controls are applied over the use of funds, FAO will ensure the following: a. The finance team located in the field is made up of sufficient qualified staff to review and properly maintain (and cause to be maintained) all original supporting documents of the Project. b. The finance team will ensure that proper controls are in place over the use of funds and that payments are made for eligible expenditures with consideration to economy and efficiency. c. Adequate arrangements are in place for funds to reach the legitimate beneficiaries. d. Proper controls are in place for management and recording of inventory. In addition, proper measures are in place to prevent double-dipping of activities. e. In case of payments to individuals in return for goods or services rendered, FAO will use banking channels or mobile banking (where feasible), payment agencies or other methods available in the country that can provide a high level of assurance that funds reached the intended beneficiaries. f. IFRs are carefully reviewed and approved before submission to the World Bank. In addition, reported expenditures in IFRs will not include advances other than those agreed with the World Bank and disclosed in the IFR. 45. Flow of Funds and Disbursement Arrangements. These arrangements are simplified to ensure prompt availability of funds to implement the proposed operation. Disbursement to FAO shall be made based on the IFRs, and FAO’s designated officials will submit the Withdrawal Applications (WAs) through Client Connection, to the World Bank’s Financing and Accounting Department (WFA). The grant proceeds will be disbursed directly by the Bank into FAO’s official bank account based on the submitted WAs. FAO will not open a designated bank account for the grant but will keep a ledger account for recording the transactions related to this grant. The initial advance will be based on projected expenditures for the activities for the first year of implementation or any such period as may be agreed with the Bank, depending on the workplan and project duration. The frequency of subsequent disbursements will be applied as mentioned in DFIL, where the Bank will document expenditures reported and provide forecasted advances based on the IFRs. C. Procurement 46. Alternative Procurement Arrangements (APA). The project will be implemented by the FAO. For procurement to be conducted under the project, FAO will follow its own procurement procedures as Alternative Procurement Page 9 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Arrangements (APA), as provided under Section III.F of the World Bank Policy - Procurement in IPF and Other Operational Procurement Matters. FAO’s procurement procedures were assessed and found acceptable to the World Bank under agreements with UN agencies. BIMSTEC will receive financing from FAO. Any procurement needed for the BIMSTEC will be conducted by FAO, with goods to be supplied to BIMSTEC. Procurement will be done by the procurement team based in the FAO Dhaka office. The procurement capacity assessment of FAO, Dhaka office was carried out and found acceptable in terms of capacity, internal controls, and external controls to meet procurement core principles and provide adequate fiduciary assurance. 47. Procurement under the project will include mainly goods and consulting services. The activities will range from low to moderate risks in term of value and complexity. FAO will prepare a Project Procurement Strategy for Development (PPSD) along with a procurement plan which will identify the activities to be implemented over the project period. The PPSD will spell out the overall procurement arrangement to be followed by FAO. 48. The overall residual procurement risk is rated as Moderate. There is potential risk of delay in implementation because of lack of coordination between FAO and BIMSTEC, technical preparation of terms of references (TORs) and other procurement activities. The risk mitigation measures include frequent reporting, supplemented by regular direct contact between the World Bank and FAO. The World Bank will (i) review and approve the procurement plan and its respective updates; (ii) work closely with FAO on the technical review of the TORs. FAO will provide quarterly reports on progress with implementation of the procurement plan. Any procurement activity under the Project that is not part of the agreed procurement plan will be considered as ineligible. 49. Monitoring Arrangement: FAO will be responsible for: (i) implementing the procurement plan as agreed with the World Bank; (ii) preparing quarterly reports on the progress of procurement activities; and (iii) ensuring pre-screening of firms/ individuals against the World Bank’s list of debarred or temporarily suspended firms prior to award of any contract. The World Bank will ensure procurement supervision through frequent contact with FAO, quarterly reports of FAO and during implementation support missions. D. Legal Operational Policies @#&OPS~Doctype~OPS^dynamics@padlegalpolicy#doctemplate Legal Operational Policies Triggered? Projects on International Waterways OP 7.50 No Projects in Disputed Area OP 7.60 No E. Environmental and Social 50. The social and environmental risks are considered ‘low’ as the project will solely focus on capacity-building activities. A majority of activities will be on the development of strategies, and developing plans needed for regional health system resilience, studies, training, policy seminars, exercise, study tours and supporting the establishment of a regional observatory for infectious disease early warning and surveillance updating guidelines and standards for regional stockpile, and others. The primary beneficiaries will be government officials, and health professionals working on pandemic PPR. However, under the project, some laboratory activities, mainly for training purposes, are expected to be implemented at the RCoEs. These laboratory activities may have environment and social implications on biosafety and biosecurity (handling biohazardous materials, and medical waste management). Page 10 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) 51. While the project will not have any significant social risks, there may be a) health & safety risks to project workers and trainees when handling biohazardous materials & medical waste during laboratory trainings & operation of RCoEs and b) possible exclusion risks due lack of inclusive & transparent processes when selecting training participants, and inadequate representation & engagement of key stakeholders from member countries during the planning & implementation of project activities. To address, biosafety risks, the project will comply & mainstream WB and WHO accepted occupational, health and safety (OHS) regulations and guidelines per E&S Standards (ESSs) and other relevant Good International Industry Practice (GIIP). The project will also have procedures & criteria in place to ensure non- discrimination and fair representation of healthcare officials by gender, race/ethnicity and by all provinces/ states in each country during implementation of capacity building programs and project activities. The project will also operate a grievances redressal mechanism (GRM) to respond to any complaints from project stakeholders including beneficiaries. The SEA/SH risks of the project are rated ‘Low’ and determined through the application of the World Bank’s SEA/SH Risk Rating tool for Health projects. The ESCP includes requirements and commitments for Stakeholder Engagement and Labor Management. No separate instruments will be prepared. E. Corporate Commitments Gender 52. For this project focusing mainly on capacity building, policy harmonization and strategy development, the following actions will be taken to ensure the project is gender-responsive: (i) at least 30% of the beneficiaires of all the capacity building activities are female, (ii) for hiring the PMO staff, when other conditions are the same, priority will be given to female candidates and (iii) ensuring any plans, strategies, roadmaps developed under the project, are gender responsive. Climate 53. Paris Alignment. The project is fully aligned with both the adaptation and mitigation goals of the Paris Agreement on Climate Change. Adaptation goal and risk reduction measures: The project is anticipated to have limited activities that are vulnerable to climate change and focuses on activities aimed at strengthening system resilience. Under Sub- Component 3, the project will finance the procurement of computers, testing and lab supplies which are resilient to SAR’s severe floods, extreme heat, cyclones and strong winds. To reduce risk of damage to the procured equipment, the project will use climate-controlled storage such as raised and flood-proof, temperature regulated, and proper ventilated storage will be used. All proposed project activities are universally aligned and are not anticipated to make substantial contribution to GHG emissions. Citizen engagement 54. The Ministries of Health of all BIMSTEC members have been consulted on this regional project in addition to (i) country specific consultations conducted in Bangladesh, Sri Lanka and Bhutan. The consultations were participated by the stakeholders from wild animal health, environmental health, and human health, and (ii) regional thank tanks and opinion leaders. VII. WORLD BANK GRIEVANCE REDRESS 55. Grievance Redress. Communities and individuals who believe that they are adversely affected by a project supported by the World Bank may submit complaints to existing project-level grievance mechanisms or the Bank’s Grievance Redress Service (GRS). The GRS ensures that complaints received are promptly reviewed to address project- related concerns. Project affected communities and individuals may submit their complaint to the Bank’s independent Accountability Mechanism (AM). The AM houses the Inspection Panel, which determines whether harm occurred, or could occur, as a result of Bank non-compliance with its policies and procedures, and the Dispute Resolution Service, which provides communities and borrowers with the opportunity to address complaints through dispute resolution. Page 11 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Complaints may be submitted to the AM at any time after concerns have been brought directly to the attention of Bank Management and after Management has been given an opportunity to respond. For information on how to submit complaints to the Bank’s Grievance Redress Service (GRS), visit http://www.worldbank.org/GRS. For information on how to submit complaints to the Bank’s Accountability Mechanism, visit https://accountability.worldbank.org. Page 12 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach(P181351) VIII. RESULTS FRAMEWORK AND MONITORING @#&OPS~Doctype~OPS^dynamics@padsgannexresultframework#doctemplate Project Development Objective Indicators Project Development Objective(s) To strengthen collaboration on and the capacity for pandemic prevention, preparedness, and response with One Health approaches in selected South Asian countries. Baseline Closing Period Enhanced BIMSTEC's capacity for effective coordination (Yes/No) Mar/2024 Dec/2026 no yes Plans or roadmaps developed and endorsed for the establishment of at least two regional pandemic PPR mechanisms by the BIMSTEC members. (Number) Mar/2024 Dec/2026 0 2 At least one regional pandemic PPR mechanism launched to facilitate collaboration and cooperation among BIMSTEC member states (Number) Mar/2024 Dec/2026 0 1 Intermediate Indicators Baseline Closing Period OH profile and OH investment plan developed in at least three countries (Number) Mar/2024 Dec/2026 0 3 Page 13 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach(P181351) Regional governance and coordination for enhanced health security among BIMSTEC members (Yes/No) Mar/2024 Dec/2026 no yes ➢at least one simulation or table top exercise held among the BIMSTEC members (Yes/No) Mar/2024 Dec/2026 0 1 ➢the BIMSTEC Public Health Expert Group (PHEG) is strengthened (Yes/No) Mar/2024 Dec/2026 No Yes BIMSTEC Secretariat's capacity for project management improved (Yes/No) Mar/2024 Dec/2025 no Yes ➢BIMSTEC Staff trained on WB project management, FM, PM and ESF. (Number) Mar/2024 Aug/2024 10 At least one regional center of excellence covering key health security core themes led by countries created, with standardized tools and enhanced capacity (Number) Mar/2024 Dec/2026 0 1 ➢a capacity building plan developed and implemented (Number) Mar/2024 May/2026 0 1 regional infectious disease early warning and surveillance observatory set up (Yes/No) Mar/2024 May/2026 no yes Page 14 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Monitoring & Evaluation Plan: PDO Indicators Enhanced BIMSTEC's capacity for effective project management and coordination (Date) the indicator will be measured from two dimensions: (i) project management capacity, in terms of project planning, Description implementation in a timely and professional manner; (ii) proper governance structure set up. Frequency Annual Data source Annual report and relevant documentation developed or collected by the project management office, BIMSTEC Methodology for Data Review of documents Collection Responsibility for Data The PMO and Public Health Expert Group, BIMSTEC Collection Plans or roadmaps developed and endorsed for the establishment of at least two regional pandemic PPR mechanisms by the BIMSTEC members (Number) plan/roadmap for the establishment of three out of four selected regional pandemic PPR mechanisms: (i) infectious Description disease early warning and surveillance; (ii) stockpile; (iii) surge capacity and/or (iv) PPR financing. Frequency Semiannual Data source Printed or E-version of Plans or roadmaps Methodology for Data Review of documents Collection Responsibility for Data FAO, with support from the PMO and Public Health Expert Group, BIMSTEC Collection At least one regional pandemic PPR mechanism launched to facilitate collaboration and cooperation among BIMSTEC member states (Number) One of the four following regional mechanisms for pandemic PPR will be functioning before the end of the project: (i) infectious disease early warning and surveillance; (ii) stockpile; (iii) surge capacity; and (iv) pandemic PPR financing. Description A funtioning mechanism is defined as having a hosting institute, developing and implementing annual work plans, and semiannual progress reporting Frequency Semiannual Data source Strategy or action plan developed, implementation progress report Methodology for Data Review of reports, field visit Collection Responsibility for Data FAO Collection At least one capacity building program conducted for the networks of regional centers of excellence to enhance knowledges and skills (Number) At least one RCoE will be identified and supported so that it is enabled to help capacity building for sister institutions in Description other member states within the SAR. Frequency Semiannual Data source Work plan, training report, implementation progress report Methodology for Data Review of reports, field visit Collection Responsibility for Data FAO Collection Monitoring & Evaluation Plan: Intermediate Results Indicators Not Categorized Page 15 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) OH profile report developed and TA provided to at least two BIMSTEC member states (Number) Out of seven BIMSTEC member states, the development of OH profile and technical assistance have been going on in Bangladesh, Bhutan and Sri Lanka. Description Under this project, at least three countries such as India, Nepal and another country will be supported to complete the country OH profile and investment plan. Frequency Semi-annual Data source Country specific report and investment plan; progress report Methodology for Data Review Collection Responsibility for Data FAO Collection Page 16 The World Bank SAR Capacity Building for Pandemic Prevention, Preparedness, and Response (PPR) with One Health approach (P181351) Annex 1: Comparison of regional entities Regional Entity Pros Cons SAARC • All eight members in SAR and include a • Ineffectiveness because of political number of influential observers tension • Wide ranges of sectors, including health • Slow progress in implementing regional • Has experiencing in establishing a number of projects regional institutions and mechanisms: South • Weak capacity for implementation Asian University and SAARC development • low level of autonomy at the Secretariate fund, SAARC-Japan Special Fund, SAARC Food General Bank, COVID-19 Emergency Fund BIMSTEC • Strong cooperation of countries across the • Slow progress in implementing regional region: five countries from SAR and two from projects/initiatives ASEAN; covering countries from two regions • Weak implementation capacity allows for cross regional learning • Limited resources/funding • Wide ranges of sectors; climate change and public health are newly added • Maintained a cooperative and inclusive approach (proved working relationship with non-member SAR countries such as Pakistan and Afghanistan) • Potential better chance for sustainability SAREC • Maintained a cooperative and inclusive • No Secretariat; more like a program than approach among participating member states sustainable institution • Limited number of countries: BBIN • Only sector covered is economic cooperation • Lack of country ownership • Limited resources/funding UN agencies • Good relationship with the ministries of • A UN system is not owed/championed by (WHO, FAO, health the region WOAH) • Inhouse technical expertise • Differences in regional coverage BBIN • No political obstacles for collaboration • Not a formal structure set up (e.g., • India supported vaccines during COVID-19 as charter), no HQ part of its overall vaccine diplomacy • Smaller regional coverage Page 17