The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) Serbia Emergency COVID-19 Response Project (P173892) EUROPE AND CENTRAL ASIA | Serbia | IBRD/IDA | Investment Project Financing (IPF) | FY 2020 | Seq No: 8 | Archived on 17- Jun-2024 | ISR00790 Implementing Agencies: Ministry of Health 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 25-May-2020) The Project Development Objective is to respond to the threat posed by COVID-19 and to strengthen the national health system for public health preparedness in Serbia. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Component 1: Emergency COVID-19 Response:(Cost 98,030,000.00) Component 2: Implementation Management and Monitoring and Evaluation:(Cost 1,970,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions Jun 17, 2024 Page 1 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) The progress in project implementation and the likelihood of achieving the project's development objectives are upgraded to Satisfactory. Of the five key results towards achieving the development objectives, four have achieved end- of-project target values (Number of acute health care facilities with isolation capacity – current value: 50, target: 36; Personal and community nonpharmaceutical interventions adopted by the Government of Serbia – current value: Yes, target: Yes; Percentage of PHC centers with improved capacity for providing emergency medical care – current value: 65, target: 50; and Number of designated laboratories with COVID-19 diagnostic equipment, test kits and reagents – current value 6, target: 5). The remaining result (laboratory capacity strengthening related to dealing with pathogens requiring Bio Safety Level 3 (BSL3)) is on track to be achieved by the Project closing date of June 30, 2025. Out of 11 intermediate results, end-of-project target values have been achieved for nine while the remaining two (platform for citizen engagement and establishing a BSL3 laboratory) are on track to be achieved by the Project closing date. Construction works on the new diagnostic building with BSL3 laboratory at the Institute of Virology, Vaccines and Sera "Torlak" are initiated and progressing on schedule. All other related project activities, including procurement of laboratory equipment, are on schedule to be completed by the Project closing date. 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) Sustained efforts continue to be made to advance the implementation of the 87 MPA operations. The overall level of disbursements is being affected by three main reasons: (i) low disbursements in six countries (Bangladesh, Kiribati, Nigeria, Solomon Islands, Trinidad and Tobago, and Zambia); (ii) pausing of disbursements in two countries – Afghanistan, and Myanmar; and (iii) processing of refunds to the project accounts, which in the past months has increased at this late stage of project implementation. Other reasons that are influencing disbursements, include: (i) large refunds have been processed to project accounts of two country projects -- Myanmar from the UN in March 2023 due to the inability to implement the project, and Trinidad and Tobago because of savings realized for medical supplies and medicines procured through PAHO; (ii) the amounts of Loans and Credits denominated in SDRs, and Euros have been affected because of fluctuations between the SDRs and Euros against the US dollar; and (iii) during the past three months, refunds have been processed under the Pakistan and Sri Lanka operations upon closing. As of May 14, 2024, 88 MPA-projects have been approved with a total commitment of US$4.22 billion (the overall commitment has been reduced from $4.25 to $4.22 in the past weeks due to partial cancellations processing prior/at project closing). One operation (Guatemala) was cancelled in mid-September 2021. Total disbursements as of May 14, 2024, amount to US$3.98 billion or 94% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations or disbursements under PEF grans as commitments do not include PEF Grants. Closing dates for MPA operations have been as follows: (i) ten operations Jun 17, 2024 Page 2 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) closed by the end of CY22, (ii) nine operations closed on June 30, 2023, and (iii) thirteen operations closed on December 31, 2023. Twenty-four operations are scheduled to close by June 30, 2024 (27 last month). As with the Mid Term Review (MTR) issued on March 25, 2023, no individual ICR will be required for COVID-19 MPA operations. Only one 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 and a Borrower’s Evaluation – Annex 2, which is optional. So far, twenty-five operations have finalized final ISR packages, and some others are under preparation. The overall conclusion of the MPA MTR was that: (i) the COVID-19 MPA Program embodied a rapid, innovative approach to new lending for human health response; (ii) the COVID-19 MPA has been successful, notwithstanding considerable uncertainty and multiple constraints in the early stages of the pandemic; (iii) the Bank’s emergency response was remarkably swift in the most vulnerable countries facing human capital losses and development setbacks; and (iv) notwithstanding the challenges, the MPA is on track to achieve its PrDO, “prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.“ Seventy-five (75) country projects or 86 percent of projects approved have reached 70-100+ percent disbursement (reasons for >100 percent disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 75 operations, 66 operations or 87 percent have disbursed 90 percent+ of commitments. Out of the 75 operations, 52 operations or 69 percent are fully disbursed, and 8 operations have disbursed 95-99 percent of commitments. There are six operations with less than 70 percent of commitments disbursed (1 in AFE, 1 in AFW, 2 in EAP, 1 in LAC, and 1 in SRA). The operation in AFW has disbursed only 47 percent, despite having been recently restructured. The projects are benefitting about 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting about 4.1 billion of 51 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. Operations in ECA and MNA are fully disbursed. In other regions, disbursements have reached: (i) LAC and SAR 95 percent, (ii) AFW 90 percent, (iii) EAP 88 percent, and (iii) AFE 83 percent. Retroactive Financing (RF) continues to represent 20 percent of commitments. SAR has the highest percentage of RF at 38 percent, followed by ECA at 18 percent. Direct Payment (DP) disbursements represent 22 percent of commitments. EAP has the highest level of disbursements using DP – 80 percent, followed by AFW at 38 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. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 07 - 27 Nov Proposed Rating 26 May 2020 2023 Political and Governance Moderate Moderate Moderate Jun 17, 2024 Page 3 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) Macroeconomic Substantial Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Moderate Moderate Moderate Sustainability Fiduciary Substantial Substantial Moderate Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Overall Substantial Substantial Substantial Jun 17, 2024 Page 4 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes To respond to the threat posed by COVID-19 in Serbia Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of acute health care 6.00 Jan/2020 50.00 13-Nov-2023 36.00 Apr/2022 facilities with isolation capacity (Number) Personal and community No Jan/2020 Yes 13-Nov-2023 Yes Apr/2022 non-pharmaceutical interventions adopted by the GOS (Yes/No) National laboratory capacity No Jul/2022 No 13-Nov-2023 Yes Aug/2023 strengthened for Comments on Construction of the BSL3 laboratory is underway and on track for completion by the current surveillance, detection and achieving targets Project closing date. research related to pathogens requiring Bio Safety Level 3, such as West Nile virus, SARS-CoV-2 and MERS-CoV (Yes/No) Percentage of PHC centers 0.00 Jul/2022 65.00 13-Nov-2023 50.00 Aug/2023 with improved capacity for providing emergency medical care (Percentage) To strengthen the national health system for public health preparedness in Serbia Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Jun 17, 2024 Page 5 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) Number of designated 0.00 Jan/2020 6.00 07-Jun-2024 6.00 07-Jun-2024 5.00 Apr/2022 laboratories with COVID-19 diagnostic equipment, test kits, and reagents (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 Proportion of health staff 0.00 Jan/2020 90.00 13-Nov-2023 70.00 Apr/2022 trained in infection prevention and control per MOH-approved protocols (Percentage) Number of designated 0.00 Jan/2020 6.00 13-Nov-2023 5.00 Apr/2022 laboratories with staff trained to conduct SARS-CoV- 2 diagnosis (Number) Coordinated disease No Jan/2020 Yes 07-Jun-2024 Yes 07-Jun-2024 Yes Apr/2022 surveillance systems in place in the public health sector for COVID-19 laboratories (Yes/No) Physical distancing 0.00 Jan/2020 12.00 07-Jun-2024 12.00 07-Jun-2024 10.00 Apr/2022 communication messages targeting vulnerable populations (Number) Jun 17, 2024 Page 6 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) Number of CT scanners with 7.00 Jan/2020 16.00 07-Jun-2024 16.00 07-Jun-2024 13.00 Apr/2022 average age <10 years per 1 million population (Number) Percentage of Primary Health 0.00 Jan/2020 39.00 07-Jun-2024 39.00 07-Jun-2024 30.00 Apr/2022 Care Facilities with newly installed X-ray machines (Percentage) Number of laboratory(ies) 0.00 Apr/2021 0.00 13-Nov-2023 1.00 May/2022 upgraded to biosafety level 3 Comments on Construction of the BSL3 laboratory is underway and on track for completion by the current (BSL-3) (Number) achieving targets Project closing date. Number of health care 0.00 May/2021 46.00 07-Jun-2024 46.00 07-Jun-2024 45.00 May/2022 facilities with ICUs equipped with new beds supported by the Project (Number) Component 2: Implementation Management and Monitoring and Evaluation Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of health facilities 0.00 Jan/2020 0.00 07-Jun-2024 0.00 07-Jun-2024 70.00 Apr/2022 (a) establishing a digital Comments on A platform has been developed as an integral part of the MoH's eHealth portal. The platform feedback platform, (b) achieving targets has the ability to obtain feedback from communities on every PHC facility, as well as a built utilizing it to actively obtain in function to facilitate feedback loop from the facilities. However, the MoH planned to feedback from communities, overhaul the entire eHealth portal with the CE platform is on hold. The PCU is following up and (c) providing feedback closely with the MoH and is discussing options for getting the platform functional as soon as from Govt. on actions taken possible. (Percentage) Percentage of grievances 0.00 Apr/2021 100.00 13-Nov-2023 90.00 May/2022 successfully addressed (Percentage) Jun 17, 2024 Page 7 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) Percentage of vulnerable 0.00 Apr/2021 100.00 07-Jun-2024 100.00 07-Jun-2024 70.00 May/2022 population/beneficiaries of government free meal program receiving COVID-19 hygiene kits (Percentage) Jun 17, 2024 Page 8 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IBRD-91200 Effective 100.00 100.00 0.00 87.23 10.58 87.23% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IBRD-91200 Effective 26-May-2020 29-May-2020 10-Dec-2020 31-May-2022 30-Jun-2025 8. KEY DATES Jun 17, 2024 Page 9 of 10 The World Bank Implementation Status & Results Report Serbia Emergency COVID-19 Response Project (P173892) Key Events Planned Actual Approval 27-May-2020 26-May-2020 Effectiveness 10-Dec-2020 10-Dec-2020 Mid-Term Review No. 01 17-May-2022 14-Mar-2022 Operation Closing/Cancellation 30-Jun-2025 9. RESTRUCTURING HISTORY Restructuring Level 2 Approved on 20-Sept-2022 Restructuring Level 2 Approved on 31-Jan-2022 Restructuring Level 2 Approved on 03-Jun-2021 Restructuring Level 2 Approved on 02-Jun-2023 10. ASSOCIATED OPERATION(S) There are no associated operations Jun 17, 2024 Page 10 of 10