The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Rwanda COVID-19 Emergency Response Project (P173855) EASTERN AND SOUTHERN AFRICA | Rwanda | IBRD/IDA | Investment Project Financing (IPF) | FY 2020 | Seq No: 9 | Archived on 26-Nov-2024 | ISR01333 Implementing Agencies: Ministry of Health (MoH) / Rwanda Biomedical Center (RBC) 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 06-Apr-2020) The objective of the Project is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda. Has the Development Objective been changed since Board Approval of the Project Objective? Yes Current Development Objective (Approved as part of Restructuring package Seq. 3 on 28-Jun-2024) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda, and provide immediate and effective response in the case of an eligible crisis or emergency 2. COMPONENTS Name Component 1. Case Detection, Confirmation and Contact Tracing:(Cost 6,840,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Nov 26, 2024 Page 1 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions The Project was initially designed with the overall objective of contributing to the prevention, detection and responding to the threat posed by COVID-19 and strengthening the national system for public health preparedness in the Republic of Rwanda. In January 2024, the “crisis and emergency” component was included. Consequently, the Project Development Objective (PDO) was amended as follows: (i) to prevent, detect, and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda; and (ii) provide immediate and effective response to an eligible crisis or emergency. The Project has been under implementation for 54 months (4.5 years) with steady progress towards achieving the PDO. With the support from different sources of financing (internal revenues, WB, and other development partners), Rwanda has performed over 6.1 million COVID-19 tests and reported over 133,208 cases with a cumulative positivity rate of 2.2 percent and an attack rate of over 1,000 per 100,000 population. With respect to vaccination, as of February 5, 2024, over 83 percent of the Rwandan population have received at least one dose of COVID-19 vaccine while 79.9 percent of the population (equivalent to 10.8 million people) are now fully vaccinated, and 79.7 percent of the population aged 18 years and above (6.04 million people) have received a booster dose. The government had set a target to reach a full vaccination coverage rate of 86 percent of the population by the end of December 2022 (including children aged 5 to 11 who represent about 17 percent of the population. To provide quick relief following the flood and landslide disasters of May 2023, US$9 million was availed to support (i) the rehabilitation of 1,322 partially damaged houses; (ii) the construction of 463 houses completely destroyed, and (iii) the establishment of 14 emergency evacuation sites (EESs) in 14 districts. As of September 20, 2024, the rehabilitation of the partially damaged houses was progressing. The government is committed to finalizing all the activities by the closure date (June 30, 2024) 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 progress continues to be made under the SPRP Program, including under the MPA. While disbursements were being affected over two months ago under the MPA by, inter alia, low disbursements in seven countries, implementation accelerated in five of them and undisbursed funds in another (Nigeria) were cancelled prior to closing. Only one country, Bangladesh, remains low at 59% disbursements. Since the Bangladesh operation is closing on December 31, 2024, a substantive amount of undisbursed balance is likely to be cancelled. Nov 26, 2024 Page 2 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) In addition, disbursements are being 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. Disbursements have also been affected by the pausing of disbursements in Afghanistan and Myanmar. In terms of Afghanistan, the AF operation of $60m closed on March 31, 2024 with $56.26 million undisbursed, while the parent project of $100.4 million will close on June 30, 2025. The original commitment of the AF was $113 million and was reduced to $60 million following a cancellation of $53 million. In terms of Myanmar, which closed in August 2023, there is an undisbursed balance which is in the process of being canceled. Delay in the cancellation has been a result of an exchange rate loss issue which has now been resolved. As of October 15, 2024, 88 MPA-projects were approved with a total commitment of US$4.16 billion (the overall commitment has been reduced from $4.25 to $4.16 in the past months due to partial cancellations processed prior/at project closing). One operation (Guatemala) was cancelled in mid-September 2021. Total disbursements as of October 15, 2024, amount to US$4.02 billion or 96% 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 grants as commitments do not include PEF Grants. Closing dates for MPA operations have been as follows: (i) ten operations closed by the end of CY22; (ii) nine operations closed on June 30, 2023; (iii) thirteen operations closed on December 31, 2023; (iv) twelve operations closed by April 2024, and (v) fourteen operations closed on June 30, 2024. Twenty operations are scheduled to close by the end of CY24. However, this number is likely to change as some extensions are being processed. There are at the moment 24 operations with closing dates -- June-December 2025. 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 and a Borrower’s Evaluation – Annex 2, which is optional. So far, thirty-eight (38) final ISR packages have been prepared; 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.“ As of October 15, 2024, sixty-four (64) operations or 74% of projects approved are fully disbursed, four have reached 98- 99%, and nine have reached 92-97%. Overall disbursements under the MPA are $4,017 million or 96% of commitments. All MPA projects in AFW, ECA, and MNA are fully disbursed. Disbursements for the other four regions are: (i) LAC 98%, (ii) SAR 95%, (iii) EAP 89%, and (iv) AFE 85%. Disbursements in EAP are being affected by relatively low disbursements in one country while in AFE, disbursements are being affected by relatively low disbursements in two countries. Nov 26, 2024 Page 3 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) 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 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 are supporting vaccine procurement and deployment efforts. Considerable efforts continue to be made to accelerate the implementation of AF operations and the SPRP Program in general. The past month has seen an acceleration of implementation of AF-V operations. Total disbursements as of October 15, 2024, amount to US$6.98 billion or 84 percent of overall commitments ($8.32 billion). EAP has the highest percentage of disbursements at 97%, followed by LAC at 95%, ECA at 94%, MNA at 90%, SAR at 83%, AFW at 78%, and AFE at 73%. AFW disbursements are likely to increase considerably by the end of the CY as disbursements under the Niger operation should become fully disbursed with the procurement of equipment expected to be delivered and installed in the selected facilities by the closing date of December 31, 2024. As of October 15, 2024, there are 114 Bank-financed operations (including MPA-V operations) to support vaccine procurement and rollout in 78 countries amounting to $8.32 billion. 121 operations had been approved amounting to $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 have been cancelled. The Afghanistan operation commitment of $113 million was reduced to $60 million. Several 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 causing overall commitments to reduce. 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. Cancellations/partial cancellations have been processed under thirty-one (31) operations -- Afghanistan, Bangladesh, Belarus, Benin, Bhutan, Cabo Verde, Cameroon, Central Africa Republic, Comoros, Côte d'Ivoire AF2, Ethiopia, Gabon, Georgia, Guinea, Guinea Bissau, Jordan, Lao, Lebanon, Madagascar, Mali, Mozambique, Nepal, Nigeria, Pakistan, Philippines, PNG, Sierra Leone, South Africa, Sudan, ROC AF2, and Togo. Nov 26, 2024 Page 4 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Thirty-two (32) operations are being implemented in Fragile and Conflict-affected situations. IDA represents 45 percent and IBRD 55 percent of disbursements. With less than planned demand for IDA/IBRD funds for vaccine procurement because, inter alia, over supply of vaccines from donations from various sources, several projects have been/are being restructured to reallocate funds or partially cancel funds originally allocated to procurement and deployment of COVID- 19 vaccines. 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 of the country projects, the procurement of Routine Immunization given that the program for immunization in many countries has suffered as funds and human resources have been directed to finance the pandemic. Seventeen (17) operations are fully disbursed (Argentina, Cambodia, El Salvador AF1 and AF2, Honduras, Indonesia, Iraq, Jordan, Mauritania, Nigeria, ROC F1 and AF2, Sri Lanka AF-V 1, Tunisia, Ukraine AF-V 3, West Bank and Gaza, and Zimbabwe). Thirty-four (34) operations have disbursed 90%+ and seventeen (17) operations have disbursed 80%+. One hundred and twelve (112) operations or 98 percent of total operations approved are disbursing. Operations that have not yet initiated disbursements include: (i) Niger AF2, and (v) Senegal AF2. Retroactive Financing (RF) continues to represent 34 percent of overall commitments. ECA has the highest level of RF at 71 percent, followed by SAR at 68 percent, LAC at 51 percent, AFE and MNA at 28 percent, and AFW at 11 percent. Disbursements to UN agencies continue to represent 24 percent of overall disbursements, while Direct Payment represents 17 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 - 26 Mar Proposed Rating 07 Apr 2020 2024 Political and Governance Low Low Low 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 Substantial Moderate Moderate Sustainability Nov 26, 2024 Page 5 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Fiduciary Substantial Moderate Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Overall Substantial Moderate Moderate Nov 26, 2024 Page 6 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Proportion of suspected cases 80.00 Apr/2020 100.00 15-Feb-2024 100.00 16-Sep-2024 100.00 Jun/2025 of COVID-19 reported and Comments on Indicator fully achieved investigated based on achieving targets national guidelines (Percentage) 1.00 Apr/2020 156.00 31-Mar-2023 156.00 16-Sep-2024 151.00 Jun/2025 Number of designated Comments on The end target for this indicator was revised in accordance with the current testing strategy. At laboratories with COVID-19 achieving targets the start, COVID-19 test was done at the National Reference Laboratory (NRL) using PCR. diagnostic capacity Overtime, with the availability of Rapid tests, all public hospitals (8 referral hospitals, 8 (Number) provincial hospitals and 39 district hospitals) and 100 private health facilities countrywide were engaged to provide rapid tests. Proportion of designated 20.00 Apr/2020 100.00 15-Feb-2024 100.00 16-Sep-2024 100.00 Jun/2025 healthcare facilities with Comments on All 56 public hospitals have isolation capacity for at least 2 cases. Health centers and private isolation capacity achieving targets health facilities does not have isolation capacity, however they may avail a holding room (Percentage) where they may keep an identified COVID-19 case before the referral. COVID-19 Vaccine Coverage Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Page 7 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Percentage of population 18 0.00 Feb/2022 79.70 15-Feb-2024 79.70 15-Feb-2024 56.00 Jun/2025 years and above receiving a Comments on As of 15th February 2024, 79.7% of the population aged 18 years and above have been booster, which is included in achieving targets reached with a booster dose the population targets defined in the national plan, disaggregated by sex (Percentage) Percentage of the population 0.00 Feb/2021 79.90 15-Feb-2024 79.90 15-Feb-2024 80.00 Jun/2025 fully vaccinated which is Comments on The vaccination coverage rate is calculated against the total population of the country included in the priority achieving targets (estimated at over 13 million in 2021. As of February 2024, 79.9% of the population population targets as defined (equivalent to 10.8 million people) have received at least two doses in the national plan disaggregated by sex, age group and location. (Percentage) 0.00 Jan/2021 3,601,440.00 31-Mar-2023 3,601,440.00 31-Mar-2023 3,600,000.00 Jun/2025 Comments on A total of 3.6 million doses were procured with World Bank funding and they were fully Number of doses of COVID-19 achieving targets delivered and deployed. Given that the country received from multiple sources enough does vaccine procured with Project to rearch the national target, no more vaccines will be procured with World Bank funding. The funding (Number) balance from the vaccine procurement sub-component has been allocated to CERC. Therefore, this indicator is marked as completed. 6.2 Intermediate Results Indicators by Components Component 1. Case Detection, Confirmation and Contact Tracing Indicator Name Baseline Actual (Previous) Actual (Current) Closing Period Page 8 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Value Month/Year Value Date Value Date Value Month/Year Number of laboratory staff 0.00 Apr/2020 192.00 31-Mar-2023 192.00 16-Sep-2024 50.00 Jun/2023 trained to conduct COVID-19 Comments on Achieved and completed in June 2023 diagnosis (Number) achieving targets 0.00 Oct/2020 100.00 15-Feb-2024 100.00 16-Sep-2024 100.00 Jun/2025 Comments on The Grievance Redress Mechanism (GRM) was established, and the committees were set up to Percentage of grievances achieving targets resolve the beneficiary issues across the country. The GRCs have resolved 10 grievances which documented, processed and 7 were solely about awareness raising to explain and remove confusion on the vaccines and resolved within 30 days the remaining 3 were concerns about not having enough food to eat since COVID-19 put down (Percentage) a lot of their livelihood businesses. The GRCs will continue resolving issues that may arise under the CERC component, and these will be documented and reported. Total tests performed by the 0.00 Oct/2020 3,634,311.00 31-Mar-2023 3,634,311.00 16-Sep-2024 0.00 Jun/2025 Government facilities, Comments on 1,877,632 males and 1,756,679 females performed by the public health facilities out of the disaggregated by sex achieving targets 5,430,216 tests performed as of September 2022 (Number) Time response to COVID-19 Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Proportion of targeted 20.00 Apr/2020 100.00 15-Feb-2024 100.00 16-Sep-2024 100.00 Jun/2023 healthcare facilities with Comments on All 55 public hospitals (8 referral hospitals, 8 provincial hospitals and 39 district hospitals) have clinical capacity for COVID-19 achieving targets established at least 2 rooms each for the management of COVID-19 cases patients (Percentage) Number of health staff 20.00 Apr/2020 3,554.00 31-Mar-2023 3,554.00 16-Sep-2024 2,000.00 Jun/2023 trained in infection prevention and control (Number) COVID-19 Vaccine Knowledge, Acceptance, and Safety Indicator Name Baseline Actual (Previous) Actual (Current) Closing Period Page 9 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Value Month/Year Value Date Value Date Value Month/Year Number of mass media 0.00 Feb/2021 96.00 31-Mar-2023 96.00 16-Sep-2024 90.00 Jun/2023 campaigns on COVID-19 prevention and vaccination (Number) Proportion of serious Adverse 0.00 Feb/2021 78.00 31-Mar-2023 78.00 16-Sep-2024 95.00 Jun/2025 events following Comments on According to table 6 of the AM, there were 641 AEFI cases reported, including 74 cases immunization (AEFI) reported achieving targets reported as severe, 23 moderate cases, and 409 minor cases. RBC has reported that 58 out of and investigated, by sex the 74 severe cases have been investigated (Percentage) Health System Strengthening Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of people screened 0.00 Mar/2021 2,164,274.00 15-Feb-2024 3,012,311 16-Sep-2024 300,000.00 Jun/2025 for underlying chronic Comments on During FY23/24, 3,012,311 out of 3,741,561 eligible people (35 years above) were screened conditions, disaggregated sex achieving targets during NCDs annual checkup. The screening rate is at 80.75% and age group (Number) Percentage of targeted 0.00 Mar/2021 100.00 15-Feb-2024 100.00 16-Sep-2024 100.00 Jun/2023 hospitals with functioning Comments on All 56 public hospitals have functioning oxygen therapy systems in place oxygen therapy system achieving targets (Percentage) Maintaining Essential Health Services during and beyond COVID-19 Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of outpatient 18,860,619.00 Mar/2021 11,185,624.00 31-Dec-2023 20,551,614 16-Sep-2024 19,622,500.00 Jun/2025 consultations, disaggregated Comments on Including 18,227,333 new OPDs and 2,324,281 old OPDs, representing a Per Capita Utilization by age and sex (Number) achieving targets rate of 1.51 (Total pop. 13,647,218) Number of new acceptors of 238,392.00 Mar/2021 170,646.00 31-Dec-2023 303,695 11-Nov-2024 248,023.00 Jun/2023 Page 10 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) modern contraception Comments on The modern contraceptive prevalence rate (mCPR) was 56% at the end of FY23/24 (according (Number) achieving targets the draft MoH report) Number of deliveries 315,814.00 Mar/2021 192,086.00 31-Dec-2023 336,897 16-Sep-2024 328,573.00 Jun/2023 conducted within the facility Comments on According to the draft FY23/24 MoH report, 99.1% of births were attended by skilled health (Number) achieving targets professionals. Number of pregnant women 0.00 Mar/2021 104,071.00 31-Dec-2023 177,035 16-Sep-2024 190,280.00 Jun/2023 receiving four antenatal care Comments on 47.1%, according to the draft FY23/24 MoH report visits (Number) achieving targets Number of infants receiving 345,423.00 Mar/2021 197,237.00 31-Dec-2023 330,013 16-Sep-2024 352,330.00 Jun/2023 Pentavalent 3 vaccine Comments on According to the draft FY23/24 MoH report, 88.7% of expected infants received Penta3 (Number) achieving targets vaccine Page 11 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed Historical Disbursed IDA-E0220 Effective 16.00 15.34 0.00 13.29 1.95 87.20% 16.00 TF-B4324 Closed 0.94 0.93 0.00 0.93 0.00 100.00 0.94 % TF-B6226 Effective 15.00 15.00 0.00 13.18 1.82 87.87% 15.00 IDA-66150 Closed 14.25 14.12 0.00 14.67 0.37 97.52% 14.25 IDA-70920 Effective 16.00 15.42 0.00 11.57 3.71 75.74% 16.00 Nov 26, 2024 Page 12 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) IDA-D8050 Effective 15.00 13.94 0.00 14.95 0.00 99.97% 15.00 IDA-68710 Effective 15.00 13.94 0.00 14.88 0.00 99.95% 15.00 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-66150 Closed 07-Apr-2020 09-Apr-2020 20-Apr-2020 30-Jun-2022 30-Jun-2022 IDA-68710 Effective 16-Apr-2021 22-Apr-2021 21-Jun-2021 30-Jun-2023 30-Jun-2025 IDA-70920 Effective 31-Mar-2022 07-Apr-2022 06-Jun-2022 30-Jun-2025 30-Jun-2025 IDA-D8050 Effective 16-Apr-2021 22-Apr-2021 21-Jun-2021 30-Jun-2023 30-Jun-2025 IDA-E0220 Effective 31-Mar-2022 07-Apr-2022 06-Jun-2022 30-Jun-2025 30-Jun-2025 TF-B4324 Closed 30-Nov-2020 06-Dec-2020 06-Dec-2020 31-Jan-2021 28-Feb-2021 TF-B6226 Effective 02-Sep-2021 02-Sep-2021 02-Sep-2021 30-Jun-2023 30-Jun-2025 8. KEY DATES Key Events Planned Actual Approval 15-Apr-2020 07-Apr-2020 Effectiveness 20-Apr-2020 20-Apr-2020 Mid-Term Review No. 01 30-Sep-2022 31-May-2022 Operation Closing/Cancellation 30-Jun-2025 9. RESTRUCTURING HISTORY Restructuring Level 2 Approved on 02-Jun-2021 Restructuring Level 2 Approved on 28-Jan-2021 Restructuring Level 2 Approved on 25-Jun-2024 10. ASSOCIATED OPERATION(S) Nov 26, 2024 Page 13 of 14 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) There are no associated operations Nov 26, 2024 Page 14 of 14