The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) STP COVID-19 Emergency Response Project (P173783) EASTERN AND SOUTHERN AFRICA | Sao Tome and Principe | IBRD/IDA | Investment Project Financing (IPF) | FY 2020 | Seq No: 10 | Archived on 23-Dec-2024 | ISR02946 Implementing Agencies: Ministry of Health 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 02-Apr-2020) The Project Development Objective (PDO) is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in São Tomé e Príncipe. Has the Development Objective been changed since Board Approval of the Project Objective? Yes Current Development Objective (Approved as part of Additional Financing package Seq. 4 on 31-Aug-2023) to prevent, detect and respond to the threat posed by COVID-19, strengthen national systems for public health preparedness in the Recipient’s territory, and in case of an Eligible Crisis or Emergency, respond promptly and effectively to it. 2. COMPONENTS Name Component 1. Emergency COVID-19 Response:(Cost 10,390,000.00) Component 2. Strengthening Multi-sector, National institutions and platforms for policy development, and coordination of prevention and preparedness including One Health approach:(Cost 800,000.00) Component 3. Implementation Management and Monitoring and Evaluation:(Cost 1,100,000.00) Component 4. Contingent Emergency Response Component (CERC):(Cost 450,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Dec 23, 2024 Page 1 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions The Project implementation progress is satisfactory and most indicators will achieve the end-targets. The project supported the response to COVID19 emergency and the capacity of the country to respond to public health threats and emergency through the rehabilitation and equipment of the Public Health Emergency Operating Center (PHEOC). The PHEOC was recently inaugurated and is full functional. 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) Considerable efforts continue to be made to accelerate the implementation of AF operations and the SPRP Program in general. As in the previous month, acceleration of implementation of AF-V operations has continued. Total disbursements as of November 16, 2024, amount to US$7.07 billion or 85 percent of overall commitments ($8.32billion). EAP has the highest percentage of disbursements at 97%, followed by LAC at 95%, ECA at 94%, MNA at 90%, SAR at 85%, AFW at 79%, and AFE at 74%. In the case of AFE, disbursements are likely to accelerate in the coming weeks with civil works contracts being implemented under the Uganda operation, which closes on December 31, 2024. 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 November 16, 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 were cancelled. The Afghanistan operation commitment of $113 million was reduced to $60 million. Many operations have processed partial cancellations, thereby decreasing the overall commitments in the past months. Also, when operations close, undisbursed funds are returned to the Bank and small adjustments causing overall commitments to reduce. In the past Dec 23, 2024 Page 2 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) several months, partial cancellations amounting to $1,108 million have been processed under 31 operations. Out of the $1,108 million cancelled, $708 million were from IDA and $400 million from IBRD. Partial cancellations have been mainly a result of evolving needs in countries given the stage of the pandemic and donations of vaccines, which have reduced the need for IBRD/IDA funds for their purchase. Guidance was issued on July 7, 2023, under an Email from the Global HNP Director, which provided direction for the use of undisbursed funds under COVID-19 operations. Thanks to this guidance, the restructurings have allowed in some cases adding as an activity under Component 1, the procurement of Routine Immunization given that the program for immunization in most countries has suffered as funds and human resources have been directed to finance the pandemic. Of the 114 approved operations: (i) 65 are in Africa – 32 in AFE and 33 in AFW; (ii) 10 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 8 in Middle East and North Africa; and (vi) 9 in South Asia. The 114 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Thirty-two (32) operations are being implemented in Fragile and conflict-affected situations. IDA represents 45 percent and IBRD 55 percent of disbursements. 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-eight (38) operations have disbursed 90%+ and seventeen (17) operations have disbursed 80%+. One hundred and thirteen (113) operations or 99 percent of total operations approved are disbursing. The only operation that has not yet initiated disbursements is Senegal AF2, but this is expected to change in the coming weeks. 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. 09 - 18 Jun Proposed Rating 02 Apr 2020 2024 Political and Governance Substantial Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Substantial Substantial Substantial Dec 23, 2024 Page 3 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Substantial Substantial Substantial Overall Substantial Substantial Substantial Dec 23, 2024 Page 4 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Emergency COVID-19 Response Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of population 0.00 Feb/2021 90.00 30-May-2024 90.00 30-May-2024 90.00 Jun/2025 vaccinated, which is included in the priority population targets defined in national plan [disaggregated by sex] (Percentage) Country has activated their No Mar/2020 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 public health Emergency Operations Center or a coordination mechanism for COVID-19 (Text) Percentage of suspected 0.00 Mar/2020 100.00 30-May-2024 100.00 30-May-2024 90.00 Jun/2025 cases of COVID-19 cases that were investigated, laboratory confirmed and reported based on national guidelines; (Percentage) Health System Strengthening Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Page 5 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Percentage of acute 0.00 Mar/2020 100.00 30-May-2024 100.00 30-May-2024 60.00 Jun/2025 healthcare facilities with isolation capacity (Percentage) Country adopted personal 0.00 Mar/2020 100.00 30-May-2024 100.00 30-May-2024 85.00 Jun/2025 and community non- pharmaceutical interventions (school closures, telework and remote meetings, reduce/cancel mass gatherings) (Percentage) 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 M&E system established to No Mar/2020 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 monitor COVID-19 preparedness and response plan (Text) Contingent Emergency Response Component (CERC) Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of suspected 0.00 Jul/2023 70.00 27-Nov-2023 70.00 27-Nov-2023 70.00 Jun/2025 cases of dengue that were investigated, laboratory confirmed, and reported, based on National Guidelines (Percentage) Page 6 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) 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 Number of health staff 0.00 Mar/2020 1,345.00 30-May-2024 1,345.00 30-May-2024 1,345.00 Jun/2025 trained in infection prevention and control per MOH-approved protocols (disaggregated by sex) (Number) No Mar/2020 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 Country has prepared a referral system to care for Comments on Referral system to care for COVID-19 patients in place and patients being referred per protocol. COVID-19 patients (Text) achieving targets 0.00 Mar/2020 9.00 30-May-2024 9.00 30-May-2024 3.00 Jun/2025 Number of designated Comments on The final target (3) was achieved and exceeded, which is explained by the fact that from now on laboratories with staff trained achieving targets all 7 Health Centers as well as the 2 reference Laboratories are carrying out rapid tests to screen to conduct COVID-19 for COVID-19. This is an updated protocol that consolidated the training of all laboratory diagnosis (Number) technicians at national level. Percentage of eligible 0.00 Mar/2020 100.00 30-May-2024 100.00 30-May-2024 80.00 Jun/2025 households provided with Comments on The country only implemented institutional quarantine and 100% of the individuals under food and basic supplies within achieving targets quarantine received support. quarantined populations (Percentage) Number of 0.00 Mar/2020 23.00 30-May-2024 23.00 30-May-2024 20.00 Jun/2025 Page 7 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) refurbished/upgraded health Comments on All Health Facilities are channeling complaints and satisfaction forms through the GRM as such facilities implementing achieving targets this indicator has been updated to reflect that. customer satisfaction survey (Number) Community Health workers 0.00 Aug/2020 110.00 30-May-2024 110.00 30-May-2024 110.00 Jun/2025 trained in event based Comments on 110 community health agents trained: 44 (40%) female and 66 (60%) male. surveillance for COVID-19 and achieving targets other epidemic-prone diseases (disaggregated by sex) (Number) Laboratory technicians 0.00 Aug/2020 18.00 30-May-2024 18.00 30-May-2024 10.00 Jun/2025 trained on COVID19 diagnosis as well as in 5 key priority diseases as per the IHR (2005) (disaggregated by sex) (Number) Percentage of PHC facilities 0.00 Aug/2020 100.00 30-May-2024 100.00 30-May-2024 100.00 Jun/2025 implementing exit surveys in a one-year period, present to MOH, and implement action plan to address issues as part of Project Operational Plan (Percentage) A National Deployment and No Feb/2021 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 Vaccination Plan (NDVP) implemented with input from relevant bodies (Text) (Text) Vaccine stock management No Feb/2021 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 tools and operating procedures updated to reflect the characteristics of COVID- Page 8 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) 19 vaccines. (Text) Effective Vaccine No Feb/2021 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 Management assessments implemented with composite scores of 80% or higher (Text) (Text) Community engagement plan No Feb/2021 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 implemented for increasing demand creation for the Covid-19 vaccine by the population (Text) Pharmacovigilance System No Feb/2021 Yes 30-May-2024 Yes 30-May-2024 Yes Jun/2025 (PVS) adapted to detect Adverse Events Following Vaccination (AEFI) for the COVID-19 vaccine (Text) Number of eligible health 0.00 Jul/2023 0.00 30-May-2024 0.00 30-May-2024 10.00 Jun/2025 facilities with improved operational cooling and refrigeration equipment financed by the Project (Number) Solar capacity installed at 0.00 Jul/2023 0.00 30-May-2024 0.00 30-May-2024 0.06 Jun/2025 health facilities supported by the project (Megawatt) Component 2. Strengthening Multi-sector, National institutions and platforms for policy development, and coordination of prevention and preparedness including One Health approach Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year At least one multi- sectoral 0.00 Mar/2020 3.00 30-May-2024 3.00 30-May-2024 2.00 Jun/2025 Page 9 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) simulation exercise conducted by the EOC with results incorporated into national COVID-19 preparedness and response plans (Number) At least two meetings per 0.00 Mar/2020 4.00 30-May-2024 4.00 30-May-2024 4.00 Jun/2025 year of an intersectoral committee on One Health (MoH, Ministry of Agriculture, Ministry of Environment) to ensure strengthened surveillance in the human- health-environment (Number) Component 3. 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 0.00 Mar/2020 100.00 30-May-2024 100.00 30-May-2024 70.00 Jun/2025 Comments on Percentage of monthly and achieving targets quarterly project M&E reports submitted on time (Percentage) Number of annual progress 0.00 Mar/2020 3.00 30-May-2024 3.00 30-May-2024 2.00 Jun/2025 reports submitted complete and on time (Number) Component 4. Contingent Emergency Response Component (CERC) Indicator Name Baseline Actual (Previous) Actual (Current) Closing Period Page 10 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) Value Month/Year Value Date Value Date Value Month/Year No Jul/2023 No 30-May-2024 No 30-May-2024 Yes Jun/2025 Laboratory Capacity to Comments on During implementation, the team encountered challenges in managing the samples, which identify dengue serotypes achieving targets made this activity difficult to carry out. Thankfully, dengue was controlled, and this activity was (Yes/No) no longer necessary. Campaign to sensitize the 0.00 Jul/2023 7.00 30-May-2024 7.00 30-May-2024 7.00 Jun/2025 public to adopt behaviors for the control of dengue and other vector transmitted diseases (Number) Page 11 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) 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 TF-B5690 Effective 3.50 3.50 0.00 3.48 0.00 99.53% 3.50 IDA-D8130 Effective 3.00 2.90 0.00 2.35 0.68 77.50% 3.00 IDA-D6060 Effective 2.50 2.52 0.00 2.66 0.00 100.00 2.50 % TF-B3913 Closed 0.94 0.94 0.00 0.94 0.00 100.00 0.94 % Dec 23, 2024 Page 12 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) TF-C2226 Effective 0.30 0.30 0.00 0.00 0.30 0% 0.30 TF-C2216 Effective 1.00 1.00 0.00 0.84 0.16 84.00% 1.00 IDA-E2230 Effective 1.50 1.56 0.00 0.85 0.72 54.20% 1.50 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-D6060 Effective 02-Apr-2020 06-Apr-2020 06-Apr-2020 30-Jun-2022 30-Jun-2025 IDA-D8130 Effective 13-May-2021 31-May-2021 28-Jun-2021 30-Jun-2024 30-Jun-2025 IDA-E2230 Effective 31-Aug-2023 11-Oct-2023 08-Feb-2024 30-Jun-2025 30-Jun-2025 TF-B3913 Closed 09-Dec-2020 15-Dec-2020 15-Dec-2020 31-Jan-2021 31-Jan-2021 TF-B5690 Effective 31-May-2021 31-May-2021 28-Jun-2021 30-Jun-2024 30-Jun-2025 TF-C2216 Effective 31-Aug-2023 11-Oct-2023 08-Feb-2024 30-Jun-2025 30-Jun-2025 TF-C2226 Effective 31-Aug-2023 11-Oct-2023 08-Feb-2024 30-Jun-2025 30-Jun-2025 8. KEY DATES Key Events Planned Actual Approval 29-May-2020 02-Apr-2020 Effectiveness 06-Apr-2020 06-Apr-2020 Mid-Term Review No. 01 01-Feb-2023 01-Jun-2022 Operation Closing/Cancellation 30-Jun-2025 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) Dec 23, 2024 Page 13 of 14 The World Bank Implementation Status & Results Report STP COVID-19 Emergency Response Project (P173783) There are no associated operations Dec 23, 2024 Page 14 of 14