The World Bank Implementation Status & Results Report Cameroon COVID-19 Preparedness and Response Project (P174108) Cameroon COVID-19 Preparedness and Response Project (P174108) WESTERN AND CENTRAL AFRICA | Cameroon | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2021 | Seq No: 4 | ARCHIVED on 25-Jul-2022 | ISR51995 | Implementing Agencies: Ministry of Public Health, Republic of Cameroon Key Dates Key Project Dates Bank Approval Date: 22-Sep-2020 Effectiveness Date: 17-Sep-2021 Planned Mid Term Review Date: 22-May-2023 Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2022 Revised Closing Date: 30-Jun-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in selected regions in Cameroon. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Emergency COVID-19 Response:(Cost $63.10 M) Supporting National and Sub-National Prevention and Preparedness:(Cost $2.00 M) Community Engagement and Risk Communication:(Cost $3.00 M) Implementation Management and Monitoring & Evaluation:(Cost $5.50 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating High High Implementation Status and Key Decisions The project was approved on September 22, 2020, in the amount of US$29 million to address urgent response needs to COVID-19 pandemic and became effective on September 17, 2021. An additional financing to support purchasing and deployment of COVID-19 vaccines and to support the continuity of essential health services related to maternal and child health, that have been negatively impacted by the pandemic, was approved on December 23, 2021, increasing the project envelope by US$44.6 million (IDA: US$29.6 million; Global Financing Facility grant: US$15 million) for a total of $73.6 million. It is expected that the project will support the vaccination of about 20% of the population and mitigate the cyclical negative effect of the maternal and child health service provision decrease related to pandemic peaks. 7/25/2022 Page 1 of 7 The World Bank Implementation Status & Results Report Cameroon COVID-19 Preparedness and Response Project (P174108) MPA Program Development Objective MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body As of July 15, 2022, 88 MPA-projects had been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Six parent projects have been restructured to include vaccine-related procurement. Total disbursements as of July 15, 2022, amount to US$3.64 billion or 85% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Sixty-seven (67) country projects or 77% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 67 operations, 48 operations or 72% have disbursed over 90% of commitments. Of these, 30 operations are fully disbursed. There were only three (3) operations with closing dates by the end of FY22. Other 16 operations which had closing dates by the end of FY22 have extended their closing dates. There are 11 operations with disbursements under 50%. Out of these 11 operations, one has not disbursed, and four have disbursed 30 percent or less. The projects are benefitting around 3.7 billion people or 50% of the global population. Of the 87 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 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. Eighty-six (86) or 99% of projects approved are disbursing. MNA has the highest percentage of disbursements, followed by SRA, EAP, ECA, LAC, AFE and AFW. Retroactive Financing represents 26% of commitments. Country teams for operations, which have been under implementation for twelve months or more by June 30, 2022, have prepared and/or finalizing Mid-Term Review (MTR) ISRs to inform the Global MPA MTR, which will be prepared by the EOC early next FY. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Implementation continues to face challenges as several countries are still under different levels of mobility restrictions. Bank staff are operating in a hybrid environment with some days at the office and others at home. Virtual missions have continued to be the norm in some countries. Notwithstanding the challenges, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements attests to the strong implementation of the Bank' response thanks to the commitment of counterparts supported by Bank country teams. The Additional Financing (MPA AF-V) to the COVID-19 Strategic Preparedness and Response Program utilizing the Multiphase Programmatic Approach (“Global COVID-19 MPA”) was approved by the Board on October 13, 2021. The AF-V was approved with an envelope of US$12 billion ($6 billion from IDA and $6 billion from IBRD) in financing. On June 30, 2021, President Malpass announced the expansion of financing available for COVID-19 vaccine financing to $20 billion over the next 18 months, adding $8 billion to the previously announced $12 billion. This financing is critical to expand affordable and equitable financing for vaccine purchase and deployment. The AF-V is expected to enable vaccination for up to 750 million people, with potential surge capacity for an additional 250 million people in the poorest countries (depending on the delivered price of approved vaccines) while scaling support to strengthen immunization delivery, with design flexibility at the country level. The AF-V is a scale-up of planned vaccination activities anticipated and supported under the Global COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. 7/25/2022 Page 2 of 7 The World Bank Implementation Status & Results Report Cameroon COVID-19 Preparedness and Response Project (P174108) As of July 15, 2022, the Bank has approved 115 operations (including MPA-V operations) to support vaccine procurement and rollout in 78 countries amounting to $10.1 billion. The 115 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. Of the 115 approved operations: (i) 64 are in Africa – 29 in AFE and 35 in AFW; (ii) 9 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 13 in Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. Thirty-four (34) operations have been approved so far this Calendar Year. Fifty-nine (59) projects are disbursing. Total disbursements as of July 15, 2022, under these projects amount to US$3.98 billion or 40% of overall commitments. Disbursements under MPA-V operations are included in this total while disbursements under the six restructured projects are counted under parent projects. Twenty-one (21) operations have disbursed over 70% of their commitments. Out of the 21, nine have disbursed 90%. Retroactive Financing (RF) represents 39% of overall commitments. High RF has been authorized under different operations Indonesia and Ukraine (100%), Panama and Turkey (90%), Argentina and Guyana (80%), and Belize, Iraq and Sri Lanka (70%). Three (3) new operations are under various stages of processing. As with the MPA operations, streamlined procedures, delegated approval, coupled with flexible project design, and intensified efforts across the Bank have contributed to the rapid design and processing of the operations. Ninety-seven (97) loan/financing agreements have been signed. Also, eighty-seven (87) loan/financing agreements have become effective; several others are expected to become effective in the coming weeks. Implementation of the AF-V operations, as with MPA operations is facing challenges as several countries are still under different levels of mobility restrictions and counterparts and Bank teams are operating in a hybrid environment with some days at the office and some at home. Virtual missions have continued to be the norm in some countries. Countries are continuing to deal with sharp increases of infections, as the Omicron variant continues to spread rapidly among populations. The omicron variant spread rapidly across the world, out-competing former variants soon after it was first detected in November 2021. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Substantial High High Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Substantial Substantial Substantial Other Substantial Substantial Substantial Overall Substantial High High Results PDO Indicators by Objectives / Outcomes 7/25/2022 Page 3 of 7 The World Bank Implementation Status & Results Report Cameroon COVID-19 Preparedness and Response Project (P174108) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems IN01157273 ►Priority population vaccinated against COVID-19, based on targets defined in the national plan (proportion of females) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.70 5.70 5.70 40.00 Date 30-Nov-2021 30-Nov-2021 27-May-2022 30-Jun-2024 IN01157274 Females (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 36.00 36.00 36.00 49.00 Date 30-Nov-2021 30-Nov-2021 27-May-2022 30-Jun-2024 IN01157275 ►Designated laboratories supported with personnel, equipment, test kits and reagents (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 16.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 IN01157331 ►Births assisted by skilled health personnel in the 3 Northern regions (Adamawa, North, Extreme North) and East region (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 178,282.00 178,282.00 178,282.00 285,600.00 Date 30-Dec-2020 30-Dec-2020 27-May-2022 30-Jun-2024 Intermediate Results Indicators by Components Emergency COVID-19 Response IN01157332 ►Health facilities with a COVID-19 case management unit (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 91.00 91.00 91.00 200.00 Date 10-Nov-2021 10-Nov-2020 27-May-2022 30-Jun-2024 IN01157336 ►Health staff trained in COVID-19 vaccination deployment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 7/25/2022 Page 4 of 7 The World Bank Implementation Status & Results Report Cameroon COVID-19 Preparedness and Response Project (P174108) Value 4,548.00 4,548.00 4,548.00 9,000.00 Date 30-Nov-2021 30-Nov-2021 27-May-2022 30-Jun-2024 IN01157339 Female health staff trained in COVID-19 vaccination (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 2,106.00 2,106.00 2,106.00 4,400.00 Date 30-Nov-2021 30-Nov-2021 27-May-2022 30-Jun-2024 IN01157340 ►Doses of eligible COVID-19 vaccines procured (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 3,500,000.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 Supporting National and Sub-national, Prevention and Preparedness IN01157333 ►Laboratories awarded with 3 stars or above based on the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) audits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 16.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 Community Engagement and Risk-Communication IN01157334 ►Radio stations and TV channels broadcasting COVID-19 vaccination information in official and local languages (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 147.00 147.00 147.00 300.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 IN01157337 ►Grievances addressed according to the project's GRM timeframe and procedures (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 IN01157338 ►Community health workers trained to delivery key messages to promote demand for COVID-19 vaccines and other essential health services (Number, Custom) 7/25/2022 Page 5 of 7 The World Bank Implementation Status & Results Report Cameroon COVID-19 Preparedness and Response Project (P174108) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 25.00 25.00 75.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 IN01157341 Female community health workers (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 49.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 Implementation Management and Monitoring and Evaluation IN01157335 ►Routine monitoring of essential health services regional reports reviewed quarterly by the MoPH (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 36.00 Date 10-Nov-2021 10-Nov-2021 27-May-2022 30-Jun-2024 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P174108 IDA-67830 Effective USD 29.00 29.00 0.00 0.00 27.21 0% Not P174108 IDA-70320 USD 29.60 29.60 0.00 0.00 29.56 0% Effective Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P174108 IDA-67830 Effective 22-Sep-2020 20-Aug-2021 17-Sep-2021 30-Jun-2022 30-Jun-2024 Not P174108 IDA-70320 23-Dec-2021 -- -- 30-Jun-2024 30-Jun-2024 Effective Cumulative Disbursements 7/25/2022 Page 6 of 7 The World Bank Implementation Status & Results Report Cameroon COVID-19 Preparedness and Response Project (P174108) Restructuring History There has been no restructuring to date. Related Project(s) P178255-Additional Financing for Cameroon COVID-19 Preparedness and Response Project 7/25/2022 Page 7 of 7