The World Bank Implementation Status & Results Report Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757) Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757) SOUTH ASIA | Bangladesh | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 7 | ARCHIVED on 23-Jun-2022 | ISR51889 | Implementing Agencies: Ministry of Health and Family Welfare, People's Republic of Bangladesh Key Dates Key Project Dates Bank Approval Date: 03-Apr-2020 Effectiveness Date: 10-Apr-2020 Planned Mid Term Review Date: 30-Jun-2022 Actual Mid-Term Review Date: 15-Jun-2022 Original Closing Date: 31-Dec-2023 Revised Closing Date: 31-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To support the Government of Bangladesh to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Emergency COVID-19 Response:(Cost $694.60 M) Component 2: Supporting National and Sub-national, Prevention and Preparedness:(Cost $4.00 M) Component 3: Implementation Management and Monitoring and Evaluation:(Cost $1.40 M) Component 4: Contingent Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating High Substantial Implementation Status and Key Decisions The project includes US$600 million credit from the World Bank and US$100 million loan from the Asian Infrastructure Investment Bank (AIIB) to support implementation of the government's National Preparedness and Response Plan for COVID-19, including vaccination related activities. The project has been instrumental in supporting the government secure critical supplies during the emergency phase. Now the focus has shifted towards prevention by ensuring vaccination for the people and strengthening health systems to deal with future outbreaks, not only of COVID-19, but any pandemic. The project has supported the following:  68 million doses of vaccines procured and already administered.  110 million pieces of auto-disable syringes procured that are being used to administer vaccines.  40 ventilators and 200 oxygen concentrators for the Field Hospital at Bangabondhu Sheikh Mujib Medical University (BSMMU) Dhaka; 6/23/2022 Page 1 of 7 The World Bank Implementation Status & Results Report Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757)  220 ICU beds for the Dhaka North City Corporation (DNCC) COVID hospital;  300 ventilators to various hospitals across the country;  Large quantities of personal protective equipment (PPE), masks, gloves, body bag and COVID-19 testing machines and kits;  Liquid medical oxygen (LMO) system established at 30 public hospitals in the country. This is a key milestone in health system strengthening as access to oxygen supplies is critical for dealing with COVID-19 as well as other respiratory diseases. These hospitals did not have centralized LMO systems before the project intervention  National Vaccine Testing Laboratory being set-up at the Directorate General of Drug Administration. This will pave the way for the country to approve vaccines locally, following international protocols. The World Health Organization (WHO) is leading the technical dialogue with the government in support of COVID-19 preparedness and response activities. 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 June 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 June 15, 2022, amount to US$3.6 billion or 84% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Sixty-seven (67) country projects or 77% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 67 operations, 48 operations or 72% have disbursed over 90% of commitments. Of these, 30 operations are fully disbursed. There are thirteen (13) operations with closing dates by the end of FY22. Other 10 operations which had closing dates by the end of the FY have extended their closing dates. There are 12 operations with disbursements under 50%. Out of these 12 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 and 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, are preparing Mid-Term Review (MTR) ISRs to inform the Global MPA MTR, which will be prepared 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. 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 is significantly expanding Bank support to client countries for COVID-19 vaccination, with the aim to support vaccination of 1 billion people globally. The AF-V was approved with an envelope of 6/23/2022 Page 2 of 7 The World Bank Implementation Status & Results Report Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757) 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. As of June 15, 2022, the Bank has approved 105 operations (including MPA-V operations) to support vaccine procurement and rollout in 77 countries amounting to $9.6 billion. The 105 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 105 approved operations: (i) 56 are in Africa – 26 in AFE and 30 in AFW; (ii) 9 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. Fifty-three (53) projects are disbursing. Total disbursements as of June 15, 2022, under these projects amount to US$3.4 billion or 35% 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. Sixteen (16) operations have disbursed over 70% of their commitments. Out of the 16, seven have disbursed 90%. Retroactive Financing represents 44% of overall commitments. Thirteen (13) 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. Eighty-eight (88) loan/financing agreements have been signed. Also, eighty-six (86) 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. Countries are dealing with new waves of infections, as the Omicron variant continues to spread rapidly among populations. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial High Substantial Institutional Capacity for Implementation and Substantial Substantial Moderate Sustainability Fiduciary High High High Environment and Social Substantial Substantial Substantial Stakeholders Substantial High Substantial Other Moderate Moderate Moderate Overall Substantial High Substantial 6/23/2022 Page 3 of 7 The World Bank Implementation Status & Results Report Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757) Results PDO Indicators by Objectives / Outcomes Prevent, detect and respond to the threat posed by COVID-19 IN01154467 ►Suspected cases of COVID-19 reported and investigated based on national guidelines (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 279,000.00 372,000.00 372,000.00 350,000.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 IN01154469 ►Public hospitals with additional capacity for oxygen therapy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30.00 30.00 30.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 IN01154470 ►Population vaccinated, which is included in the priority population targets as defined in the National Deployment and Vaccination Plan for COVID-19 Vaccines (NDVP) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 46.50 31.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 Strengthen national systems for public health preparedness IN01154468 ►Public hospitals with isolation capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 30.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 Intermediate Results Indicators by Components Component 1: Emergency COVID-19 response IN01154471 ►Laboratories with COVID-19 diagnostic equipment, test kits, reagents, and trained staff per MoHFW guidelines (Number, Custom) 6/23/2022 Page 4 of 7 The World Bank Implementation Status & Results Report Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 2.00 2.00 27.00 Date 31-Mar-2020 30-Nov-2021 08-Jun-2022 31-Dec-2023 IN01154475 ►National Deployment and Vaccination Plan for COVID-19 Vaccines (NDVP) with input from relevant bodies is updated by the government, as needed (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 IN01154476 ►Vaccination centers with a female vaccinator/attendant present (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 IN01154477 ►Doctors and nurses at district-level facilities trained in IPC per MoHFW guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Mar-2020 30-Nov-2021 08-Jun-2022 31-Dec-2023 Component 2: Supporting National and Sub-national, Prevention and Preparedness IN01154472 ►Emergency operations center functional with required inputs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 1.00 1.00 1.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 IN01154473 ►Health care workers who have completed field epidemiology training program (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 150.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 Component 3: Implementation Management and Monitoring and Evaluation 6/23/2022 Page 5 of 7 The World Bank Implementation Status & Results Report Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757) IN01154474 ►Percentage of received grievances that are addressed in the last one month by the existing grievance redressal mechanism (GRM) of DGHS (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 80.00 80.00 60.00 Date 13-Feb-2021 30-Nov-2021 08-Jun-2022 31-Dec-2023 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173757 IDA-66050 Effective USD 100.00 100.00 0.00 42.67 55.96 43% P173757 IDA-68460 Effective USD 500.00 500.00 0.00 431.02 34.50 93% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173757 IDA-66050 Effective 03-Apr-2020 10-Apr-2020 10-Apr-2020 31-Dec-2023 31-Dec-2023 P173757 IDA-68460 Effective 18-Mar-2021 11-Apr-2021 15-Apr-2021 31-Dec-2023 31-Dec-2023 Cumulative Disbursements 6/23/2022 Page 6 of 7 The World Bank Implementation Status & Results Report Bangladesh: COVID-19 Emergency Response and Pandemic Preparedness Project (P173757) Restructuring History Level 2 Approved on 07-May-2021 ,Level 2 Approved on 02-Feb-2022 Related Project(s) P175837-Additional Financing for and Restructuring of the COVID-19 Emergency Response and Pandemic Preparedness Project 6/23/2022 Page 7 of 7