The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) Concept Environmental and Social Review Summary Concept Stage (ESRS Concept Stage) Public Disclosure Date Prepared/Updated: 05/04/2022 | Report No: ESRSC02695 May 05, 2022 Page 1 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) BASIC INFORMATION A. Basic Project Data Country Region Project ID Parent Project ID (if any) Timor-Leste EAST ASIA AND PACIFIC P176767 Project Name Timor-Leste COVID-19 Response and Health System Preparedness Project Practice Area (Lead) Financing Instrument Estimated Appraisal Date Estimated Board Date Health, Nutrition & Investment Project 5/13/2022 Population Financing Borrower(s) Implementing Agency(ies) DEMOCRATIC REPUBLIC Ministry of Health OF TIMOR LESTE Proposed Development Objective To strengthen Timor-Leste’s capacity to respond to the COVID-19 pandemic and strengthen national systems for Public Disclosure health emergency preparedness Financing (in USD Million) Amount Total Project Cost 5.00 B. Is the project being prepared in a Situation of Urgent Need of Assistance or Capacity Constraints, as per Bank IPF Policy, para. 12? No C. Summary Description of Proposed Project [including overview of Country, Sectoral & Institutional Contexts and Relationship to CPF] The Project aims to strengthen Timor-Leste’s capacity to respond to the COVID-19 pandemic and strengthen national systems for health emergency preparedness. The project will help the government deploy COVID-19 vaccines that meet Bank’s vaccine approval criteria (VAC) and strengthen relevant health systems that are necessary for a successful deployment and to enhance the health system’s readiness to respond to outbreaks and pandemics in the future. The proposed project will help vaccinate 90 percent of the targeted population, by supporting the deployment of vaccines provided by COVAX AMC facility (cover around 263.000 population) and other donors (bilateral partners co-financiers will cover 1,050,000 population by the end of CY2022). May 05, 2022 Page 2 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) The project is limited to finance: i) support to the implementation of the COVID-19 vaccination program (component 1) by supporting for vaccine rollout, in particular the transport cost and M&E supervision (1.1) and support investments in health system for vaccine delivery in the longer term (1.2), which will include purchase of vehicles and IT equipment (laptops/desktops) to enhance capacity for rapid and equitable distribution of essential supplies (vaccines, medicines, medical supplies) and to provide equitable access for COVID19 vaccine to the community at large, including those residing in areas with limited road network and public transport services; ii) strengthening health system capacities for health emergency preparedness and delivery of essential health services (component 2) through investments in disease surveillance systems such as developing a web-based integrated epidemiological surveillance reporting system (2.1), strengthening Timor-Leste’s pandemic preparedness capacity through preparation of assessments and plans for health emergencies preparedness and by conducting simulation exercises (2.2), enhancing health systems and building competencies of service delivery for future emergencies (2.3) such as rapid mobilization of the needed supplies and human resources and supporting innovative technologies (performance- based budgeting and financing mechanisms, digital geospatial monitoring, planning and decision making, piloting drone-based technologies to deliver consumables and supplies to the most remote and hard to reach areas - learning from experiences of such technology use in other countries). The proposed project activities were anticipated under the MOH’s National Contingency Plan for Public Health Emergencies COVID-19, and the national COVID-19 vaccination program, as responses to areas where gaps have been identified. This Contingency Plan has compiled all the actions and procedures that are currently underway in the country that will be implemented by Ministry of Health, which largely refer to WHO guidelines. It also aims to present general measures to be adopted by all sectors that have impacts on health, in a process that involves the participation Public Disclosure of all the relevant sectors with a view to minimizing the risk of introducing and disseminating COVID-19 in Timor-Leste as well as the negative social and economic impact of the pandemic for the country. The project design is aligned with Timor-Leste’s National Contingency Plan for Public Health Emergencies and the national COVID-19 vaccination program, responding to areas where gaps have been identified. The project will also enhance innovative information systems for better data management, planning and epidemiological surveillance; build country capacity to better assess the risks and plan for future health emergencies; and strengthen health system and health facility capacities to manage potential future emergencies. The Project will be financed by the Health Emergency Preparedness and Response (HEPR) Umbrella Program and its associated Trust Fund (HEPRTF) and will include US$2 million from the HEPR response component to support vaccine deployment (excluding purchase of vaccines), and US$3 million from the HEPR preparedness component. As per rules of the HEPR Umbrella Program, funds for each component are distinct and cannot be intermingled. No construction or major civil works will be financed under this project and the activities will take place in existing area of COVID- response operation. The project will also not involve any associated facilities. D. Environmental and Social Overview D.1. Detailed project location(s) and salient physical characteristics relevant to the E&S assessment [geographic, environmental, social] The COVID19 vaccination program in Timor-Leste (TL) is currently underway that is dividing in three phases: (i) frontline workers and some people with co-morbidities; (ii) population over 60 years old and other priority groups; and (iii) the rest of the population (80%). The program (first phase) was launched on April 7, 2021. The second phase May 05, 2022 Page 3 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) was scheduled to start in June 2021 and third phase in September 2021. Vaccinations are being administered at health posts and immunization posts set up by the Ministry of Health (MOH). The project will be implemented throughout TL and will benefit the TL population at large and support the deployment of the COVID19 vaccine to the general population. Currently, 70% of TL’s population live in rural areas. The project will also benefit those in priority groups who had not been vaccinated in earlier phases. TL is a multi- lingual country, with Tetum speakers, accounting for 25% of the population, being the largest group; while other groups include the Mambae, Kemak, Bunak and Fataluku. The ethno-lingustic landscape is so diverse that each sub district has its own language. For example, Covalima municipality has 3 languages i.e. Tetum Terik, Kemak and Bunak. Most people in this municipality are using Bunak and Tetum Terik including in urban area/Suai subdistrict. Only two sub districts in Cova Lima are using the Kemak language, mixed with Bunak like Maucatar and Zumalai. Viqueque Municipality has 3 languages in use, including Tetum Terik, Makasae and Nauweti. TL has relatively high vaccine rates for the first two doses for 18 years and over (as of March 11, 2022, 84.9% have received first dose and 72.2% second dose), and over 1.8% of the population above 18 years have received a booster dose. The vaccinate rates (first dose) at municipality level ranges from 71.3% at Ermera to 96.8% at Covalima, which are considered remote municipalities. First dose vaccination rate in seven out of thirteen municipality is still below national coverage, where accessing remote areas is the biggest challenge. Hence, providing finance to purchase multifunction (all terrain) vehicles as well as motorcycles, will allow for more effective outreach in vaccine deployment. The vaccine deployment plan provides clear guidance on who are the target population, including by ethno-linguistic group and gender. About 348,737 male and 330,984 female have received the first dose of COVID19 Public Disclosure vaccine, and about 291,104 male and 282,126 female received second dose vaccine. The project will include piloting drone-based technologies to deliver consumables and supplies to the most remote areas. The delivery drones operations may affect birds from the collision risk and disturbance due to noise generated. There are 4 bird species in TL registered as endangered based on the IUCN Red List of Threatened Species (IUCN Red List): Wetar Ground-dove (Alopecoenas hoedtii) and Timor Green-pigeon (Treron psittaceus) that are terrestrial non migratory birds thus have least collision risk, and Far Eastern Curlew (Numenius madagascariensis), Great Knot (Calidris tenuirostris) that are full migratory birds. The distribution of these birds is currently unknown but most probably within the fourteen key biodiversity areas in TL. Most migratory flights typically occur up to 1500m above ground level while delivery drones commonly operating at low altitude, usually below 500m. Additionally, the project is not expected to impact cultural heritage sites. The National Contingency Plan for Public Health Emergencies COVID19 includes measures refer to WHO technical guidelines for prevention and protection from infection in working environment, physical distancing and personal hygiene measures, provision of adequate number of PPE, regular training, and safe disposal of medical waste. MOH has also issued guideline for IPC on the used PPE, health consumables. Medical waste and e-waste management will follow Decree-Law 2/2017 on urban solid waste management. D. 2. Borrower’s Institutional Capacity The Ministry of Health (MOH) of Timor-Leste will be responsible for implementation of the project, including overall coordination, results monitoring and communicating with the World Bank on the implementation of the project. The Director of Cabinet for Policy, Planning and Cooperation at MOH will be the Project Director and provide oversight and support coordination of project implementation among the relevant line agencies. The Director of Cabinet also May 05, 2022 Page 4 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) leads the National Contingency Plan for the COVID-19 response, and coordinates the different departments of MOH, autonomous agencies in the health sector, and municipal health authorities. The Cabinet has appointed focal points for Procurement, Environmental and Social Standards, and Financial Management. The focal points will lead the E&S management implementation throughout the project and will be assisted by two staff who took part in ESF training held by the Bank on February 2022. The Environmental and Social standards focal points is responsible in preparing and implementing E&S instruments in compliance with the World Bank Environmental and Social Standards as well as the monitoring of environmental and social performance throughout project implementation. MOH has previous experience with World Bank projects through the Timor-Leste COVID-19 Emergency Support Project (P174404). The MOH has performed satisfactorily in managing environmental and social risks during the implementation of the COVID-19 Emergency Support Project. MOH through its ES focal point will provide monitoring reports of the environmental and social performance to ensure application of the national Environmental and Social regulations and relevant ESSs. Additionally, the World Bank ES specialists will provide support throughout the project implementation. MOH is the main actor in the preparation of the National Contingency Plan for Public Health Emergencies New Coronavirus 2019 (COVID-19), which includes the objective to bolster the implementation of the measures included in the International Health Regulations 2005 (IHR 2005) to strengthen inter-sectoral coordination and cooperation to enforce the prevention and control measures related to COVID-19 measures, to reduce the risk of the virus entering the national territory through Points of Entry, to guide the institutions of the National Health System for an active, immediate and timely adoption of infection prevention, diagnosis, treatment and control measures; and to Public Disclosure strengthen human and animal epidemiological surveillance procedures, the appropriate investigation and follow-up of cases, infection prevention and control measures. The National Contingency Plan also includes a number of environmental and social safeguards measures in relation to COVID-19 response, among others preparation of technical guidelines and Standard Operational Procedures (SOPs) at national and local level for defining and addressing cases and management of suspected cases and contacts, imposing the necessary restrictive measures at all healthcare facilities for prevention and protection from the infection in the working environment, imposing physical distancing measures and personal hygiene measures, provision of adequate number of Personal Protective Equipment (PPE), provision of regular training of health professionals to properly use the PPE and management of waste, and safe disposal of medical waste. Based on WHO situation reports in Timor-Leste, multiple trainings have been conducted to various stakeholders in Timor-Leste, including training for surveillance officers, ambulance crew and other personnel involved in COVID-19 response. These trainings cover 12 main areas which include: introduction to COVID-19; IPC; Triage; PPE; Mild and moderate case management; Psychology; Safe transfer of patients; Communicating with patients and families; TB & HIV care in the context of COVID-19; Maintaining essential health services; Health promotion; and Palliative care. II. SCREENING OF POTENTIAL ENVIRONMENTAL AND SOCIAL (ES) RISKS AND IMPACTS A. Environmental and Social Risk Classification (ESRC) Moderate Environmental Risk Rating Low May 05, 2022 Page 5 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) The environmental risk rating is Low. The Project will support response to COVID-19 pandemic and expected to simultaneously strengthen national health systems for future public health emergencies. The project's main long-term impacts are likely to be positive as the project aims to support for COVID-19 vaccine rollout and delivery, including procurement of vehicles (10 multifunction vehicles, 10 motorcycles) and 100 units of laptops/desktops, and improve health system capacity for health emergency preparedness through technical assistance supports, capacity building activities, and piloting a drone-based technology for medical supply delivery with 2 drones to be procured. The multifunction vehicle will be utilized for transporting people and non-hazardous medical supplies and consumables and will not be equipped with medical equipment nor cool storage. The laptops/desktops procured will not replace existing computer that currently in use by the MOH, while the delivery drones are expected to facilitate last-mile delivery of medical supplies and consumables to the most remote areas in health emergencies. The capacity building activities will include trainings, workshops, and peer-to-peer knowledge exchange/inter-country learning. The project will not involve any civil works and will not generate any medical waste since there will be no medical consumables procured. The main risks include: (i) OHS risks from operation of multifunction vehicles & motorcycles include road accidents and low probability of COVID-19 transmission during project implementation; (ii) land and water contamination due to improper hazardous waste management from disposal of laptops/desktops and used drone battery; (iii) risk of collision with birds and disturbance due to noise generated by the operation of drones; and (iv) community health and safety risks from the debris resulting from collisions and dropped cargo and the related responsibility for their disposal. Potential environmental impacts from multifunction vehicle and motorcycle operations are negligible and there is low probability of adverse impacts to human health related to occupational safety risks. The risk of pollution due to hazardous waste generation from disposal of used laptop/computer at its end-of-life is very low considering the amount of procured equipment. The risk of collision with the endangered bird Public Disclosure species in Timor-Leste is considered low as the delivery drones commonly operating at low altitude, usually below 500 meters, while most migratory flights typically occur up to 1500 m above ground level. The risk of noise disturbance from drone operation will be minimum since the drones will only be operated in the time of health emergencies and not in in regular basis. These risks are mostly temporary, predictable, site specific, and relatively easy to be managed and considering existing available measures. The project will follow existing measures to manage COVID-19 exposure risks, including relevant existing regulations and IPC guidelines stipulated in the National Contingency Plan developed referring to WHO guidelines. Multifunction vehicles and motorcycles operations will follow MOH’s Inventory and Moveable Assets Management Manual and trip management system. Disposal of laptops/desktops and used drone battery will follow national regulations on disposal of e-waste and will collaborate with equipment’s supplier. The community health & safety risks of debris from drone collisions and dropped cargo will be anticipated by inclusion of drone safety and security aspects in the SOP for the drone implementation as part of Project Operation Manual. The MOH previous experience and good performance in dealing with environmental and social risk management in implementing the COVID-19 Emergency Support Project also contribute to the low environmental risks. The MOH has assigned an ES focal points to ensure procedures implementation and training executions during project implementation. Social Risk Rating Moderate The social risk rating is moderate. The project type and nature contain low social risk associated with the activities of enhancing system of preparedness for health emergencies, through supporting vaccine roll out, better data management, planning and epidemiological surveillance, better assess risks and plans; and strengthen health system and health facility capacities to manage potential future emergencies. The overall social impact is expected to be positive with no adverse social impacts. The project is being assigned a moderate rather than a low social risk due to possibility of resistance by populations in hard to reach areas, especially indigenous communities on receiving May 05, 2022 Page 6 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) vaccinations given the limited information on vaccination and stigma around vaccination, etc. The use of drones is experimental and risks related to data privacy will also need to be addressed, as well as the borrower limited capacity. Component 1 will finance transport cost for enumeration, advocacy and social mobilization, monitoring and evaluation in COVID19 vaccine deployment, as well as procuring vehicles and computers for supporting investment in health system. This component will help to cover gaps in the vaccine deployment to achieve national target and support in transportation is essential for rapid and equitable distribution to reach underserved areas for an equitable access. Population who had not been vaccinated in earlier phase will be benefited including disadvantaged or vulnerable groups. Social exclusion is not envisaged as the project will fill the gaps of vaccine deployment that the country targets to vaccinate all population. Advocacy works or public awareness activities related to the readiness of the population and response to the COVID-19 pandemic in component 1 will ensure an effective engagement strategy to use relevant local languages as the project will be implemented throughout country and need to reach out to multiple linguistic groups, including Indigenous Peoples. Addressing social stigma will be included as part of the community awareness activities. Component 2 will finance consultants, training and workshops, travels and learning for investments in disease surveillance systems and pandemic preparedness capacity through performance-based budgeting mechanisms, leveraging ICT platform such as digital geospatial monitoring, and piloting of drone-based technologies to deliver consumables and supplies to the most remote and hard to reach areas. The social risk is an activity of using drones associated with ethical issues on privacy. Provision of privacy guideline or code of conduct in drone operation will be provided in Project Operation Manual (POM). Potential Occupational, Health, and Safety (OHS) risks related to the spread of the SARS-CoV-2 among health workers, and among the population at large if the vaccination programs/events are not managed properly and due to poor training of the health personnel, and to project workers (direct and contracted workers for the leveraging ICT platform), although it is considered low, as the Public Disclosure existing measures related to COVID-19 response have been in place and included in the COVID-19 National Contingency Plan which is developed referring to WHO guidelines. The potential social risks will be addressed through the preparation of a Stakeholder Engagement Plan (SEP), including a Grievance Mechanism, a Labor Management Procedure (LMP) and the Environmental and Social Commitment Plan (ESCP). LMP will include an assessment of labor risks and systems as well as any measures and resources necessary to address project labor issues. POM and SEP will also include aspects in community awareness activities to use relevant local languages in advocacy works. Potential risk of sexual exploitation and abuse/ sexual harassments (SEA/SH) is deemed to be low due to the nature of supported activities. ES focal point at MoH will oversee E&S risk management of the project and will be specified in the ESCP. B. Environment and Social Standards (ESSs) that Apply to the Activities Being Considered B.1. General Assessment ESS1 Assessment and Management of Environmental and Social Risks and Impacts Overview of the relevance of the Standard for the Project: ESS 1 is relevant as it applies to all projects supported through Investment Project Financing. The project will not involve any civil works and will not generate any medical waste since there will be no medical consumables procured. Multiple disadvantaged or other vulnerable groups will benefit, starting with the elderly and those with compromised immune systems due to pre-existing conditions. However, the project entails low environmental and social risks with respect to the COVID-19 pandemic situation as well as Timor-Leste’s environmental features. The primary risks May 05, 2022 Page 7 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) identified include: 1) occupational health and safety risks from operation of multifunction vehicles and motorcycles, which include road accidents; 2) low probability of COVID-19 transmission during project implementation; 3) land and water contamination due to improper hazardous waste management from disposal of laptops/desktops upon end of item’s lifespan and used battery of delivery drones; 4) use drones associated potentially violating privacy; 5) risk of collision with birds and disturbance due to noise generated by the operation of drones; and 6) community health and safety risks from the debris resulting from collisions and dropped cargo and the related responsibility for their disposal. The exclusion of disadvantaged or vulnerable groups is not considered a significant risk, as the project is designed to fill the gaps in the Timor-Leste’s goal of vaccine deployment to vaccinate the entire population. An effective engagement strategy to use relevant local languages will be implemented throughout country, and outreach to multiple linguistic groups will be a key element of public awareness activities. There are Potential Occupational, Health, and Safety (OHS) risks related to the spread of the SARS-CoV-2 among health workers, and among the population at large if the vaccination programs/events are not managed properly and due to poor training of the health personnel, and to project workers (direct and contracted workers for the leveraging ICT platform), although it is considered low, as the existing measures related to COVID-19 response have been in place and included in the COVID-19 National Contingency Plan which is developed referring to WHO guidelines, including proper training for health workers. To manage the risks related to COVID-19 exposure, The MOH, through its commitment in the National Contingency Plan for Public Health Emergency COVID-19, will make available sufficient Personal Protective Equipment (PPE) for all personnel involved in the Project, including the multifunction vehicle drivers and motorcycle riders, and provide Public Disclosure compulsory training on appropriate use of PPE and infections prevention and control (IPC) measures prior to their involvement in COVID-19 response. In the National Contingency Plan, MOH has also provided a guideline for early detection, prevention and protection of healthcare personnel that are likely to exposed to COVID-19 case in their work environment. Multifunction vehicles and motorcycles procured will be operated by licensed or professional drivers who will receive refresher/new training on infection prevention and control prior to mobilization. The operation and maintenance of the ambulances and operational vehicles practices will also follow requirements of Government of Timor-Leste Decree-Law No. 2 of 2003 on Basic Law on the Road Transport System, Decree-Law No. 8 of 2003 on Regulation and the Assignment and use of State-Owned Vehicles, MOH’s existing Inventory and Moveable Assets Management Manual and trip management system, as well as the manufacturer recommended operation and maintenance programs. The procurement of laptops/desktops as well as pilot operation of delivery drones are not expected to generate significant hazardous waste during the project lifetime. Safe disposal of these items upon end of item’s lifespan will be done in compliance with Decree-Law No. 2 of 2017 on Urban Solid Waste Management System and in collaboration with equipment’s supplier. The risk of collision with the endangered bird species in Timor-Leste is considered low as the delivery drones are commonly operating at low altitude, usually below 500 meters, while most migratory flights typically occur up to 1500 m above ground level. The risk of noise disturbance from drone operation will be minimum since the drones will only be operated in the time of health emergencies and not in in regular basis. While the community health and safety risks of debris from drone’s collisions and dropped cargo will be anticipated by inclusion of drone safety and security aspects in the Standard Operational Procedure for the drone pilot May 05, 2022 Page 8 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) implementation which will be developed as part of Project Operation Manual and aligned with the World Bank Group General EHS Guidelines. Provision of privacy guideline or code of conduct in drone operation will be provided in Project Operation Manual (POM). The project also requires effectiveness of inclusion processes, the need to reach out to multiple linguistic groups, and strong social dimension under-pinning the acceptability of COVID-19 management measures. The MOH will be committed via the ESCP to not operate the vehicles, use the laptop/desktops procured and operate delivery drones until the above requirements are in place. The SEP will also be prepared and will include measures to prevent COVID-19 transmission during project implementation and guide safe disposal of used PPE. The SEP and Draft ESCP will be disclosed prior Appraisal Stage. The commitments under ESCP are expected to be implemented after project effectiveness. Additionally, MOH will be responsible to carry out monitoring and evaluation of ESCP implementation and will also prepare necessary documentations to be reviewed by Bank specialists as part of project progress report. Implementation Support Missions will be utilized to confirm the documentation submitted and to discuss findings or non-compliance (if any). Areas where “Use of Borrower Framework” is being considered: Not applicable ESS10 Stakeholder Engagement and Information Disclosure ESS10 is relevant. During project preparation, a number of engagements were carried out on July-August 2021 with Public Disclosure TL MOH and other donor partners to discuss on scope of Component 1, to ensure no duplication with other donor’s support. A Stakeholder Engagement Plan (SEP) will be prepared to establish a systematic approach to stakeholder engagement in the project. The SEP in particular will: i) identify various groups who are: directly or indirectly affected of likely to be affected by the project such as vaccine recipients, suspected CoVID19 patients, medical emergency personnel, surveillance officers; and other interested parties such as local governments, international donors, non- governmental organizations, etc.; ii) include guidance and protocols on conducting public meetings, including conducting vaccination programs/events during COVID-19 pandemic to prevent further spread of the SARS-CoV-2 , iii) include key requirements under ESS7 for conducting public meetings with Indigenous Peoples, and iv) elements on procurement transparency and public disclosure, especially for purchasing of vehicles. The SEP will help the MOH to build and maintain, over time, a constructive relationship with their stakeholders, especially the project beneficiaries. Stakeholder engagement will be an iterative process during project implementation. A guideline for conducting public meetings under COVID-19 constraints for the purposes of the project will be prepared by referring to World Bank Technical note on Public Meetings and Stakeholder Engagement, WHO guideline, and necessary restrictive measures for the prevention and protection from infection during public meeting outlined in the Timor-Leste National Contingency Plan. Additionally, the SEP will also guide safe disposal of used PPE generated during public meetings as well as by project personnel during field implementation. Since the project works at the national level, specific engagement requirements under ESS7 to ensure the inclusion of Indigenous Peoples will be provided in the SEP to accommodate effective engagement and to ensure they benefit from the project. This engagement process will be culturally appropriate, such as communicating in relevant local languages that are understandable to the community, in a manner and time frame acceptable to them. May 05, 2022 Page 9 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) A Grievance Redress Mechanism (GRM), as part of the SEP, will be provided by the project that will be proportionate to the potential risks and impacts of the project and will be accessible and inclusive. The implementation of the SEP will be outlined in the ESCP. The SEP, LMP, and ESCP will be disclosed on the MOH website as early as possible during project preparation process. B.2. Specific Risks and Impacts A brief description of the potential environmental and social risks and impacts relevant to the Project. ESS2 Labor and Working Conditions ESS2 is relevant. The project will involve direct workers and contracted workers to support the project activities, including project management (government/health workers and/or individual consultants), and piloting of drone- based technology (a consultant firm, with number of contracted workers around 5 peoples). The piloting of drone activity will be carried out remotely based in Dili (capital city). There will be no deployment of contracted workers to remote areas. Potential Occupational, Health, and Safety (OHS) risks related to the spread of the SARS-CoV-2 among project workers is considered low and the existing measures related to COVID-19 response have been in place and included in the COVID-19 National Contingency Plan for infection prevention and control to prevent COVID-19 exposure to personnel involved in the project. Labor Management Procedure (LMP) will be prepared as a guideline for project risk management related to the project workers. The LMP will specify the type of project workers to be employed, general provisions on the work Public Disclosure requirements for project workers referring to national laws and regulations in line with international labor requirements, identification of main labor risk associated with the project, and relevant mitigation measures to be implemented under the project. In order to prevent SEA/SH incidents, a code of conduct on prevention of SEA/SH will also be included in the LMP. Labor and working conditions shall be in compliance with Government of Timor-Leste Labor Law No. 4 of 2012. The labor law addresses the basic requirements on labor relations applicable to individual and collective labor relations. Of specific requirement are Article 6 on Principles of Equality, Articles 19, 20, and 21 on mutual duties and responsibilities of employees and workers, Article 34 on Occupational Health, Hygiene and Security, Article 35 on General Obligations of the employer to ensure dignified conditions for occupational health, hygiene and security, Article 68 on Minimum Age for Work Admission, Article 69 on the definition of light work, and Section 3, Article 71 on Workers with Disabilities. Risks related to the operation of procured vehicles are minor, site specific and relatively easy to be managed by ensuring operation and maintenance practices of the multifunction vehicles and motorcycles are in compliance with Government of Timor-Leste legislations as well as the manufacturer recommended operation and maintenance programs. Additionally, the risk of low probability of COVID-19 transmission to project personnel will be addressed through regular training on appropriate use of PPE and infections prevention and control measures. The SEP and LMP will include health protocols to protect and avoid transmission and infection of COVID-19 and a guideline on conducting meetings under COVID-19 constraints based on GoTL, WHO and WB guidelines. A Grievance May 05, 2022 Page 10 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) Redress Mechanism (GRM) for project workers to raise grievances in relation to the project will be included in the LMP. The LMP will be prepared prior to appraisal. ESS3 Resource Efficiency and Pollution Prevention and Management ESS3 is relevant for this project considering waste that will be generated from the use of PPE during implementation this project, used laptops/desktops upon end of item’s lifespan, used delivery drone battery, and debris from drone collisions and dropped cargo. The PPE waste generated from the project is not expected to contribute significantly to the volume of waste in the country, considering the scale of project implementation. The MOH has issued a guideline for Infection Prevention Control on the Covid-19 related used PPE and health consumables in accordance with the National Contingency Plan for Public Health Emergency, national regulations, and WHO technical guidelines. Additionally, a simple procedure to manage the used PPE waste will be developed in accordance with national regulations and WHO technical guidelines as part of the ESCP and SEP to ensure the proper handling, collection and disposal of PPE waste generated from the project. Safe disposal of laptops/desktops upon end of item’s lifespan and used delivery drone battery will be done in compliance with Decree-Law No. 2 of 2017 on Urban Solid Waste Management System, with reference to good international industry practices (GIIP) and relevant World Bank Group General EHS Guidelines, and in collaboration with equipment’s supplier. The collection of debris from drone collisions and dropped cargo will be anticipated by inclusion of drone safety and security aspects in the Standard Operational Procedure for the drone pilot implementation which will be developed as part of Project Operation Manual and aligned with the World Bank Group General EHS Guidelines. Additionally, to minimize air pollution generated by Public Disclosure operations of multifunction vehicles and motorcycles, proper vehicle maintenance will be done based on MOH’s existing Inventory and Moveable Assets Management Manual as well as the manufacturer recommended operation and maintenance programs. ESS4 Community Health and Safety ESS4 is relevant for the project. Protecting the safety of communities from infection with COVID-19 is a main focus of the GoTL Emergency Response and the current RETF project. Community exposure to health issues therefore is relevant and the project activities are designed to mitigate these risks, primarily by increasing national capacity in surveillance, monitoring and containment of COVID-19 in the country in their preparedness for response to the COVID-19 and other health emergencies. This risk will be mitigated by the preparation of health protocols to protect and avoid transmission and infection of COVID-19 for project personnel as well as communities participating in the project and guidelines to conduct meetings and emphasizing requirement for small and restricted assemblies under COVID-19 constraints. Notwithstanding, there is a low probability of risks related to road safety to the community due to the operation of multifunction vehicles and motorcycles. These risks can be addressed through operation of multifunction vehicles and motorcycles by licensed/professional drivers who will receive training on infection prevention and control measures prior to mobilization and operation and maintenance practices of the vehicles and motorcycles in compliance with Government of Timor-Leste Decree-Law No. 2 Year 2003 on Basic Law on the Road Transport System, Decree-Law No. 8 Year 2003 on Regulation and the Assignment and use of State-Owned Vehicles, MOH’s existing Inventory and Moveable Assets Management Manual and trip management system, as well as the May 05, 2022 Page 11 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) manufacturer recommended operation and maintenance programs. The community health and safety risks of debris from drone’s collisions and dropped cargo will be anticipated by inclusion of drone safety and security aspects in the Standard Operational Procedure for the drone pilot implementation which will be developed as part of Project Operation Manual and aligned with the World Bank Group General EHS Guidelines. Potential risk of sexual exploitation and abuse/ sexual harassments (SEA/SH) is deemed to be low due to the nature of supported activities under the project (primarily technical assistance and the provision of equipment). Proportionate to the risk level, the SEA/SH risk would be mitigated through requirement for all project workers to sign and commit to an SEA/SH code of conduct. ESS5 Land Acquisition, Restrictions on Land Use and Involuntary Resettlement ESS5 is considered not relevant. The project will not include any activities which require land acquisition, physical and/or economic displacement. ESS6 Biodiversity Conservation and Sustainable Management of Living Natural Resources ESS6 is relevant as the project entails low to negligible risk of collision with the endangered bird species in Timor- Leste and the risk of noise disturbance to the wildlife from drone operation. The risk of collision with birds is considered low as the delivery drones commonly operating at low altitude, usually below 500 meters, while most Public Disclosure migratory flights typically occur up to 1500 m above ground level. While the risk of noise disturbance from drone operation will be minimum since the drones will only be operated in the time of health emergencies and not in regular basis. Additionally, the project does not involve construction or other physical activities, thus there will be no environmental risks related to land preparation and construction activities. The ensure that the collision and noise disturbance risks as low to negligible, the Standard Operational Procedure for the drone pilot implementation which will be developed as part of Project Operation Manual, by taking into account the above risks and aligned with the World Bank Group General EHS Guidelines. ESS7 Indigenous Peoples/Sub-Saharan African Historically Underserved Traditional Local Communities ESS7 is relevant for this project. This standard applies for this project since the project works at the national level and ethnic groups (Indigenous Peoples) possessing the four characteristics listed in para 8 of ESS7 are present in the country. Applying the principle of proportionality, this project will not have to prepare any additional specific Indigenous Peoples Plans, as the relevant measures for engaging indigenous people in a culturally appropriate manner will be included in the SEP. The SEP will also include provisions communicating about each project activities using the relevant local language(s), and in a manner and time frame acceptable indigenous beneficiaries. This provision will also be included in the advocacy works under component 1. ESS8 Cultural Heritage May 05, 2022 Page 12 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) This standard is considered not relevant. The project will not support any construction or rehabilitation activities that would involve earth works (thereby potentially having an impact on tangible cultural heritage), or other activities that could have an impact on tangible and / or intangible cultural heritage. ESS9 Financial Intermediaries This standard is considered not relevant since the planned project interventions will not involve any financial intermediaries. C. Legal Operational Policies that Apply OP 7.50 Projects on International Waterways No OP 7.60 Projects in Disputed Areas No III. WORLD BANK ENVIRONMENTAL AND SOCIAL DUE DILIGENCE A. Is a common approach being considered? No Financing Partners Public Disclosure The project is not engaging other financing partners. B. Proposed Measures, Actions and Timing (Borrower’s commitments) Actions to be completed prior to Bank Board Approval: Stakeholder Engagement Plan (SEP) Labor Management Procedure (LMP) Environmental and Social Commitment Plan (ESCP) Possible issues to be addressed in the Borrower Environmental and Social Commitment Plan (ESCP): Prepare Project Operation Manual (POM) that include: - Privacy guideline/code of conduct in drone operation. - Consideration of risk of collision with birds and noise disturbance to wildlife in drone operation in compliance with the World Bank Group General EHS Guidelines. - Procedure for response and safe collection of debris from drone collisions and dropped cargo in drone operation in compliance with the World Bank Group General EHS Guidelines. - Procedure for hazardous waste management in particular for safe disposal of laptops/desktops upon end of item’s lifespan in compliance with Decree-Law No. 2 of 2017 on Urban Solid Waste Management System and with reference to good international industry practice (GIIP) and relevant World Bank Group General EHS Guidelines. May 05, 2022 Page 13 of 14 The World Bank Timor-Leste COVID-19 Response and Health System Preparedness Project (P176767) IV. CONTACT POINTS World Bank Contact: Eko Setyo Pambudi Title: Health Specialist Telephone No: 5781+3325 / 62-21-5299-3325 Email: epambudi@worldbank.org Contact: Naoko Ohno Title: Senior Operations Officer Telephone No: +1-202-473-9103 Email: nohno@worldbank.org Borrower/Client/Recipient Borrower: DEMOCRATIC REPUBLIC OF TIMOR LESTE Implementing Agency(ies) Implementing Agency: Ministry of Health V. FOR MORE INFORMATION CONTACT The World Bank 1818 H Street, NW Public Disclosure Washington, D.C. 20433 Telephone: (202) 473-1000 Web: http://www.worldbank.org/projects VI. APPROVAL Task Team Leader(s): Eko Setyo Pambudi, Naoko Ohno Practice Manager (ENR/Social) Janamejay Singh Recommended on 04-Apr-2022 at 06:25:2 GMT-04:00 May 05, 2022 Page 14 of 14