The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) WESTERN AND CENTRAL AFRICA | Togo | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 5 | ARCHIVED on 30-Jul-2022 | ISR52421 | Implementing Agencies: Ministère de la Santé, de l’hygiène Publique et de l’accès universel aux soins, Republic of Togo Key Dates Key Project Dates Bank Approval Date: 17-Apr-2020 Effectiveness Date: 28-Apr-2020 Planned Mid Term Review Date: 30-Apr-2021 Actual Mid-Term Review Date: 09-Mar-2021 Original Closing Date: 31-Mar-2022 Revised Closing Date: 31-Dec-2023 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 Togo. 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 $53.60 M) Component 2: Supporting National and Sub-national, Prevention and Preparedness:(Cost $7.40 M) Component 3: Project Implementation Management and Monitoring and Evaluation:(Cost $1.60 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Project has been under implementation since effectiveness of the parent project on April 28, 2020. With the first and second additional financing, the total project amount is now US$62.6 million. The parent project closed on March 31, 2022. Progress toward the achievement of the project development objectives is rated satisfactory. As of March 31, 2022, four out of the five project development objectives indicators have met or exceeded the expected targets. As of July 14, 2022, the value of the fifth indicator, related to the percentage of the population fully immunized, was 25.5 percent compared to an annual target of 60 percent by December 31, 2022. The resources from the first AF have supported the deployment of vaccines that meet the World Bank's vaccines approval criteria nationwide, and further strengthen the health system. MPA Program Development Objective 7/30/2022 Page 1 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) 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. 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 7/30/2022 Page 2 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) 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 Moderate Moderate Moderate Macroeconomic Moderate Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Moderate Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Substantial Substantial Other -- -- -- Overall Moderate Substantial Substantial Results PDO Indicators by Objectives / Outcomes Prevent, detect and respond to the threat posed by COVID-19 and strengthen national system for publi IN01170781 ►Activation of public health Emergency Operations Centre or a coordination mechanism for COVID-19 (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 7/30/2022 Page 3 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) Value NO YES YES YES Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been achieved by that date. Comments: IN01170782 ►Designated acute healthcare facilities with isolation capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 38.00 38.00 9.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been achieved by that date. Comments: IN01170783 ►Designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 12.00 12.00 3.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been achieved by that date. Comments: IN01170784 ►Suspected cases of COVID-19 reported and investigated based on national guidelines (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 483.00 28,608.00 28,608.00 1,500.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been achieved by that date. Comments: IN01170785 ►Population fully vaccinated, which is included in the priority population targets defined in the national plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8.00 29.00 25.48 70.00 Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 7/30/2022 Page 4 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) The PNDV was revised to cover individuals 12 years and over (vs 18 years and over as reported in the previous ISR). Thus, the denominator for this indicator has been updated to the total number of this new Comments: targeted population: 5,407,219 Overall Comments PDO The targets for all four Project Development Objectives (PDO) indicators included in the parent project had been met or exceeded as of the closing date of the parent project, on March 31, 2022. As of July 14, 2022, the PDO indicator added to the AF - “Percentage of population fully vaccinated, which is included in the priority population targets defined in the national plan” - was 25.5 percent (1,378,018 individuals out of targeted 5,407,219 12 years and over), compared to an annual target of 60 percent by December 31, 2022. Intermediate Results Indicators by Components Component 1: Emergency COVID-19 Response IN01170786 ►Points of entry staff trained on screening and management of suspected COVID-19 case (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 180.00 180.00 500.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The parent project closed on March 31, 2022. The end target had been achieved by that date. Comments: IN01170789 ►Suspected COVID-19 cases diagnosed by designated laboratories within 24 hrs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 5.00 5.00 50.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 Comments: IN01170792 ►Designated laboratories with PPE, regent and infection control products and supplies, without stock-outs in last two weeks (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 12.00 12.00 3.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The parent project closed on March 31, 2022. The end target had been achieved by that date. Comments: IN01170795 7/30/2022 Page 5 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) ►Diagnosed cases treated in the designated treatment centers per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 15.00 15.00 80.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been achieved at 19 percent by that date. The approved protocol can be followed for severe cases for patients treated at the hospital and in Comments: designated centers. The majority of the patients are isolated and are following the treatment protocol in their home. IN01170798 ►Estimated target populations who will be prioritized for access to vaccines, stratified by target group and geographic location (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 425,501.00 404,610.00 1,651,200.00 3,500,000.00 Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 The Actual number has exceeded the annual target by 128%. Comments: IN01170803 ►Vaccination sites with functional cold chain (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 75.00 93.00 93.00 95.00 Date 31-Mar-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 The Actual number has exceeded the annual target Comments: IN01170806 ►Recorders trained in the use of the data digitization platform for the COVID-19 vaccination campaign (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,016.00 2,016.00 2,500.00 Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 The Actual number has exceeded the annual target Comments: IN01170807 ►Eligibility for vaccination criteria include informal and/or volunteer health workers (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 The annual target is achieved. Comments: 7/30/2022 Page 6 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) Component 2: Supporting National and Sub-national, Prevention and Preparedness IN01170788 ►Regional and district’s Laboratories equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 12.00 12.00 40.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been achieved at 30 percent. These Comments: are the 12 designated laboratories that ought to receive the protective and infection control equipment. IN01170791 ►Medical and veterinary laboratory personnel trained (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 62.00 170.00 170.00 1,000.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been achieved at 17 percent. Comments: IN01170794 ►Designated laboratories with staff trained to conduct COVID-19 diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 13.00 13.00 9.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been exceeded. Comments: IN01170797 ►Health staff trained in infection prevention per Ministry of Health (MoH) approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 1,101.00 1,101.00 1,000.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 31, 2022. The End target had been exceeded. Comments: IN01170800 ►Key gender-responsive messages and materials developed for public communications and advocacy, in alignment with demand plan (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 7/30/2022 Page 7 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) The communication plan is being updated to include key gender-responsive messages and materials for Comments: public communications and advocacy. IN01170802 ►Community Engagement and monitoring of interventions against GBV and SEA/SH reported (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 Community Engagement plan and monitoring of interventions against gender-based violence (GBV) and Comments: SEA/SH have been developed and are being implemented. IN01170804 ►Women who responded correctly to 70 percent of questions on COVID-19 vaccines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 28.00 28.00 28.00 60.00 Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 Pending completion of the KAP survey. The value of the indicator will be reported in the next ISR. Comments: IN01170805 ►People vaccinated in hesitancy/refusal areas reached by communication activities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 24.00 24.00 50.00 Date 30-Nov-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 Pending completion of the KAP survey. The value of the indicator will be reported in the next ISR. Comments: Component 3: Project Implementation Management and Monitoring and Evaluation IN01170787 ►Training attended by project management unit members and technical consultants (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3.00 3.00 5.00 Date 28-Apr-2020 31-Mar-2022 31-Mar-2022 31-Mar-2022 The Parent project closed on March 2022. The End target has been achieved at 60 percent. Comments: IN01170790 ►Complaints received and addressed within the Grievance Redress Mechanism (GRM) specified timeframe (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 7/30/2022 Page 8 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) Value 0.00 100.00 13.30 80.00 Date 31-Oct-2020 31-Mar-2022 14-Jul-2022 31-Dec-2023 16 complaints have been registered, of which three have been satisfactorily treated and 13 are in the Comments: process of being addressed. IN01170793 ►M&E system established to monitor COVID-19 preparedness and response plan. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value NO YES YES YES Date 28-Apr-2020 31-Mar-2022 14-Jul-2022 31-Mar-2022 A digitalized COVID-19 data management system is operational with weekly reporting of the pandemic Comments: situation and COVID-19 vaccination results. IN01170796 ►Proportion of vaccination sites that transmit their data via DHIS2 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.00 97.00 97.00 85.00 Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 The Annual target has been exceeded. Comments: IN01170799 ►Vaccinators trained on GBV/SEA/SH (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 568.00 568.00 4,838.00 4,600.00 Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 The Annual target has been exceeded. Comments: IN01170801 ►Beneficiaries reporting that community engagement and outreach meet their needs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 31-Oct-2021 31-Mar-2022 14-Jul-2022 31-Dec-2023 Pending completion of the KAP survey. The value of the indicator will be reported in the next ISR. Comments: Overall Comments IR The parent project closed on March 31, 2022. The end target for six out of the 12 intermediate indicators have been achieved or have been exceeded. 7/30/2022 Page 9 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173880 IDA-66280 Closed USD 4.05 4.05 0.00 4.50 0.01 100% P173880 IDA-69420 Effective USD 12.50 12.50 0.00 7.18 3.76 66% P173880 IDA-70260 Effective USD 12.50 12.50 0.00 0.00 12.59 0% P173880 IDA-D6260 Closed USD 4.05 4.05 0.00 4.27 0.00 100% P173880 IDA-D8640 Effective USD 12.50 12.50 0.00 10.80 1.41 88% P173880 IDA-D9610 Effective USD 12.50 12.50 0.00 0.00 12.62 0% P173880 TF-B5887 Effective USD 4.50 4.50 0.00 1.35 3.15 30% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173880 IDA-66280 Closed 17-Apr-2020 22-Apr-2020 28-Apr-2020 31-Mar-2022 31-Mar-2022 P173880 IDA-69420 Effective 10-Jun-2021 25-Jun-2021 30-Jun-2021 31-Dec-2022 31-Dec-2022 P173880 IDA-70260 Effective 21-Dec-2021 24-Dec-2021 20-Jan-2022 31-Dec-2023 31-Dec-2023 P173880 IDA-D6260 Closed 17-Apr-2020 22-Apr-2020 28-Apr-2020 31-Mar-2022 31-Mar-2022 P173880 IDA-D8640 Effective 10-Jun-2021 25-Jun-2021 30-Jun-2021 31-Dec-2022 31-Dec-2022 P173880 IDA-D9610 Effective 21-Dec-2021 24-Dec-2021 20-Jan-2022 31-Dec-2023 31-Dec-2023 P173880 TF-B5887 Effective 10-Jun-2021 25-Jun-2021 30-Jun-2021 31-Dec-2022 31-Dec-2022 Cumulative Disbursements 7/30/2022 Page 10 of 11 The World Bank Implementation Status & Results Report Togo COVID-19 Emergency Response and Systems Preparedness Strengthening Project (P173880) Restructuring History There has been no restructuring to date. Related Project(s) P176335-Togo, Additional Financing to the COVID-19 Emergency Response and System Preparedness Strengthening Project ,P177956-Togo Second Additional Financing to the COVID-19 Emergency Response and Systems Preparedness Strengthening Project 7/30/2022 Page 11 of 11