43704 Authorized INTEGRATED SAFEGUARDS DATASHEET APPRAISAL STAGE Disclosure I. Basic Information Date prepared/updated: 01/15/2007 Report No.: AC2645 Public 1. Basic Project Data Country: Vietnam Project ID: P101608 Project Name: VN-Avian & Human Influenza Control &Prep Task Team Leader: Severin L. Kodderitzsch Estimated Appraisal Date: December 22, Estimated Board Date: February 20, 2007 2006 Authorized Managing Unit: EASRE Lending Instrument: Emergency Recovery Loan Sector: Health (50%);Animal production (50%) Disclosure Theme: Other communicable diseases (P);Rural services and infrastructure (P);Natural disaster management (P) Public IBRD Amount (US$m.): 0.00 IDA Amount (US$m.): 20.00 GEF Amount (US$m.): 0.00 PCF Amount (US$m.): 0.00 Other financing amounts by source: BORROWER/RECIPIENT 3.00 Authorized JAPAN: MINISTRY OF FINANCE - PHRD GRANTS 5.00 FOREIGN MULTILATERAL INSTITUTIONS (UNIDENTIFIED) 10.00 18.00 Environmental Category: B - Partial Assessment Disclosure Simplified Processing Simple [] Repeater [] Is this project processed under OP 8.50 (Emergency Recovery) Yes [X] No [ ] Public 2. Project Objectives Consistent with the GPAI, the project's development objective is to support the implementation of Vietnam's plans for control of avian influenza. As stated in the OPI, the overall objectives of Vietnam's plans for the medium to long-term control of avian influenza is to reduce the health risk to humans from avian influenza by controlling the disease at source in domestic poultry, by early detection and response to human cases, Authorized and by preparing for the medical consequences of a human pandemic if it occurs over the next five years 3. Project Description Disclosure The Project comprises three components: Component A -- HPAI Control and Eradication in the Agricultural Sector; Component B -- Influenza Prevention and Pandemic Public Preparedness in the Health Sector; and Component C -- Integration and OPI Coordination, Results M&E, and Project Management. Through implemention of these components, VAHIP would help consolidate the gains made under AIERP and under various human health projects by (a) further strengthening veterinary and human health services, (b) improving the quality and scope of disease control and surveillance and public awareness, and (c) supporting integration of animal and human health activities and OPI coordination. The proposed project would focus on support for activities not already covered by other donors and financiers, and would be implemented in some eleven provinces (see IBRD Map 35196). Component A -- HPAI Control and Eradication in the Agricultural Sector (US$15 million). Component A will be implemented in each of the eleven project provinces and will comprise five subcomponents: Subcomponent A1: Strengthening of veterinary services. This subcomponent will provide technical assistance, equipment, training, and allowances to: (a) ensure testing needs for avian influenza are met and that the reliability of these tests is improved under appropriate biosafe conditions; (b) a portable BSL-3 unit will be established at the Ho Chi Minh City Regional Veterinary Centre to enable laboratory workers to isolate viruses under biosafe conditions, and (c) strengthen veterinary service networks with a focus on community animal health workers; Subcomponent A2: Enhanced disease control. This subcomponent comprises five activities conducted in live-bird markets, slaughterhouses, poultry farms and border areas to consolidate gains already made in avian influenza control. These five activities are (a) a market-based avian influenza control will be introduced at the Ha Vi live-poultry market in Ha Tay province, which supplies around 50 percent of consumer demand for poultry to Hanoi, (b) procedures will be developed to break the infection chain between farms and slaughterhouses, (c) develop pilot disease monitoring systems for large, commercial poultry farms to demonstrate sustained freedom from infection with H5N1 avian influenza, (d) five vaccination related activities, and (e) strengthen animal quarantine activities in the border province of Lang Son, a major route for illegally smuggled poultry into northern Vietnam. Subcomponent A3: Surveillance and epidemiological investigations. This subcomponent will provide technical assistance, equipment, and training for cost- effective surveillance methods. Subcomponent A4: Support to the Department of Livestock Production (MARD) capacity to plan on poultry industry restructuring. This subcomponent will provide technical assistance, equipment, training, and allowances to: (a) plan, appraise and pilot poultry development schemes that meet economic, social and environmental criteria; and (b) conduct studies and pilot schemes or demonstrations for bio-secure, efficient and equitable poultry production and processing pilots. Subcomponent A5: Emergency outbreak containment plan. This subcomponent will provide technical assistance, equipment, protective clothing, disinfections, training, and contracted services to: (a) enhance early reporting of disease outbreaks by villagers to animal health authorities to ensure effective outbreak control, (b) undertake simulation exercises in avian influenza outbreak containment, (c) stockpile protective gear and consumables in strategic locations, (d) establish an emergency contingency to cover the cost of large scale vaccination in case of widespread outbreaks, and (e) undertake studies on streamlining compensation payments for rapid disbursement in case of avian influenza outbreaks. Component B -- Influenza Prevention and Pandemic Preparedness in the Health Sector (US$ 15 million). This component aims to improve the MOH?s capacity to detect and manage HPAI infection in humans and to reduce the impact of any human influenza epidemic by strengthening the effectiveness of the sector's response to the HPAI threat, consistent with the goals of the government's National Plan for Avian and Human Influenza Control. It has four subcomponents: Subcomponent B1: Improving the technical quality of the surveillance and response system. This sub-component will start with a review of the current surveillance system, its performance at different levels, options for better coordination with veterinary surveillance, and comparisons with other countries'systems. A key input will be a review of the human resource situation, including the adequacy of mechanisms for attracting, retaining, and motivating suitable staff. This work will guide the subcomponent's support to implementation of a flexible system appropriate for Vietnam in the project provinces. It will also guide support to pilot efforts to implement and integrate the EWARS in the routine surveillance system, backed up by funding for mobile rapid response teams and for testing the system through simulation exercises. This subcomponent will finance staff training, selected equipment items, stockpiles of protective material, and technical assistance. Subcomponent B2: Improving the technical quality and efficiency of curative care preparedness. This subcomponent will support the MOH to review (i) the curative care sub-sector's strategy to respond to HPAI, focusing on roles of the centre and the provinces and the different levels of hospitals; (ii) an estimate of the baseline demand for intensive care services and mechanisms to reduce the mismatch between supply of and demand for these services across the project provinces, and (iii) the strategy (and action plans) to respond to an overwhelming epidemic or public health emergency. On the basis of these reviews, the subcomponent will support staff training, acquisition of medical equipment, rehabilitation of isolation facilities, and revision of clinical care and infection control guidelines. It will also support the revision of epidemic response action plans at the central and provincial levels, set up of an emergency hospital management structure linked to the PPC and the DOH, completion of the stockpile of personal protective equipment and materials for establishing field hospitals, and a contingency budget in the case of an outbreak. Finally, it will finance epidemic simulation exercises to test preparedness measures and coordination structures. Subcomponent B3: Strengthening communication for behavior change in health care staff. This subcomponent would fund a KAP survey which will then be used to develop a BCC strategy and action plan for the health sector with the following goals: (i) to reduce the risk of HPAI and human influenza transmission between patients and from patients to health staff, and (ii) to allow preventative and curative staff to educate patients and target groups in the local population. This strategy would look at communication needs, target audiences, and ways of delivering messages under different phases of an epidemic (current situation, limited human-to-human transmission, overwhelming epidemic). In addition to the technical assistance for the KAP survey and strategy, this subcomponent would also finance the adaptation of the strategy by each of the provinces; staff training and capacity building measures; implementation needs such as BCC materials; incremental operating costs; and evaluation of the BCC program. Subcomponent B4: Piloting approaches to improving surveillance & response and hospital performance in the provinces and districts. This subcomponent would allow the provinces to develop and pilot approaches to improving the performance of these key systems as the HPAI response moves from an emergency mode to one which must be sustainable into the medium term. A focus of this subcomponent will be developing and testing novel approaches to coordinated activities with animal health, particularly in surveillance and response. Although provinces will be supported in identifying their own priorities, well known system-level constraints include staff motivation and performance management, participation of private sector doctors in the surveillance system, information sharing between the preventative and curative sectors, and management of important hospital initiatives such as nosocomial infection control. Other areas of interest are pilots of community health worker involvement in surveillance and potential contributions of the newly proposed district preventative medicine centers to case detection. The subcomponent would support technical assistance to identify key issues, help provinces develop proposals, and evaluate performance of the pilot activities. The technical assistance would undertake a review of human resource issues in the surveillance system in project provinces and selected hospitals to help guide the proposals. Component C - Project Management and Capacity Building (US$ 5 million). Component C will support the integration and coordination between MARD, MOH and other concerned ministries and agencies in implementing the government's National Plan for Avian and Human Influenza Control. It will also support the design, establishment and implementation of a result-based M&E system to evaluate the project's progress, performance, and impact at the sector and regional levels. Lastly, this component will strengthen institutional capacity in order to undertake project management in terms of planning, coordination, and actual implementation of the overall project at the national, provincial, district, and commune-levels. 4. Project Location and salient physical characteristics relevant to the safeguard analysis The project would be carried out in eleven provinces: Lang Son, Ha Tay, Thai Binh, Thua Thien - Hue, Binh Dinh, Long An, Tien Giang, Dong Thap, Thanh Hoa, Ha Tinh, and Tay Ninh. 5. Environmental and Social Safeguards Specialists Ms Lan Thi Thu Nguyen (EASSO) Ms Trang Phuong Thi Nguyen (EASRE) 6. Safeguard Policies Triggered Yes No Environmental Assessment (OP/BP 4.01) X Natural Habitats (OP/BP 4.04) X Forests (OP/BP 4.36) X Pest Management (OP 4.09) X Physical Cultural Resources (OP/BP 4.11) X Indigenous Peoples (OP/BP 4.10) X Involuntary Resettlement (OP/BP 4.12) X Safety of Dams (OP/BP 4.37) X Projects on International Waterways (OP/BP 7.50) X Projects in Disputed Areas (OP/BP 7.60) X II. Key Safeguard Policy Issues and Their Management A. Summary of Key Safeguard Issues 1. Describe any safeguard issues and impacts associated with the proposed project. Identify and describe any potential large scale, significant and/or irreversible impacts: The project would overall have positive environmental and social impacts. The project's environmental and social issues relate to two main activities: Strengthened Veterinary Services and enhanced disease surveillance control in the Agricultural Sector. The project will support facilities, equipment, and training to ensure that (a) the veterinary diagnostic laboratory network has the capacity and capability to meet demands for avian influenza testing. These tests will be performed using standardized quality assured procedures under bio-safe conditions; (b) live-bird market and slaughterhouse hygiene is improved. Live-bird markets form the hub in the poultry marketing chain from which upstream producers, traders and transporters and downstream processors and consumers handle poultry. Securing these markets from infectious disease is a major step forward in controlling avian influenza, thereby protecting the general public and poultry workers from this disease; and (c) disease control in poultry sector restructuring guidelines and production models is enhanced. Poultry sector restructuring will be focused on the basic rationale for this undertaking, namely the prevention of transmissible infectious disease by means of building design and location, hygiene and disinfection, vaccination, and sustained disease surveillance. Improve capacity of the Health Sector in detecting and managing HPAI infection in humans. The project will support facilities, equipment, and training to (a) improve the technical quality of the surveillance and response system; (ii) improve the technical quality and efficiency of curative care preparedness; (iii) strengthen communication for behavior change in health care staff; and (iv) pilot approaches to improving surveillance & response and hospital performance in the provinces and districts. To a large extent this entails capacity building activities. In particular, the project will ensure guidelines and practices for specimen collection, handling, and transport which meet international standards; improved in-hospital infection control standards, procedures, and monitoring in normal facility operations and during a pandemic; and agreed, priority measures to address health care waste related to project investments in health facilities. 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area: The project would not cause or contribute to long term or cumulative negative impacts. 3. Describe any project alternatives (if relevant) considered to help avoid or minimize adverse impacts. There are no viable long term alternatives to effectively address avian and human influenza in an integrated manner. In fact, this project is following with the Integrated National Operational Program for Avian and Human Influenza (the OPI, or Green Book), endorsed by the Government of Vietnam and the donor community for the medium to long term control of avian influenza, and in line with the Emergency Disease Contingency Plan for Control of Highly Pathogenic Avian Influenza in Vietnam and approved by MARD on December 5, 2005. 4. Describe measures taken by the borrower to address safeguard policy issues. Provide an assessment of borrower capacity to plan and implement the measures described. The measures taken by the Borrower are to be considered according to safeguard issues, as follows: On controlling avian influenza and with regard to the temporary construction-related impacts, MARD has sufficient experience with the environmental mitigation measures used to manage these, as they are commonly used in projects financed by GoV and the World Bank. These mitigations will be included in possible construction contracts. With regard to the human health issues arising from sample collection and testing for avian influenza, the issue of capacity has been the subject of technical reviews by several agencies, including WHO, FAO, and the CDC, with additional information collected by the preparation team. There is good capacity within the National Institute for Hygiene and Epidemiology and the Pasteur Institute HCMC for basic handling and typing of AI- infected samples. The Borrower will need to address weaknesses in several areas related to safeguarding human health: (a) Capacity is weak at the provincial to communal levels on procedures for handling and transporting samples to Hanoi and HCMC for testing; (b) Capacity-strengthening measures for infection control in hospital need to be strengthened further; (b) The project will finance an action plan to be prepared and undertaken by the Borrower in the course of project implementation [to be confirmed with MOH] The project is specifically designed to build capacity in these areas, with investments to upgrade laboratory facilities and provide training to improve the safety of lab workers. In animal health, the project would require adoption of and adherence to international standards for laboratory safety in accordance with OIE standards. The project design includes technical assistance and independent inspection of the lab facilities and practices to ensure that the appropriate standards are met. 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. Stakeholders of the project include: (i) poultry farmers throughout Vietnam, and in particular those of the projects provinces where most of the project?s activities will be implemented; (ii) state institutions such as the Ministry of Agriculture and Rural Development, the National Institute for Veterinary Research, and the Ministry of Health; (iii) and provincial and local officials. Consultation: The project has been discussed with each of these stakeholders. B. Disclosure Requirements Date Environmental Assessment/Audit/Management Plan/Other: Date of receipt by the Bank 04/15/2007 Date of "in-country" disclosure 04/25/2007 Date of submission to InfoShop 04/25/2007 For category A projects, date of distributing the Executive Summary of the EA to the Executive Directors Resettlement Action Plan/Framework/Policy Process: Date of receipt by the Bank 01/27/2007 Date of "in-country" disclosure 02/10/2007 Date of submission to InfoShop 02/10/2007 Indigenous Peoples Plan/Planning Framework: Date of receipt by the Bank 01/27/2007 Date of "in-country" disclosure 02/10/2007 Date of submission to InfoShop 02/10/2007 * If the project triggers the Pest Management and/or Physical Cultural Resources, the respective issues are to be addressed and disclosed as part of the Environmental Assessment/Audit/or EMP. If in-country disclosure of any of the above documents is not expected, please explain why: N/A C. Compliance Monitoring Indicators at the Corporate Level (to be filled in when the ISDS is finalized by the project decision meeting) OP/BP/GP 4.01 - Environment Assessment Does the project require a stand-alone EA (including EMP) report? No If yes, then did the Regional Environment Unit or Sector Manager (SM) N/A review and approve the EA report? Are the cost and the accountabilities for the EMP incorporated in the N/A credit/loan? OP/BP 4.10 - Indigenous Peoples Has a separate Indigenous Peoples Plan/Planning Framework (as Yes appropriate) been prepared in consultation with affected Indigenous Peoples? If yes, then did the Regional unit responsible for safeguards or Sector Yes Manager review the plan? If the whole project is designed to benefit IP, has the design been reviewed N/A and approved by the Regional Social Development Unit or Sector Manager? OP/BP 4.12 - Involuntary Resettlement Has a resettlement plan/abbreviated plan/policy framework/process Yes framework (as appropriate) been prepared? If yes, then did the Regional unit responsible for safeguards or Sector Yes Manager review the plan? The World Bank Policy on Disclosure of Information Have relevant safeguard policies documents been sent to the World Bank's No Infoshop? Have relevant documents been disclosed in-country in a public place in a No form and language that are understandable and accessible to project-affected groups and local NGOs? All Safeguard Policies Have satisfactory calendar, budget and clear institutional responsibilities been prepared for the implementation of measures related to safeguard policies? Have costs related to safeguard policy measures been included in the project cost? Does the Monitoring and Evaluation system of the project include the monitoring of safeguard impacts and measures related to safeguard policies? Have satisfactory implementation arrangements been agreed with the borrower and the same been adequately reflected in the project legal documents? D. Approvals Signed and submitted by: Name Date Task Team Leader: Mr Severin L. Kodderitzsch Environmental Specialist: Ms Trang Phuong Thi Nguyen Social Development Specialist Ms Lan Thi Thu Nguyen Additional Environmental and/or Social Development Specialist(s): Approved by: Regional Safeguards Coordinator: Mr Glenn S. Morgan 12/06/2006 Comments: Sector Manager: Ms Hoonae Kim Comments: