Page 1 INTEGRATED SAFEGUARDS DATASHEET APPRAISAL STAGE I. Basic Information Date prepared/updated: 06/09/2009 Report No.: AC4180 1. Basic Project Data Country: Lesotho Project ID: P107375 Project Name: Lesotho HIV and AIDS Technical Assistance Project Task Team Leader: Feng Zhao Estimated Appraisal Date: March 20, 2009 Estimated Board Date: July 28, 2009 Managing Unit: AFTH1 Lending Instrument: Technical Assistance Loan Sector: Health (60%);Other social services (23%);Sub-national government administration (10%);Central government administration (7%) Theme: HIV/AIDS (25%);Health system performance (25%);Participation and civic engagement (24%);Decentralization (13%);Other accountability/anti-corruption (13%) IBRD Amount (US$m.): 0.00 IDA Amount (US$m.): 5.00 GEF Amount (US$m.): 0.00 PCF Amount (US$m.): 0.00 Other financing amounts by source: BORROWER/RECIPIENT 0.00 0.00 Environmental Category: B - Partial Assessment Simplified Processing Simple [X] Repeater [] Is this project processed under OP 8.50 (Emergency Recovery) or OP 8.00 (Rapid Response to Crises and Emergencies) Yes [ ] No [ ] 2. Project Objectives The proposed project aims at building capacity of government agencies and civil society organizations at both the national and local level to address the identified key gaps in implementing the National HIV and AIDS Strategic Plan in an effort to contain and reverse the epidemic. 3. Project Description The proposed technical assistance/project has three components: 1)Component 1: Improved institutional capacity and organizational efficiency to implement the multisectoral response ($1.8 million). This component will support capacity building of national level institutions, both public and private, in support of Lesotho's HIV and AIDS multisectoral response. Specifically, the component will: (i) strengthen the NAC's capacity to coordinate the national multisectoral response; (ii) strengthen the country's ™ HIV and AIDS research capacity to generate timely and accurate evidence to guide the national response; (iii) contribute towards the implementation of a national HIV monitoring and evaluation system; and (iv) strengthen Page 2 the NAC's capacity to monitor resources for implementation of the HIV national strategic plan. 2) Component 2: Improved capacity to scale up the health sector response ($1.9 million): This component will mainly support Ministry of Health and Social Welfare units to build capacity for delivering essential and effective HIV services and to mitigate the impact of the epidemic. Specifically, it will fill gaps in existing programs to support: (i) integration of effective HIV services with other health services such as TB and sexual reproductive health; (ii) mitigate the impact of the epidemic on Orphans and Vulnerable Children (OVC); and (iii) strengthen institutional capacity for evidence-based planning, monitoring and evaluation. This component will build on earlier support provided under the HCTA and complement support provided by other development partners such as the GFATM, European Commission and the Millennium Challenge Corporation (MCC). 3) Component 3: Capacity Support to the decentralized local response ($1.3 million): This component will build capacity through provision of technical assistance to government and civil society implementers at district and community levels to plan, coordinate and implement and monitor a range of deemed essential HIV and TB services that need to be in every community for an effective, expanded HIV response to scale and to ensure Universal Access. Specifically, it will (i) coordinate the implementation, monitoring and evaluation of the Essential Service Package(ESP); (ii) develop and strengthen the operational and management capacities of the District AIDS Committee and the proposed Community AIDS Committee to harmonize HIV and TB activities at the community level, and (iii) strengthen the skills and operational capacity of the community-based organizations to provide, monitor, evaluate and report on HIV and TB services at the community. 4. Project Location and salient physical characteristics relevant to the safeguard analysis National, district and community level interventions. 5. Environmental and Social Safeguards Specialists Ms Lungiswa Thandiwe Gxaba (AFTEN) 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 Page 3 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 proposed project will not entail any major civil works as its main objective is technical assistance in the form of capacity building for government and civil society organizations to implement the National HIV and AIDS Strategy. There will be minor civil works or infrastructure development undertaken during the project. This will involve construction of prefabricated offices on premises already owned by the Lesotho Council of NGOs. Accordingly, there will be no land acquisition and no involuntary resettlement as a result of the project. The project triggers OP/BP 4.01 as result of potential increase in health care waste to be generated as a result of increased access to health care services. 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area: The activities to be supported by the project are expected to improve capacity and increase access to health and HIV related services. Increased access to health services would result in some increase in the amount of medical waste generated by the various health care facilities in the country, such as the testing centers. If not properly managed, the increased medical waste generated would result in increased contamination risks. The project, therefore, triggers OP/BP 4.01: Environmental Assessment, and has been classified as Category B-Partial Assessment. 3. Describe any project alternatives (if relevant) considered to help avoid or minimize adverse impacts. No negative environmental impacts are envisaged as a result of the proposed project. 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. A National Health Care Waste Management Plan is in place that will inform the collection transportation, treatment and disposal of medical waste to be generated during the implementation of the project. In terms of capacity for implementing the Health Care Waste Management Plan, the MOHSW has recently established a health care waste management unit for handling health care waste. This function was previously managed under the Pollution Control Unit within the Ministry. Currently there are two officials in the newly established health care waste management unit. The implementation of the Health Care Waste Management Plan is also being supported by the Bank's Health Sector Reform Program Phase II and MCC. 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. The key stakeholders (and beneficiaries) are national level institutions, both public and private (in support of Lesotho’s HIV and AIDS multisectoral response), implementers in the health sector, and government and civil society implementers at district and community levels. A National Health Care Waste Management Plan has been under Page 4 implementation since 2005. It has also been disclosed last March 2009 in the Ministry of Health and Social Welfare's website. B. Disclosure Requirements Date Environmental Assessment/Audit/Management Plan/Other: Was the document disclosed prior to appraisal? Yes Date of receipt by the Bank 02/16/2009 Date of "in-country" disclosure 03/09/2009 Date of submission to InfoShop 02/25/2009 For category A projects, date of distributing the Executive Summary of the EA to the Executive Directors Resettlement Action Plan/Framework/Policy Process: Was the document disclosed prior to appraisal? Date of receipt by the Bank Date of "in-country" disclosure Date of submission to InfoShop Indigenous Peoples Plan/Planning Framework: Was the document disclosed prior to appraisal? Date of receipt by the Bank Date of "in-country" disclosure Date of submission to InfoShop Pest Management Plan: Was the document disclosed prior to appraisal? Date of receipt by the Bank Date of "in-country" disclosure Date of submission to InfoShop * 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: 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? Yes If yes, then did the Regional Environment Unit or Sector Manager (SM) review and approve the EA report? Yes Are the cost and the accountabilities for the EMP incorporated in the credit/loan? Yes The World Bank Policy on Disclosure of Information Page 5 Have relevant safeguard policies documents been sent to the World Bank's Infoshop? Yes Have relevant documents been disclosed in-country in a public place in a form and language that are understandable and accessible to project-affected groups and local NGOs? Yes All Safeguard Policies Have satisfactory calendar, budget and clear institutional responsibilities been prepared for the implementation of measures related to safeguard policies? Yes Have costs related to safeguard policy measures been included in the project cost? Yes Does the Monitoring and Evaluation system of the project include the monitoring of safeguard impacts and measures related to safeguard policies? No Have satisfactory implementation arrangements been agreed with the borrower and the same been adequately reflected in the project legal documents? Yes D. Approvals Signed and submitted by: Name Date Task Team Leader: Mr Feng Zhao 06/02/2009 Environmental Specialist: Ms Lungiswa Thandiwe Gxaba 06/03/2009 Social Development Specialist Additional Environmental and/or Social Development Specialist(s): Approved by: Sector Manager: Mr Christopher J. Thomas 06/03/2009 Comments: