Document of The World Bank Report No: 54515-KG RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF THE AVIAN INFLUENZA CONTROL AND HUMAN PANDEMIC PREPAREDNESS AND RESPONSE PROJECT (P099453) IDA GRANT H203 KG BOARD DATE: 9 FEBRUARY 2006 TO THE KYRGYZ REPUBLIC MAY __, 2010 ABBREVIATIONS AND ACRONYMS APIU Agricultural Projects Implementation Unit EMP Environmental Management Plan GP AI - Global Program for Avian Influenza HPAI - Highly Pathogenic Avian Influenza IDA - International Development Association ISDS - Integrated Safeguard Data Sheet MOA Ministry of Agriculture MOH - Ministry of Health PCC Project Component Coordinators PDO - Project Development Objective SDR Special Drawing Rights SVD - State Veterinary Department Regional Vice President: Philippe H. Le Houerou Country Director: Motoo Konishi Sector Manager: Dina Umali-Deininger Task Team Leader: Brian G. KYRGYZ REPUBLIC AVIAN INFLUENZA CONTROL & HUMAN PANDEMIC PREPAREDNESS & RESPONSE PROJECT CONTENTS Page SUMMARY PROJECT STATUS PROPOSED CHANGES ANNEX 1: RESULTS FRAMEWORK AND MONITORING 3 Restructuring Status: Submitted to SECPO Restructuring Type: Level one Last modified on date : 05/18/2010 1. Basic Information Project ID & Name P099453: AVIAN FLU (AICHPPCP) Country Kyrgyz Republic Task Team Leader Brian G. Bedard Sector Manager/Director Dina Umali-Deininger Country Director Motoo Konishi Original Board Approval Date 02/09/2006 Original Closing Date: 12/30/2010 Current Closing Date 12/30/2010 Proposed Closing Date [if applicable] EA Category B-Partial Assessment Revised EA Category B-Partial Assessment-Partial Assessment EA Completion Date 06/30/2006 Revised EA Completion Date 2. Revised Financing Plan (US$) Source Original Revised BORR 0.30 0.30 IDAT 4.00 4.00 JPN 1.00 1.00 ZBIL 0.10 0.10 Total 5.40 5.40 3. Borrower Organization Department Location Kyrgyz Republic Kyrgyz Republic 4. Implementing Agency Organization Department Location Ministry of Health (MOH) Kyrgyz Republic Ministry of Agriculture, Water Kyrgyz Republic Resources and Processing Industry (MAWRPI) i 5. Disbursement Estimates (US$m) Actual amount disbursed as of 06/17/2010 2.87 Fiscal Year Annual Cumulative 2010 0.00 2.87 Total 2.87 6. Policy Exceptions and Safeguard Policies Does the restructured project require any exceptions to Bank policies? N Does the restructured projects trigger any new safeguard policies? If yes, please select N from the checklist below and update ISDS accordingly before submitting the package. 7a. Project Development Objectives/Outcomes Original/Current Project Development Objectives/Outcomes The overall objective of the Project is to minimize the threat in the Kyrgyz Republic posed to humans and to the poultry industry by Highly Pathogenic Avian Influenza (HPAI) infection and to prepare for, control, and respond to an influenza pandemic. 7b. Revised Project Development Objectives/Outcomes [if applicable] The overall objective of the project is to minimize the threat in the Kyrgyz Republic posed by the Highly Pathogenic Avian Influenza (HPAI) infection as well as other poultry and livestock diseases and to prepare for the control and response to an influenza pandemic and other zoonotic or infectious disease emergencies in humans. ii AVIAN INFLUENZA CONTROL & HUMAN PANDEMIC PREPAREDNESS & RESPONSE PROJECT RESTRUCTURING PAPER SUMMARY 1. The proposed changes include (i) changes in the Project's Development Objective and project description to reflect proposed new activities under the project; (ii) re-allocation of the IDA Grant (H203 KG) proceeds to accommodate the proposed changes; (iii) a revised Results Framework reflecting the proposed changes to outcome and intermediate outcome indicators; and (iv) changes in the definition of "Operating costs" in the Appendix, Section I. Definitions, clause 13 on a retroactive basis to include the financing of insurance charges and employer's contributions to the social fund. The proposed changes of the Project's Development Objectives, project components, outcome indicators and budget re-allocation would allow the project to address other prevailing veterinary emergency issues in the country such as brucellosis, anthrax, rabies, TB, echinococcosis and others, while maintaining the original focus on avian influenza preparedness. PROJECT STATUS 2. The project is currently rated satisfactory. The activities completed to date have contributed to achieving the Project Development Objectives. The country is better prepared for a Highly Pathogenic Avian Influenza (HPAI) outbreak than prior to the project, but there are still some activities that need to be completed in order to finish this work. There is an increased public and institutional awareness, with the public having been informed mainly through broadcast media on the occurrence of the disease elsewhere in the region, and the State Veterinary Department (SVD) continues to raise awareness of staff at oblast and raion (regional) levels. In addition, considerable progress has been made towards achieving the project outcomes related to Animal Health and Human Health Components. The Agricultural Projects Implementation Unit (APIU) in the Ministry of Agriculture continues to effectively manage the project as the primary unit entrusted with the coordination of project activities, technical assistance and training, as well as with the fiduciary tasks of procurement and financial management. Currently, the project has disbursed SDR 1.86 million or 66% of the total IDA Grant of SDR 2.80 million. 3. The APIU is in compliance with the financial covenants under the project. The financial management arrangements of the project have been reviewed periodically as part of the project supervision and have been found satisfactory. The last supervision was performed in December 2009. According to the Financial Management Supervision results, the financial management arrangements of the project are satisfactory to the Bank and good internal control procedures are in place. The client is in compliance with the audit covenant: audit reports have been received by due dates and the auditor has given an unqualified opinion on the project financial statements with no serious internal control issues in the management letter. The overall FM risk for the project remains Substantial. PROPOSED CHANGES · Project's Development Objectives 4 · Components Original PDO: 4. The overall objective of the project is to minimize the threat in the Kyrgyz Republic posed to humans and to the poultry industry by Highly Pathogenic Avian Influenza (HPAI) infection and to prepare for, control, and respond to an influenza pandemic. Revised PDO: 5. The overall objective of the project is to minimize the threat in the Kyrgyz Republic posed by the Highly Pathogenic Avian Influenza (HPAI) infection as well as other poultry and livestock diseases and to prepare for the control and response to an influenza pandemic and other zoonotic or infectious disease emergencies in humans. 6. Although the improved preparedness with Project support has contributed to a reduced risk for Avian Influenza in the Kyrgyz Republic, there are other pressing animal and human health concerns that could be integrated with the ongoing avian influenza activities, including brucellosis, anthrax, rabies, TB, echinococcosis and others. Minor adjustments in the capacity building interventions under the project including technical assistance related to epidemiology, support for the national animal disease surveillance system, and public awareness would similarly address these serious problems while continuing to develop capacity to prevent Avian Influenza. In addition, the revision of the current PDO will allow for support to upgrade the existing vaccine storage facilities adjacent to the SVD headquarters to provide sufficient cold storage capacity for the national vaccination program. 7. The required changes in the project essentially involve a revision to the Project's Development Objectives and project components to allow the project to encompass some of these pressing issues, yet to preserve the integrity of the original Project design related to Avian Influenza. The initial Development Objectives and project components continue to be relevant and fully in line with the main objective of the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI). Expanding the scope of the Project Development Objectives, however, would lead to broadening the Project's impact on animal health issues and addressing the current emergency to incorporate other disease priorities while maintaining the original project design. 8. In accordance with the proposed revisions in the PDO, the following modifications are proposed to be made in the project components: Component 1 Animal Health: This component will support national prevention and control strategies to cover the country's needs in the short, medium or long term. It will support activities for: (i) enhancing prevention of HPAI and other zoonoses, and preparedness capability, (ii) strengthening of veterinary services, disease surveillance, diagnostic capacity and applied research, (iii) strengthening HPAI and other zoonoses control programs and outbreak containment plans, and improving bio-security in poultry production and trade. This component will also provide resources for a Compensation Fund to compensate owners of poultry and other domestic animals for the loss of assets caused by mandatory culling. Component 2 Human Health: This component targets the reduction of the impact of the virus of a pandemic influenza and other zoonoses through: (i) year-round surveillance; (ii) effective and accurate methods of diagnosis; (iii) social distance interventions; (iv) vaccines; 5 (v) anti-viral drugs; and (vi) strengthened medical services. It will support activities for: (i) enhancing public health program planning and coordination, (ii) strengthening of the national public health surveillance system, and (iii) strengthening health system response capacity. Component 3 Public Awareness and Information: This component is designed to promote awareness and improved coordination of the execution of the national action plan for control of Avian Influenza and other zonoses. Information and communication activities to increase the attention and commitment of government, the private sector and civil society organizations and raise awareness, knowledge and understanding among the general population about the risk and potential impact of a pandemic. It will also support the Country Multi-sectoral Coordination Committee on Socially Significant and Dangerous Diseases in its roles of triggering emergency responses by the Ministry of Agriculture and the Ministry of Health, monitoring the actions taken by them, coordinating public statements to the media, and executing project evaluation activities. Component 4 Implementation Support and Monitoring and Evaluation: [the component description remains unchanged] Component 5 Emergency Imports: In case of a declared pandemic of influenza or any other zoonoses, this component will finance emergency imports identified as necessary under a well-defined preparedness and response program to be prepared as part of project implementation. These imports are likely to include: (i) pharmaceuticals and vaccines, (ii) medical and veterinary supplies and equipment, (iii) communication equipment, supplies and information campaigns, and (iv) protective gear and clothing. · Results/indicators 9. Neither the change of Project's Development Objectives, nor the reallocation of proceeds would require revision of the project outcomes. The outcomes continue to be relevant and significant; the indicators would serve as the proxies to track the expanded scope of the project. The additional outcome indicators would be added to monitor the impact of reduced incidence of zoonotic diseases in the Kyrgyz Republic. The suggested new indicators would be: (i) data collection and reporting including outbreak reporting, annual prevalence data; (ii) increased number of animals vaccinated; and (iii) increased number of private veterinarians delivering vaccination on a fee basis ( Revised Results Framework and Monitoring is provided in Annex I). · Safeguards 10. The SVD made specific requests for support to upgrade the existing vaccine storage facilities adjacent to the SVD headquarters to provide sufficient cold storage capacity for the national vaccination program. The project team agreed with this proposal and requested detailed cost estimates for these additional civil works. Although the storage would provide for HPAI vaccine if deemed necessary, it was recognized that this facility would be used primarily for other animal vaccines such as anthrax, rabies, brucellosis and, as such, could only be accommodated through a restructured project. Minor environmental disturbances may occur during upgrading of the vaccine storage facilities in Bishkek. The current ISDS has been updated to reflect this new activity. The project's Environmental Management Plan (EMP) has been also updated to include the Annex on the monitoring and mitigation measures for minor renovation works. Both ISDS and EMP have been disclosed to Infoshop; the updated EMP has been also disclosed in country. 6 o Reallocations Category of Expenditure Allocation (SDR) % of Financing Current Revised Current Revised Current Revise (1) Goods (1) Goods 804,000 1,630,000 100% 100% (2) Civil works (2) Civil works 56,000 100,000 100% 100% (3) Consultants services, (3) Consultants services, 390,000 390,000 100% of local 100% of local including audit and including audit and expenditures, expenditures, training training and 90% of and 90% of foreign foreign expenditures expenditures (4) Operating costs (4) Operating costs 320,000 265,000 100% 100% (5) Compensation Fund (5) Compensation Fund 700,000 415,000 100% 100% in accordance with in accordance with Part Part I.2 of the Project I.2 of the Project (6) Eligible imported 320,000 0,00 100% goods and commodities required for the Projects as specified in Section IV.C of this Agreement (7) Unallocated 210,000 0,00 100% Total amount 2,800,000 2,800,000 · Procurement The Procurement Plan has been revised by the APIU to reflect the proposed re-allocations between the disbursement categories and will be provided to the Bank for No Objection upon approval of the Restructuring. · Others (changes to the Financing Agreement) Furthermore, it is proposed to amend the definition of "Operating Costs" in the Appendix to the Financing Agreement to include the retroactive financing of insurance charges and employer's contributions to the social fund as follows: "Operating cost" means incremental expenses incurred by MAWRPI, MoH, APIU and PCCs on account of Project implementation such as the costs of communication, printing and publication, supplies, operation and maintenance of vehicles, banking fees, local travel costs and field trip expenses, as well as insurance contributions by employees incurred after April 27, 2006 and employer's deductions to the Social Fund incurred after April 27, 2006, and such other reasonable expenditures as may be agreed with the Association, all based on annual budget that shall be prepared by the APIU and shall have been approved by the Association." 7 ANNEX 1: Results Framework and Monitoring KYRGYZ REPUBLIC: AVIAN INFLUENZA CONTROL & HUMAN PANDEMIC PREPAREDNESS & RESPONSE PROJECT Intermediate Results Intermediate Result (Component I.B.): Animal disease surveillance and diagnostic capacities strengthened and training of the veterinary services designed and completed Evidence of timely and satisfactory progress toward delivery of Component I.B outputs, including specific indicators as follows: · Laboratory equipment and materials are procured, distributed and installed; · Staff is trained in surveillance and diagnostic methods; · Reporting and reaction time for suspected cases of AI is reduced to the minimally acceptable levels; · 75% average monitoring coverage in at-risk areas Revised Intermediate Result (Component I.B.): Animal disease surveillance and diagnostic capacities strengthened and training of the veterinary services designed and completed Evidence of timely and satisfactory progress toward delivery of Component I.B outputs, including specific indicators as follows: · Laboratory equipment and materials are procured, distributed and installed; · Staff is trained in surveillance and diagnostic methods; · Reporting and reaction time for suspected cases of AI is reduced to the minimally acceptable levels; · 75% average monitoring coverage in at-risk areas; · Data collection and reporting including outbreak reporting, annual prevalence data Intermediate Result (Component I.C.): Outbreak Containment Plan prepared and activated as needed in response to AI outbreaks Evidence of timely and satisfactory progress toward delivery of Component I.C outputs, including specific indicators as follows: · Emergency supplies procured and available at strategic locations in the field; · If appropriate, ring vaccination around infected areas completed; · Culling, disposal and disinfection activities completed as needed; · Compensation provided to poultry owners rapidly and in a monitorable way Revised Intermediate Result (Component I.C.): Outbreak Containment Plan prepared and activated as needed in response to AI outbreaks Evidence of timely and satisfactory progress toward delivery of Component I.C outputs, including specific indicators as follows: · Emergency supplies procured and available at strategic locations in the field; 8 · If appropriate, ring vaccination around infected areas completed; · Culling, disposal and disinfection activities completed as needed; · Compensation provided to poultry owners rapidly and in a monitorable way · Increased number of animals vaccinated; · Increased number of private veterinarians delivering vaccination on a fee basis 9