MARIANNE FAY
Country Director
Bolivia, Chile, Ecuador and Peru


                                                                                               29-Jul-2021



          H.E. Simón Cueva
          Minister of Economy and Finance
          Ministry of Economy and Finance
          Av. Amazonas y Pereira
          Plataforma Financiera
          Quito, Ecuador

          Excellency,

          We refer to the Loan Agreement 9228-EC between the Republic of Ecuador (Borrower) and the
          International Bank for Reconstruction and Development (Bank) for the Additional Financing to the
          Ecuador COVID-19 Emergency Response and Vaccination Project.

          We are pleased to notify you that on April 16, 2021, the Bank has approved a modification to the
          eligibility threshold for COVID-19 vaccines under Bank-financed projects (Vaccine Approval
          Criteria, or VAC). According to the new VAC, the Bank accepts as eligible for inclusion in the
          Project COVID-19 vaccines that: (i) have received regular or emergency licensure or authorization
          from at least one of the SRAs identified by WHO for vaccines procured and/or supplied under the
          COVAX Facility, as may be amended from time to time by WHO; or (ii) have received WHO
          Prequalification or WHO Emergency Use Listing.

          We also refer to the definition of the term “Vaccine Approval Criteria”, included in the Appendix
          to the Loan Agreement, which allows for a change to the VAC to be agreed in writing between the
          Borrower and the Bank.

          We propose to apply the new VAC to the Project by modifying the referred definition of the term
          “Vaccine Approval Criteria” to read as follows:

                     “Vaccine Approval Criteria” means that the Project COVID -19 Vaccine: (a) has received
                     regular or emergency licensure or authorization from at least one of the Stringent
                     Regulatory Authorities identified by WHO for vaccines procured and/or supplied under the
                     COVAX Facility, as may be amended from time to time by WHO; (b) has received the
                     WHO Prequalification or WHO Emergency Use Listing; or (c) has met such other criteria
                     as may be agreed in writing between the Borrower and the Bank.

          The term “WHO Emergency Use Listing” would be understood to mean “a risk-based procedure
          for assessing and listing by WHO of unlicensed vaccines, therapeutics, and in vitro diagnostics
          with the aim of expediting the availability of these products to people affected by a declared public
          health emergency”.
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If you agree, please countersign two originals of this Letter Agreement, and return one
countersigned original of this Letter Agreement to us. You should keep the second countersigned
original for your records.

We look forward to working with you.


                                          Sincerely,



                         _____________________________________
                                        Marianne Fay
                                      Country Director
                              Bolivia, Chile, Ecuador and Perú


ACKNOWLEDGED AND AGREED BY:

REPUBLIC OF ECUADOR



By:
        Authorized Representative
              Carlos Iván Carrera
Name: ____________________________
                Subsecretary of Public Financing
Title: _____________________________
             29-jul.-2021
Date: _____________________________


cc:    Juan Carlos Alvarez, Resident Representative of The World Bank in Ecuador