Page 1 ARAB REPUBLIC OF EGYPT May 22, 1998 International Development Association 1818 H Street, N.W. Washington, D. C. 20433 United States of America Re: Credit No. 3076-EGT (Health Sector Reform Project) Monitoring Indicators Dear Sirs and Mesdames: We refer to the Performance Indicators to be utilized by the Arab Republic of Egypt (the Borrower) pursuant to the provisions of Section 4(a) of Schedule 4 to the Development Credit Agreement for the above captioned Project, of even date herewith between us. We hereby confirm that the said Indicators shall consist of those set forth in the Attachment to this Letter, as the same may be amended with the agreement of the Association. Very truly yours, ARAB REPUBLIC OF EGYPT By /s/ Zafer El-Bishry Authorized Representative CONFIRMED: INTERNATIONAL DEVELOPMENT ASSOCIATION By /s/ Khalid Ikram Authorized Representative