Document of The World Bank Report No: 77534-GLB PROJECT PAPER FOR SMALL RETF GRANT (US$ 3.120 MILLION EQUIVALENT) TO THE WORLD ORGANISATION FOR ANIMAL HEALTH (OIE) FOR A National Human and Animal Health Systems Assessment Tools and Bridges April 22, 2013 CURRENCY EQUIVALENTS Currency Unit = US$ FISCAL YEAR Jan 1 – Dec 31 ABBREVIATIONS AND ACRONYMS AHIF Avian and Human Influenza Facility CDC Centers for Disease Control (US) DGF Development Grant Facility FAO Food and Agriculture Organization IHR International Health Regulation OIE World Organisation for Animal Health PAHO Pan American Health Organization (Regional Office of the WHO) PVS Performance of Veterinary Services WAHWF World Animal Health and Welfare Fund WHO World Health Organization Regional Vice President: Rachel Kyte Sector Director: Juergen Voegele Sector Manager: Sari Soderstrom Task Team Leader: Francois Le Gall COUNTRY Project Name TABLE OF CONTENTS Page I. STRATEGIC CONTEXT .................................................................................................7 A. Country Context ............................................................................................................ 7 B. Sectoral and Institutional Context ................................................................................. 7 C. Higher Level Objectives to which the Project Contributes .......................................... 9 II. PROJECT DEVELOPMENT OBJECTIVES ..............................................................10 A. PDO............................................................................................................................. 10 B. Project Beneficiaries ................................................................................................... 10 C. PDO Level Results Indicators ..................................................................................... 11 III. PROJECT DESCRIPTION ............................................................................................11 A. Project Components .................................................................................................... 11 B. Project Financing ........................................................................................................ 14 Instrument ......................................................................................................................... 14 Project Cost and Financing ............................................................................................... 14 IV. IMPLEMENTATION .....................................................................................................15 A. Institutional and Implementation Arrangements ........................................................ 15 B. Results Monitoring and Evaluation ............................................................................ 16 C. Sustainability............................................................................................................... 16 V. KEY RISKS AND MITIGATION MEASURES (if required by concept note) ........16 A. Risk Ratings Summary Table ..................................................................................... 16 B. Overall Risk Rating Explanation ................................................................................ 17 VI. APPRAISAL SUMMARY ..............................................................................................17 DATA SHEET World National Human and Animal Health Systems Assessment Tools and Bridges Small RETF Grant Project Paper . World AES . Basic Information Date: April 22, 2013 Sectors: AES, HNP Country Director: Themes: Health – Animal Production Sector Manager/Director: Sari Soderstrom / Juergen Voegele EA Category: C Project ID: P133572 Instrument: RETF Team Leader(s): Francois Le Gall . Recipient OIE (World Organisation for Animal Health) Executing Agency: OIE Contact: Alain Dehove Title: Coordinator of the World Animal Health and Welfare Fund Telephone No.: +33 (0)1 44 15 19 63 Email: a.dehove@oie.int . Project Implementation Period: Start Date: April 30, 2013 End Date: April 30, 2014 Expected Effectiveness Date: April 30, 2013 Expected Closing Date: April 30, 2014 . Project Financing Data(US$M) [ ] Loan [x] Grant [ ] Other [ ] Credit [ ] Guarantee For Loans/Credits/Others Total Project Cost : 3.12 Total Bank Financing : 3.12 Total Cofinancing : Financing Gap : 0 . Financing Source Amount(US$M) BORROWER/RECIPIENT IBRD IDA: New IDA: Recommitted Others AHI Facility Trust Funds US$M 3.12 Financing Gap Total US$M 3.12 . Expected Disbursements (in USD Million) Fiscal Year 13 Annual 3.12 Cumulative 3.12 . Project Development Objective(s) The objective of this Grant is to support the development and refinement of harmonized operational assessment tools and guide by leading international organizations on human and animal health. This would contribute to increase capacity of countries to address priority diseases, including zoonoses and pandemic threat, and build synergies among human and animal health systems. Those tools and guide based on international standards and regulations would have a strong focus on cross-sectoral activities and cooperation areas to effectively address key diseases and issues causing negative public health impacts. The joint WHO/OIE operational guide would be developed using experience from 2 to 3 pilot countries. Such tools and guide would then be available to all countries in all regions, as well as to donors and partners. They would allow benchmarking human and animal health system performance and guide the development of appropriate strategies and programs based on sound analyses to sustainably strengthen systems and optimally address national cross-cutting human and animal health priorities.. . Components Component Name Cost (USD Millions) Development of tools for further deployment and implementation of WHO 750,200 IHR Refinement of OIE PVS Pathway tools 1,000,000 Development of an operational Guide for countries on Good Governance 1,169,800 of human and animal health services Management, coordination, monitoring and evaluation 200,000 . Compliance Policy Does the project depart from the CAS in content or in other significant respects? Yes [ ] No [x ] . Does the project require any exceptions from Bank policies? Yes [ ] No [x ] Have these been approved by Bank management? Yes [ ] No [ ] Is approval for any policy exception sought from the Board? Yes [ ] No [ ] Does the project meet the Regional criteria for readiness for implementation? Yes [ ] No [ ] . Safeguard Policies Triggered by the Project 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 Waters OP/BP 7.50 x Projects in Disputed Areas OP/BP 7.60 x . Legal Covenants Name Recurrent Due Date Frequency Description of Covenant . Team Composition Bank Staff Name Title Specialization Unit UPI Francois Le Gall Adviser Team Leader AES 85554 Maryse B. Pierre-Louis Lead health specialist HDNHE 20855 Olga Jonas Economic adviser HDNHE 15263 Brian Bedard Sr Livestock specialist ECSAR 311011 Caroline Plante Livestock specialist AES 399637 Madhavan Balachandran Sr Financial management FEUCA 200947 specialist Jay Pascual Counsel LEGCF 304441 Non Bank Staff Name Title Office Phone City Seyoum Solomon Procurement specialist (301) 330-4740 Washington, DC . Locations Country First Administrative Location Planned Actual Comments Division World . I. STRATEGIC CONTEXT A. Country Context 1. In order to protect people and livestock against major health threats with the potential to spread internationally, to adversely affect human and economic development and interfere with international trade and movements, countries need to have in place adequate systems to effectively prevent and control infectious diseases, including zoonotic diseases. Knowing that around 60% of all human diseases and around 75% of emerging infectious diseases are zoonotic (transmissible from animals to humans), not only human and animal health systems need to be strong, but they also have to work in close partnership to address common issues as effectively and efficiently as possible. This will reduce the risks of health and income shocks caused by unchecked disease outbreaks, including the potentially catastrophic global impacts of pandemics. It is estimated that together, 56 zoonoses are responsible for an estimated 2.7 human million deaths and around 2.5 billion cases of human illness a year. For the top 13 zoonoses, the figures give 2.2 million human deaths and 2.4 billion cases of illness (source DFID 2012). The WB estimated that a severe pandemic could cost $3 trillion globally, comparable to the 2008 global financial crisis. 2. Strengthening surveillance, reporting and response capacity are common requirements for both human and animal health services, and form part of international standards developed by the WHO (World Health Organization) and the OIE (World Organisation for Animal Health) in the International Health Regulation (IHR) and in the Terrestrial and Aquatic Codes and Manuals respectively. 3. However, many countries, in particular developing countries, continue to face challenges in fulfilling minimum core requirements developed by WHO and OIE and fail to implement efficient strategies and programs due to inadequate structures and resources. Strengthening governance of such systems is therefore essential for countries to be able to address their weaknesses in a sustainable manner and to reduce risks to animal and human health, economies, trade, nutrition, food safety, and food security. Such risks cross borders and if not addressed, can impact entire regions, continents, and the world. Assessments of such systems are also key for donors and partners because the efficiency and sustainability of the projects and programs they support critically depend on the quality of governance of national systems. Appropriate tools and guidance are needed for individual countries to evaluate objectively their situation and address deficiencies and to comply with international requirements. As a matter of fact those international organizations are the best placed to provide guidance to countries to achieve these common global objectives and the WHO and OIE have joined forces in this effort, using a “One Health”1 approach. B. Sectoral and Institutional Context 4. Two main global institutions (WHO and OIE) are responsible for international standards affecting human and animal health. 1 One Health is a framework for addressing disease risks at the interfaces between humans, animals and the environment. To reduce these risks, including those of a pandemic, countries need high quality systems for veterinary and human health and enhanced collaboration among these systems. 7 5. WHO is the international organization establishing public health regulations which are laid down in the IHR (2005). According to this document, countries should have developed, strengthened and maintained no later than 5 years from its entry into force (15 June 2007) the capacity to detect, assess, notify and report events in accordance with these Regulations, and the capacity to respond promptly and effectively to public health risks and public health emergencies of international concern. WHO established a list of minimum core public health capacities to guide effective implementation of the IHR, and provided a checklist and indicators to countries so that they could assess their degree of compliance. Acknowledging difficulties faced by countries to set up effective systems complying with international requirements, the WHO may accept a two year extension on the mandatory timeline, should countries deliver a convincing work plan. In this context, WHO plans to further develop operational tools for countries to help them address gaps identified and for planning and budgeting purposes to meet their obligations in the development and maintenance of IHR core capacities in the area of infectious disease surveillance and response. WHO would in particular readjust the WHO/IHR current capacity assessment tool to i) better include zoonoses in the core public health performance assessment and ii) propose a similar operational approach as OIE based on review of capacities, strategies to address gaps and costs associated. 6. In accordance with the WTO Agreement on the Application of Sanitary and Phytosanitary measures (SPS Agreement), the OIE is the international organization responsible for developing standards, guidelines and recommendations for animal health and zoonoses. Those are mainly laid down in the Terrestrial and Aquatic Animals Codes and Manuals. In order to achieve the sustainable improvement of national Veterinary Services' compliance with those standards, in particular on the quality of Veterinary Services, the OIE has developed the Performance of Veterinary Services (PVS) Pathway, which includes different tools for countries to objectively assess and address the main weaknesses of their Veterinary Services. The tools include, in particular, the OIE PVS Tool (qualitative assessment of level of compliance with standards on quality of Veterinary Services), the PVS Gap Analysis tool (qualitative and quantitative assessment of priorities and investments needed to address identified key gaps), and others to determine the scope and costs of reform and upgrading and, for example, the modernization of veterinary legislation. A pilot PVS One Health tool has been developed that would be integrated into the OIE PVS tool and manual for assessors through the project. Many countries (120) have already requested OIE’s support to conduct these evaluations and have benefitted from the program, but those tools need continuous refinement and updates to take recent developments into account, including strengthening cooperation with other national authorities, public health services in particular. 7. These international organizations responsible for setting such standards are committed to develop and expand appropriate tools and collaborate across the sectors, where appropriate, to support countries to improve public health and animal health globally. During the last decade, dialogue amongst international organizations and joint events to address common topics have grown continuously. In a context of globalized world, it is essential that such cooperation and synergies be also built at national level to best address existing and (re)emerging threats of both national and international importance. 8. The World Bank has been actively involved and instrumental in pushing this agenda forward. It had a catalytic role at institutional level through its continuous dialogue with the international and regional organizations involved and its pro-active participation in international 8 fora on human health, animal health and “One Health”. Recognizing the global public good character of the program developed by the OIE since 2005 to strengthen the governance of Veterinary Services worldwide, the World Bank was the first organization to contribute through a 3 year DGF Grant (2006-2008) to the OIE World Animal Health and Welfare Fund (“OIE World Fund”) established to finance projects supporting the achievement of this goal. This helped leverage other donors’ contributions and led to a successful take off of the program. Building on this experience, and taking advantage of the governance structure of the OIE Fund, the project would use the same OIE institutional framework to include WHO above mentioned initiatives and foster cross-sectoral work. 9. The World Bank was also a key actor in the global coordinated response towards H5N1 highly pathogenic avian influenza since 2005, and helped to frame a multisectoral approach under the GPAI (Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response), building on OIE/FAO and WHO strategies, that brought to bear international expertise in human health and animal health, analytical and technical support, and development communication to underpin comprehensive and integrated country-led responses to HPAI that were implemented in 72 operations totaling $1.3 billion. 10. At corporate level, it has been a strong advocate of systemic and cross-sectoral approaches: e.g. increasingly, pre-operational tools like PVS Pathway reports have been utilized and provided strong ground for World Bank’s project preparation, as they are fully owned by countries and “certified” by the reference organization. The World Bank has also developed various cross-sectoral projects, often building on Avian Influenza projects achievements, e.g. in Central Asia, Eastern Europe and South Asia, promoting a “One Health” approach, using existing reference tools (PVS Pathway) and developing others (in particular a public health assessment tool used in a Central Asia project and developed in cooperation with CDC and PAHO) to address country priorities. This practical experience would be shared within this project, be it to further develop the tools or to pilot them. Strategically, the World Bank has recently developed policy documents such as the recent Public Health Policy Note that will be an important vehicle fostering interactions within the World Bank at the human and animal interface and an important element to ensure operationalization of this Grant going forward. To that aim the World Bank would take full advantage of the products developed through this Grant to develop its own corporate operational framework on human and animal health governance that would, in the spirit of GPAI, target task teams and guide them in building human and animal health projects. C. Higher Level Objectives to which the Project Contributes 11. The project would contribute to strengthen governance of national veterinary and public health services needed to improve human and animal health globally. This would ultimately reduce the overall social and economic burden of existing and future diseases and contribute to improved livelihoods and sustainable development. 9 II. PROJECT DEVELOPMENT OBJECTIVES A. PDO 12. The objective of this Grant is to support the development and refinement of harmonized operational assessment tools and guide by leading international organizations on human and animal health. This would contribute to increase capacity of countries to address priority diseases, including zoonoses and pandemic threat, and build synergies among human and animal health systems. 13. Those tools2 and guide based on international standards and regulations would have a strong focus on cross-sectoral activities and cooperation areas to effectively address key diseases and issues causing negative public health impacts. The joint WHO/OIE operational guide would be developed using experience from 2 to 3 pilot countries. Such tools and guide would then be available to all countries in all regions, as well as to donors and partners. They would allow benchmarking human and animal health system performance and guide the development of appropriate strategies and programs based on sound analyses to sustainably strengthen systems and optimally address national cross-cutting human and animal health priorities. B. Project Beneficiaries 14. The ultimate beneficiaries would be the countries that would be able to use harmonized and internationally recognized tools and methodologies developed by the relevant international agencies to objectively assess their situation and evaluate necessary investments needed to progressively reach international standards requirements within their national and regional strategies framework. The project would also help build synergies between human and animal health services to address cross-sectoral public health issues in the countries using the tools and guide. 15. The international organizations mandated for human and animal health would benefit from the project by supporting their efforts to jointly addressing weaknesses in national veterinary and public health services, through the development, piloting and implementation of specific complementary tools and operational guide at the animal-human interface. 16. The international as well as regional donors and technical partners community would also benefit from the project. Implementation of common tools and methodologies in countries would provide them with reliable, comprehensive and comparable elements needed to inform project design and tailor their technical and financial support, aligning national priorities and strategies with global public goods and international standards requirements. 2 OIE has developed the OIE PVS Tool (qualitative assessment of level of compliance with standards on quality of Veterinary Services) and the PVS Gap Analysis tool (qualitative and quantitative assessment of investments needed to address identified key gaps) that would be further refined. The pilot PVS One Health tool will be integrated into the Manual for PVS assessors. WHO would readjust the WHO/IHR current capacity assessment tool to i) better include zoonoses in the core public health performance assessment and ii) propose a similar operational approach as OIE based on review of capacities, strategies to address gaps and costs associated. 10 C. PDO Level Results Indicators 17. Due to the short duration of the project, only outputs would be measurable. They would contribute to outcome that could be monitored after project closure in particular through the OIE World Fund Steering Committee chaired by the World Bank. Outputs expected under this project would include : - Improved harmonization of WHO and OIE tools and common guide - Better coordination and collaboration of human and animal health sectors at national and institutional levels - Better visibility and awareness of human and animal health systems importance and processes to support them III. PROJECT DESCRIPTION A. Project Components (a) Component 1 : Development of tools for further deployment and implementation of WHO IHR 18. The development objective of Component 1 of the program is to support the development of analytical tools on human health systems. These tools would help countries and the WHO evaluate main gaps and identify ways and costs to address them in a sustainable manner. This would contribute to the global improvement of human health system governance and in particular implementation of IHR requirements. 19. A WHO costing tool prototype would be developed, based on a detailed review of the operational capacities to deliver the IHR mandatory outcomes, and necessary investments needed to achieve and sustain expected capacity levels using an approach comparable to the PVS Pathway. 20. A readjustment of the WHO/IHR assessment tool would also be made to better approach zoonoses in the core public health performance assessment, to better consider the outputs/outcomes of the PVS Pathway missions at country level, and to propose a similar Gap Analysis approach based on the review of capacities, strategies to be improved and the corresponding costs associated. Additionally, specific activities conducted by WHO would be reviewed and improved to better address the human-animal interface; this includes (i) the review of the WHO Laboratory Assessment Tool, (ii) antimicrobial resistance (AMR) laboratory based surveillance, and (iii) laboratory quality management system. 21. Workshops and Trainings for WHO experts in the regions would be needed for these revisions. These tools would be validated by WHO with their regional offices. 22. Participation of WHO experts in OIE PVS Pathway missions would ensure mutual understanding of processes to strengthen systems and foster cross-sectoral cooperation. (b) Component 2 : Refinement of OIE PVS Pathway tools 23. The development objective of Component 2 of the program is to support the refinement of the tools developed by the OIE to strengthen animal health services. These tools include in 11 particular the OIE PVS Tool designed to evaluate the level of compliance of Veterinary Services with OIE international standards (qualitative assessment) and the PVS Gap Analysis Tool which identifies the strategic priorities for the country and related investments needed to reach a defined level of advancement (qualitative and quantitative assessment). Additionally, a specific tool still in draft form aimed at addressing the laboratory sector would be further developed. 24. More emphasis would be placed on the tools and attached methodologies on cross-sector areas of collaboration with the human and environmental sectors (starting with wildlife aspects, to be later expanded based on the recommendations of the concept note on environment integration to the work on human/animal interface developed under the project) to better address the interface. The specific pilot PVS One Health Tool which has already been tested by the OIE in three pilot countries would be further refined and fully integrated into the Manual for PVS Assessors to provide countries with possible in-depth evaluation of Veterinary Services focused more on public health issues at the human-animal interface. The new PVS Gap Analysis Tool (2013 Edition) would also be aligned with this revised version of the PVS Manual. This revised PVS Manual would be used systematically when carrying out new initial PVS evaluations or regular PVS Pathway follow-up evaluations to monitor progress made and to conduct a more detailed review of the public health functions of Veterinary Services. 25. An OIE PVS Gap Analysis tool on Veterinary Laboratories is currently prepared at a pilot scale. This tool prototype, which aims at complementing the main OIE PVS Gap Analysis Tool and addressing the management strategies and networking systems of the veterinary laboratory services, would be further developed and tested to identify best option(s) to improve the functioning of the Veterinary Laboratory system in meeting the needs of the National Veterinary Services and to comply with international standards. The OIE PVS Gap Analysis tool on Veterinary Laboratories would complement the WHO Laboratory Assessment Tool and vice versa. 26. Training of PVS Pathway experts and staff of the respective organizations would ensure full awareness of tools improvements, and the adequate implementation of such tools in countries focusing more the added public health issues at the human-animal interface, as well as capacity to advocate for optimum cross sector work to address diseases and issues of common interest. 27. The OIE would continue to engage countries in the implementation of the PVS Pathway as a continuous process in order to sustainably improve the compliance of Veterinary Services with international standards of quality. This would involve follow-up missions in any country requesting such support to the OIE, using the most updated tools and methodologies. 28. Participation of OIE experts in WHO IHR missions would ensure mutual understanding of processes to strengthen systems and foster cross-sectoral cooperation. 29. A workshop would be organized with OIE and World Bank experts to explore how to better use the outputs of PVS Pathway missions at country level and to prepare a document facilitating the preparation of projects and investments at country level on the basis of these outputs. Such workshop would build on existing PVS Gap Analysis mission reports as well as OIE and World Bank task teams feedback to facilitate the incorporation of PVS Gap Analysis missions’ outputs into World Bank project design. Such process could later be replicated with WHO once implementation of their tools at country level would be at a more advanced stage. 12 (c) Component 3 : Development of an operational guide for countries on good Governance of human and animal health services 30. The development objective of Component 3 of the program is to prepare an operational guide for countries highlighting ways to improve national veterinary and public health services governance, and identify bridges between them. In the context of PVS and IHR sustainable capacity building activities, the joint WHO/OIE Guide would provide all relevant information on key animal health and human health requirements, standards and good governance principles, references documents, processes and methodologies available to assess systems and address deficiencies. This document would attempt to identify main possible “bridge points” between animal health services (Veterinary Services) and human health services and outline when and how the parties responsible might jointly identify and strategize on their national priorities to “bridge” and therefore improve governance related to the identified priority areas. The Guide could be used by countries to support the preparation of investments at country level or by the World Bank in conjunction with its forthcoming operational framework to develop projects 31. The Guide would be composed in particular of WHO and OIE comprehensive operational manuals that would clarify how to roll out the above described tools of WHO and OIE (components 1 and 2) and sustain the coordination of efforts and efficient use of resources. These documents would benefit from previous experiences conducted at country and regional level. They would be validated by both organizations and would be disseminated and explained to the countries. 32. The preparation of these manuals and Guide would require the organization of national workshops in at least 3 pilot countries in 2 regions (Eastern Europe and South and East Asia – see table 1). Taking stock of the outcomes of the relevant Stone Mountain Workgroups and of the Central Asia One Health Project carried out by the World Bank, these workshops would foresee contributions mainly from WHO and OIE experts from HQ and regional levels and would include the participation of World Bank experts. The participation of those pilot countries would provide the opportunity to share their views and results from the assessments conducted in respectively the human health (IHR monitoring) and animal health (PVS pathway missions) sectors. In order to guaranty optimal return from experience, pilot countries would be selected among countries that are relatively advanced in the implementation of the PVS Pathway missions and/or the IHR assessments, that have confirmed an interest in the work at the human- animal interface (One Health approach) and/or in which World Bank projects are under preparation on the basis of the recommendations of the PVS Pathway and IHR assessments. Table 1. Candidate Countries for Pilot Assessments under this Project AHI Facility East & South Asia Window (TF070533) Eastern Europe Window EC Trust Fund window Countries: (TF070541) Countries World Bank Region East Asia and Pacific South Asia Region Europe and Central Asia Region (EAP) (SAR) Region (ECA) Eligibility under Trust Cambodia Afghanistan Armenia Fund Window China Bangladesh Azerbaijan Indonesia Bhutan Belarus Laos India Georgia Malaysia Maldives Moldova Mongolia Nepal Russia 13 Myanmar Pakistan Ukraine Philippines Sri Lanka Thailand Vietnam 33. Regular consultation with the World Bank would take place during the development process of the Guide to ensure that it would ultimately be relevant not only to the countries but also to the World Bank that would use the Grant outputs to develop its operational framework for task teams wishing to prepare projects in countries to strengthen animal and human health systems and improve their collaboration. Although the final version of the Guide may not be available by the end of the project, feedback and lessons learned from the workshops would provide valuable elements for the development of an intermediary framework/concept note that would serve as a basis to finalize the Guide. 34. The project would also contribute to the preparation of a document establishing various options on how to further work and integrate the environment sector in the assessments and coordination activities to address the animal-human-ecosystems interfaces triangle. 35. In order inform a large audience of public health, agriculture and environment specialists of the World Bank, a final workshop would be organized to explain and widely disseminate project outputs. This would ensure a full understanding of existing global and corporate strategies to strengthen governance of human and animal health systems as well as refined or newly developed tools available to support project preparation and design. This workshop would involve OIE and WHO senior staff and experts involved in project implementation, World Bank anchor and regional operational staff as well as European Commission representatives. (d) Component 4 : Management, coordination, monitoring and evaluation 36. The development objective of Component 4 would be to ensure the overall management of the program. This would include planning, monitoring, coordination, communication and reporting activities. Visibility rules of Donors and partners concerned would be taken into consideration. 37. This Component would also include an independent external audit of the program. B. Project Financing Instrument 38. The project would be financed through a Grant from two windows (East and South Asia and Eastern Europe) of the European Commission Avian and Human Influenza Trust Fund. Project Cost and Financing 39. The total project cost would be US$3.12 million. 14 Project Components Project cost Grant Financing % Financing 1. Development of tools for the 750,200 750,200 100 further deployment and implementation of the WHO IHR 2. Refinement of OIE PVS 1,000,000 1,000,000 100 Pathway tools 3. Development of an operational 1,169,800 1,169,800 100 Guide for countries on Good Governance of human and animal health services 4. Management, Coordination, 200,000 200,000 100 evaluation, monitoring and evaluation Total Baseline Costs Physical contingencies Price contingencies Total Project Costs 3,120,000 3,120,000 100 Interest During Implementation Front-End Fees Total Financing Required 3,120,000 3,120,000 100 IV. IMPLEMENTATION A. Institutional and Implementation Arrangements 40. This project would be implemented by the OIE (World Organisation for Animal Health) and WHO (World Health Organization). The OIE, as recipient of the Grant will be held accountable for the whole project implementation. Component 1 would be implemented by WHO, component 2 would be implemented by the OIE, and components 3 and 4 would be implemented by both the OIE and WHO. 41. In order to clarify financial flow of funds and disbursement conditions, monitoring and evaluation, as well as reporting requirements and mechanisms, the two organizations would sign a subsidiary agreement that will be reflected in the Grant Agreement. In particular, WHO activities and expenditures would be reported to the OIE and the OIE would incorporate these elements in their report to the World Bank. 42. A detailed budget attached in annex 3 and a simplified procurement plan will have been established and approved before project starts. 15 B. Results Monitoring and Evaluation 43. The OIE would send to the World Bank a 6 monthly report, within 30 days after the end of the period. As the project duration would be very short (around 1 year), the second report would correspond to a final report. 44. An external financial audit would be conducted at the end of the project and the report would be submitted to the World Bank within 6 months from the Grant closing date. 45. Supervision would be conducted as desk review. If the risk assessed would change during such review, a field mission would be conducted and reported. C. Sustainability 46. There is no sustainability issue as the activities developed through the Grant would continue to be supported and developed by the 2 international organizations involved as part of their global support to their member states. V. KEY RISKS AND MITIGATION MEASURES (IF REQUIRED BY CONCEPT NOTE) A. Risk Ratings Summary Table Stakeholder Risk Risk Rating Mitigation measures Implementing Agency Risk Capacity Low Governance Low Project Risk Design Moderate Two organizations would be jointly and equally involved in the implementation of the project activities. Procedures would be established between the OIE and WHO in order to clarify respective responsibilities and activities for this project, including financial and procurement management, as well as monitoring and reporting Social and Environmental Low Program and Donor Low Delivery Monitoring and Sustainability Low Other : Timeframe Substantial The impossibility to extend the closing date of the AHIF will place a major time constraint on both organizations. Detailed prior consultations and strong commitment of WHO and OIE to carry out these activities, that would be continued even after project closure, would help move forward as rapidly as possible. The task team together with the Recipient and WHO have discussed all deliverables and assigned for each of them a 16 completion stage (initiated, advanced draft, completed). Overall Implementation Risk Moderate B. Overall Risk Rating Explanation 47. The international organizations involved (OIE and WHO) have well established organizational, financial and reporting procedures. They have concluded cooperation agreements with many other international and regional organizations and have long been implementing capacity building projects globally with proven efficacy. Activities supported by the Grant would be sustainable as they would be continuously embedded into those organizations technical support programs and continuously improved in the interest of countries and their developing partners. VI. APPRAISAL SUMMARY 48. All economic studies available concur to say that prevention is far less costly than response to disease outbreaks. The recent World Bank report, People, Pathogens and Our Planet: The Economics of One Health (Vol 2- June 2012) explains in particular that benefits far exceed costs of One Health investments in all plausible scenarios: for instance, if the international community invests [in One Health systems] at the upper end of the range (US$3.4 billion per year), the annual expected rate of return would be between 44 % and 71 % (corresponding to, respectively, half or all mild pandemics being prevented). The World Bank also financed studies conducted by the OIE in 2006 and 2007 including on prevention versus outbreak costs that made similar demonstrations. Good governance is key to ensure optimally functioning national human and animal health systems, able to rapidly detect and respond to emerging or reemerging diseases wherever they occur and to ensure a high sanitary status level through appropriate prevention and control policies. To build sustainable systems in line with international standards, countries need to objectively identify their strengths and weaknesses and evaluate and cost their needs to address gaps. The project would support WHO and OIE, the 2 reference international organizations dealing with human and animal health respectively to develop and advance IHR (International Health Regulations ) and PVS (Performance of Veterinary Services) -related tools and processes in order for countries to be able to objectively assess their situation in terms of compliance with human and animal health regulations and standards and to invest to ensure sustainable improvement of human and animal health, including through joint efforts where relevant. Activities supported by the project would mainly include (i) international experts work to develop the respective tools and the joint operational guide; (ii) trainings and workshops to get feed-back from the regions and countries on the proposed tools and approaches and to ensure a broad and common understanding of WHO and OIE program to strengthen governance of public health and veterinary services globally; and (iii) in-country missions to test and refine the tools being developed. Products developed through this Grant would benefit both countries and donors and partners, which would be able to optimize their investments and eventually reduce costs through improved prevention and control of human and animal diseases. 49. The OIE would be the recipient of the Grant and would implement defined activities with the WHO according to an agreed financial plan. Procurement plan and guidance in line with the 17 World Bank policies would be followed by the OIE. A subsidiary agreement signed between the OIE and WHO would establish responsibilities and detailed conditions regarding financial, procurement and reporting issues for both organizations. No issues were identified with regard to financial or procurement aspects. This project would not trigger any safeguard policies. 50. The ORAF is attached in annex 2 and budget in annex 3. 18 Annex 1: Results Framework and Monitoring World: National Human and Animal Health Systems Assessment Tools and Bridges Project Development Objective (PDO): The objective of this Grant is to support the development and refinement of harmonized operational assessment tools and guide by leading international organizations on human and animal health. This would contribute to increase capacity of countries to address priority diseases, including zoonoses and pandemic threat, and build synergies among human and animal health systems. PDO Level Cumulative Target Values** Responsibility Description (indicator Core Unit of Data Source/ definition etc.) Results Baseline YR 1 Frequency for Data Measure Methodology Indicators* Collection Indicator One: documents No linkages WHO/IHR and OIE/PVS Pathway Documents WHO and OIE IHR assessment tool Improved nor common tools better integrating cross sectoral available revised to better address harmonization of documents issues zoonoses (document WHO and OIE between finalized). tools and common WHO and Costing tool document guide OIE tools in advanced draft form (prototype). Laboratories assessment tool reviewed to better address interface with Vet. Labs in particular on zoonotic diseases New version of the (i) PVS evaluation tool, PVE Gap Analysis tool and related Manuels of the assessor (ed. 2013) finalized and published. PVS Gap Analysis for Vet. Laboratories document in advanced draft form. Guide in advanced draft form ; OIE and WHO manuels (part of the Guide) finalized ; concept note for the Guide finalized Indicator Two: documents No joint Joint documents developed and Documents OIE WHO and OIE manuals Better coordination documents endorsed by both organizations at available and concept note for the and collaboration between international level and joint Guide ; results of pilot of human and WHO and documents established in pilot countries workshops 19 animal health OIE aiming at countries by human and animal sectors at national improving health services. and institutional human and levels animal health systems Indicator Three: number of No Number of WHO, OIE, countries, Document WHO and OIE List of meetings, Better visibility people information WB, EC staff informed/trained available trainings and workshops and awareness of reached on joint WHO and participants. human and animal and OIE Evaluation forms of health systems strategies and knowledge gained importance and tools processes to disseminated support them INTERMEDIATE RESULTS Intermediate Result (Component One): Development of tools for further deployment and implementation of WHO IHR Intermediate Result Number No staff At least 60 WHO staff trained List of WHO indicator 1: trained participants to WHO regional staff the trained workshops Intermediate Result Number No WHO staff At least 10 WHO staff involved in PVS List of staff WHO indicator 2: WHO participating in missions having experts participating OIE PVS participated in missions in OIE PVS OIE PVS missions missions Intermediate Result (Component Two): Improvement of OIE PVS Pathway tools Intermediate Result Number No training 2 training organized and at least 30 List of OIE indicator 3: OIE organized on experts trained per session participants to PVS trainings the new the trainings versions of the organized and tools experts trained Intermediate Result Number No missions At least 10 missions carried out List of OIE indicator 4: PVS carried out missions pathway missions using revised tools carried out using the revised PVS tools Intermediate Result Document No existing Workshop minutes and recommendations Workshop OIE indicator 5: instruction on available minutes and Linkages between best possible recommendati use of PVS PVS pathway ons to 20 missions results and pathway facilitate World Bank project missions results operationaliza development by the WB task tion of PVS teams facilitated pathway missions results Intermediate Result Number No OIE staff At least 10 OIE staff or experts involved List of staff OIE indicator 6: OIE participating in in PVS missions having experts participating WHO IHR participated in missions in WHO/IHR WHO/IHR missions missions Intermediate Result (Component Three): Development of an operational Guide for countries on Good Governance of human and animal health services Intermediate Result Number No countries 3 countries List of OIE and WHO indicator 7 involved workshops Countries involved organized in joint human and animal health sectors bridges and strategy development under WHO and OIE auspices Intermediate Result Document No inputs Reports from joint workshops Reports OIE and WHO indicator 8: Results from available and inputs integrated in the available from joint countries joint WHO/OIE advanced draft WHO/OIE/Country operational guide workshops results used in operational Guide development Intermediate Result (Component Four): Management, coordination, monitoring and evaluation Intermediate Result Document No report 1 intermediate report after 6 month Reports OIE indicator 9: of project implementation available Six-monthly 1 final report after project closing intermediate and final reports provided to the Bank Intermediate Result Document No report 1 final audit Audit report OIE indicator 10: available 21 External financial audit carried out *Please indicate whether the indicator is a Core Sector Indicator (see further http://coreindicators) **Target values should be entered for the years data will be available, not necessarily annually 22 Annex 2 : ORAF Simplified Operational Risk Assessment Framework (ORAF) for small RETFs P133572 - RETF National Human and Animal Health Systems Assessment Tools and Bridges 1. Project Stakeholder Risks Rating Low Description: Risk Management: Continuous communication between OIE and WHO and their member Countries will be the ultimate beneficiaries of the products countries through regional offices and directly during regular meetings will ensure a common developed by WHO and the OIE. Missions will have to take understanding of expected benefits and secure countries’ volunteering as pilot for this project. place in countries to test and further refine those tools, on a voluntary basis. Risk would be to see a limited interest Status: in expressed by countries which would result in difficulties or Resp: OIE and WHO Due Date: continuous progress delays to conduct pilot missions for this project 2. Implementing Agency Risks (including fiduciary) Capacity Rating: Low Description: Risk Management: A subsidiary agreement will clarify responsibilities between the OIE and The OIE, a worldwide recognized intergovernmental WHO in terms of financial management, procurement rules, and responsibilities. The budget organization will be in charge of the implementation of the will be detailed per activity and organization and procurement mechanisms agreed upon, project. This organization has a strong capacity in developing which will ensure clarity and ease implementation. global products and implementing global programs in an effective and efficient manner. The project will support activities carried out by both the OIE and WHO. Those organizations have strong fiduciary systems in place. Resp: OIE and WHO Due Date: December 2012 Status: in progress WHO would receive a share of the funds through the OIE and manage these funds in accordance with their procedures recognized by the WB. Governance (including Fraud & Corruption) Rating: Low Description: Risk Management: The OIE has been established in 1924 and its governance Audits will continue to take place according to normal OIE procedures. mechanisms are well spelled out in the Organic and General Rules. The OIE is managing a global program for the strengthening of Veterinary Services since 2005. The OIE World Animal Health and Welfare Fund (WAHWF) as well as the regular budget of the OIE have their accounts audited yearly and submitted to management committees and reviewed Resp: OIE Due Date: May 2013 and May 2014 Status: not yet due and endorsed by the Administrative Commission of the OIE and finally approved by the 178 national Delegates composing the World Assembly. An independent evaluation of a DGF (WB contribution to the WAHWF from 2006 to 2008), also gave satisfactory results. 3. Project Risks 23 Design Rating: Moderate Description: Two main international organizations will be Risk Management: involved in the implementation of the project: the OIE and Permanent exchanges and coordination will be ensured to deliver expected outputs in the WHO. The project has components corresponding to activities shortest timeframe. The OIE has in particular seconded an expert to the WHO to further to be carried out in parallel or jointly. A constraint will be for facilitate coordination between the organizations. WHO and OIE have already agreed on a both organizations to coordinate and monitor closely the work plan in line with this project. If necessary, more detailed procedures would be advancement of their respective activities which constitute pre- developed to clarify all aspects relevant for the smooth management of the project. requisite to develop the expected joint products. Resp: OIE and WHO Due Date: N/A Status: done Social & Environmental Rating: Low Description: Risk Management: The project would focus on institutional aspects and would Not applicable therefore not present any adverse impact on social or Resp: N/A Due Date: N/A Status: N/A environmental aspects Delivery Monitoring Rating: Low Description: Risk Management: The OIE WAHWF team would monitor and collect necessary The OIE and WHO will coordinate reporting procedures to ensure compliance with WB information on all activities implemented under this project and requirements. provide reports as required to the WB. Due Date: mid term and end of Resp: OIE and WHO Status: not yet due project Other Rating: Significant Description: The main constraint is the short duration of the Risk Management: The OIE and WHO are prepared to start activities immediately. Detailed project that may hinder the completion of all planned activities. prior consultations and strong commitment of WHO and OIE to carry out these activities will ensure that the project will move as rapidly as possible. The task team together with the Recipient and WHO have also discussed all deliverables and assigned for each of them a completion stage (initiated, advanced draft, completed). In the worst case scenario, if implementation delays were observed for some unexpected reason, the organizations being committed to pursue this program would follow on these activities towards full their full achievement. Resp: OIE and WHO Due Date: N/A Status: done 4. Overall Risk Rating Comments: Moderate 24 Annex 3 : Budget DETAILED COST TABLE DATE: 1/2/2013 PROPOSED ACTIVITY: National Human and Animal Health Systems Assessment Tools and Bridges COUNTRY/PROGRAM: AHIF - East and South Asia Window and Eastern Europe Windows Components & Activities Expenditure Quantity Unit Unit Rate Total Cost / Category (US$) (US$) COMPONENT 1: Development of tools for the further deployment and implementation of the WHO IHR OIE WHO 1.a) Development of a costing tool Services (International): Expert related costs for IHR development and testing Daily fee for WHO expert Fees 202 days 500 101,000 Travel (economy class) to mission location Travel 28 trip 2,200 61,600 Per diem rate Subsistence 186 stipend/day 300 55,800 SUBTOTAL 1.a: 218,400 - 218,400 1.b) Adjustment of IHR assessment tool Services (International): Expert related costs to assesment of the IHR assessment tool Daily fee for WHO expert Fees 119 days 500 59,500 Travel (economy class) to mission location Travel 12 trip 2,200 26,400 Per diem rate Subsistence 50 stipend/day 300 15,000 SUBTOTAL 1.b: 100,900 - 100,900 1.c) Review of WHO laboratory assessment tool Services (International): Expert costs for the review of the IHR assessment tool Daily fee for WHO expert Fees 70 days 500 35,000 Travel (economy class) to mission location Travel 4 trip 2,200 8,800 Per diem rate Subsistence 22 stipend/day 300 6,600 SUBTOTAL 1.c: 50,400 - 50,400 1.d) Assessment of and support to AMR laboratory-based surveillance Services (International): Expert costs to assess and support AMR laboratory-based surveillance Daily fee for WHO expert Fees 100 days 500 50,000 Travel (economy class) to mission location Travel 15 trip 2,200 33,000 Per diem rate Subsistence 75 stipend/day 300 22,500 Laboratory reagents and material Goods 40,800 SUBTOTAL 1.d: 146,300 - 146,300 1.e) Assessment of and support to public health laboratories quality management system Services (International): Expert costs to assess and support public health laboratories quality management system Daily fee for WHO expert Fees 90 days 500 45,000 Travel (economy class) to mission location Travel 17 trip 2,200 37,400 Per diem rate Subsistence 50 stipend/day 300 15,000 SUBTOTAL 1.e: 97,400 - 97,400 1.f) Training workshops in the regions (10 participants) Fee for international consultant Fees 45 days 500 22,500 Travel (economy class) to training location Travel 10 trip 2,200 22,000 Per diem rate Subsistence 35 stipend/day 300 10,500 SUBTOTAL 1.f: 55,000 - 55,000 1.g) Participation of WHO experts as observers to OIE PVS Pathway missions Services (International): Participation to OIE PVS missions Daily fee for WHO IHR expert Fees 60 days 500 30,000 Travel (economy class) to mission location Travel 14 trip 2,200 30,800 Per diem rate Subsistence 70 stipend/day 300 21,000 SUBTOTAL1.g: 81,800 - 81,800 SUBTOTAL COMPONENT 1: 750,200 - 750,200 25 COMPONENT 2: Refinement of OIE PVS Pathway tools OIE WHO 2.a) Refinement of PVS Pathway tools integrating the pilot PVS One Health tool Services (International): Daily fee for PVS Pathway expert Fees 40 days 600 24,000 Travel (economy class) to meeting location Travel 5 trip 1,150 5,750 Per diem rate Subsistence 25 stipend/day 300 7,500 SUBTOTAL 2.a: 37,250 37,250 - 2.b) Further development of the OIE PVS Laboratory Gap Tool Services (International): Conduct PVS Pathway missions Daily fee for PVS Pathway expert Fees 40 days 600 24,000 Travel (economy class) to training location Travel 5 trip 1,150 5,750 Per diem rate Subsistence 25 stipend/day 300 7,500 SUBTOTAL 2.b: 37,250 37,250 - 2.c) Further Piloting of the OIE PVS Laboratory Gap Tool (4 missions x 3 pax x 14 days) Services (International): Daily fee for PVS Pathway expert Fees 120 Day 600 72,000 Travel (economy class) to mission location Travel 12 trip 1,150 13,800 Per diem rate Subsistence 168 stipend/day 300 50,400 SUBTOTAL 2.c: 136,200 136,200 - 2.d) Editing and translation of refined PVS Pathway tools Services (International): Editing fees Fees 30 days 400 12,000 Translation costs (official OIE languages) Fees 172500 words 0.200 34,500 Publication costs Fees 300 copies 20 6,000 SUBTOTAL 2.d: 52,500 52,500 - 2.e) Training of PVS Pathway Experts on refined and One Health-integrated tools (2 session x 40 experts x 4 days) Services (International): Daily fee for PVS Pathway expert Fees 30 days 600 18,000 Travel (economy class) to training location Travel 80 trip 1,150 92,000 Per diem rate Subsistence 400 stipend/day 300 120,000 Materials for training seminars Fees 80 person 15 1,200 SUBTOTAL 2.e: 231,200 231,200 - 2.f) PVS Pathway missions focusing on the integrated One Health approach (14 missions x 3 pax x 14 days) Services (International): Daily fee for PVS Pathway expert Fees 420 days 600 252,000 Travel (economy class) to training location Travel 42 trip 1,150 48,300 Per diem rate Subsistence 588 stipend/day 300 176,400 SUBTOTAL 2.f: 476,700 476,700 - 2.g) Workshop on PVS Pathway outputs for World Bank experts Services (International): Daily fee for PVS Pathway expert Fees 30 days 600 18,000 Travel (economy class) to training location Travel 4 trip 1,150 4,600 Per diem rate Subsistence 20 stipend/day 300 6,000 Materials for training seminars Fees 20 person 15 300 SUBTOTAL 2.g: 28,900 28,900 - SUBTOTAL COMPONENT 2: 1,000,000 1,000,000 - 26 COMPONENT 3: Development of an operational Guide for countries on Good Governance of human and animal health services OIE WHO 3.a) Development of Joint WHO/OIE documents, includes comprehensive operational manuals on Good Governance Services (International): Daily fee for OIE expert consultant Fees 120 days 500 60,000 60,000 Travel (economy class) Travel 35 trip 1,150 40,250 40,250 Per diem rate Subsistence 100 stipend/day 300 30,000 30,000 Editing fees Fees 70 days 400 28,000 28,000 Translation costs Fees 151500 words 0.200 30,300 30,300 Publication costs Fees 400 copies 20 8,000 8,000 Daily fee for WHO consultant Fees 250 days 500 125,000 125,000 Travel (economy class) Travel 60 trip 1,150 69,000 69,000 Per diem rate Subsistence 170 stipend/day 300 51,000 51,000 SUBTOTAL 3.a: 441,550 196,550 245,000 3.b) National/Regional Workshops (3 meetings in 2 regions x 20 participants x 4 days) Services (International): Fee for international OIE consultant Fees 80 days 500 40,000 40,000 Travel (economy class) Travel 65 trip 1,150 74,750 74,750 Per diem rate Subsistence 240 stipend/day 300 72,000 72,000 Materials for training seminars Fees 60 person 25 1,500 1,500 Training seminar venue rental Fees 3 venue 3,000 9,000 9,000 Fee for international WHO consultant Fees 190 days 500 95,000 95,000 Travel (economy class) Travel 71 trip 1,150 81,650 81,650 Per diem rate Subsistence 342 stipend/day 300 102,600 102,600 SUBTOTAL 3.b: 476,500 197,250 279,250 3.c) Development of a framework/concept note on the operational Guide in close cooperation with the World Bank Training: Fee for international consultant Fees 60 days 500 30,000 Travel (economy class) Travel 20 trip 1,150 23,000 Per diem rate Subsistence 150 stipend/day 300 45,000 Editing fees Fees 60 days 400 24,000 Translation costs Fees 50000 words 0.200 10,000 Publication costs Fees 400 copies 20 8,000 SUBTOTAL 3.c: 140,000 140,000 3.d) Development of a document on further integration of the environment within human/animal interfaces Services (International): Fee for international consultant Fees 40 days 500 20,000 Travel (economy class) Travel 5 trip 1,150 5,750 Per diem rate Subsistence 40 stipend/day 300 12,000 Editing fees Fees 12 days 400 4,800 Publication costs Fees 100 copies 20 2,000 SUBTOTAL 3.d: 44,550 44,550 3.e) Final project results workshop Services (International): Travel (economy class) Travel 30 trip 1,600 48,000 Per diem rate Subsistence 60 stipend/day 300 18,000 Materials for training seminars Fees 60 person 20 1,200 SUBTOTAL 3.e: 67,200 67,200 SUBTOTAL COMPONENT 3: 1,169,800 645,550 524,250 27 COMPONENT 4: Management, Coordination, Monitoring and Evaluation OIE WHO 4.a) Monitoring and evaluation Services (International): Consultant costs for monitoring and evaluation Fee for external audit Fees 1 lump sum 15,200 15,200 15,200 Fee for project coordination and management consultants Fees 12 months 4,000 48,000 48,000 Travel (economy class) Travel 15 trip 1,150 17,250 17,250 Per diem rate Subsistence 70 stipend/day 250 17,500 17,500 Editing fees Fees 15 days 450 6,750 6,750 - Goods: Communication and information technology related costs - Information technology equipment for project management 2 equipment 3,000 6,000 6,000 - Operational expenses: 7% Overheads for WHO 1 lump sum 89,300 89,300 89,300 SUBTOTAL 4.a: 200,000 SUBTOTAL COMPONENT 4: 200,000 110,700 89,300 TOTAL COSTS 3,120,000 1,756,250 1,363,750 SUMMARY TABLE BY COMPONENT AND EXPENDITURE CATEGORY Component 1 Goods 40,800 Services 654,400 Training 55,000 Sum of expenditures 750,200 Component 2 Services 768,800 Training 231,200 Sum of expenditures 1,000,000 Component 3 Services 626,100 Training 543,700 Sum of expenditures 1,169,800 Component 4 Goods 6,000 Services 104,700 Operational Expenses 89,300 Sum of expenditures 200,000 Total for All Components 3,120,000 Goods 46,800 Services 2,154,000 Training 829,900 Civil works - Operational Expenses 89,300 TOTAL COSTS 3,120,000 28