Integrated Safeguards Data Sheet (ISDS) Section I ­ Basic Information Date ISDS Prepared/Updated: November 2, 2004 Report No.:AC1038 A. Basic Project Data A.1. Project Statistics Country: Africa Project ID: P080413 Project: Great Lakes Initiative on TTL: Richard Seifman HIV/AIDS Total project cost (by component): Appraisal Date: October 5, 2004 Loan/Credit amount($m): IDAH: 20 Board Date: December 7, 2004 Other financing amounts by source: ($m.) IDA GUARANTEE 0 Managing Unit: AFTH3 Sector: Health (60%);Other social services (40%) Lending Instruments: Adaptable Program Loan Is this project processed under OP 8.50 (Emergency Yes? [ ] No? [X] recovery? Environmental Category: B A.2. Project Objectives The development objectives of the project are to facilitate: · Establishment of HIV/AIDS prevention, care, treatment, and mitigation programs for mobile and vulnerable groups such as refugees, transport sector workers, and highly affected/infected populations in each of the GLIA member countries, and · Enhancement of prospects for coordinated approaches addressing HIV/AIDS prevention, care and treatment among the GLIA member countries. The key performance indicators measuring effectiveness of project interventions (in those areas where GLIA directly intervenes), will be: (a) a reduction in HIV prevalence in the refugee and surrounding populations; (b) a reduction in the number of infected infants born to HIV infected mothers; (c) an increase in the number of youth (aged 15-24) reporting condom use during sexual intercourse with a non-regular partner (adapted UNGASS indicator); (d) improved gender sensitivity in the target population; and (e) an increase in the number of youth respondents (aged 15-24) who correctly identify ways of preventing HIV transmission and who reject major misconceptions about HIV transmissions or prevention (adapted UNGASS indicator). · Concerted action by UNAIDS partners, including the World Bank, other donors in support of a regional initiative, national and regional ownership and accountability. · NEPAD objectives that relate to HIV/AIDS and regional institutions increasing taking on responsibility for coordinated efforts. · Addressing Great Lakes problems of transient populations and policy coordination through: (a) Regionally owned institutional capacity to coordinate a multi-sectoral HIV/AIDS response; (b) Improving the situation of vulnerable and often underserved vulnerable groups; and (c) Confidence building among the GLIA countries in working together for mutual benefit in addressing a common enemy, namely the HIV virus. A.3. Project Description The proposed IDA Grant of $20.0 million would finance a four-year program. The direct beneficiaries are a) refugees, IDPs, returnees, and surrounding area communities at selected sites (in every GLIA country), and b) transport and PLWA association members. Indirect beneficiaries are those in the Region who gain from better health policies, programs and service delivery as a result of cross-fertilization. The four components are as follows; Component l: HIV/AIDS support to refugees, affected areas surrounding the refugee communities, internally displaced people, returnees (US$8.0 million). Refugee sites and adjacent affected areas represent underserved Great Lakes populations; and returnees constitute another potential target population. This component will provide services to a limited number of such populations, and could include the full range of prevention, care, treatment and mitigation, principally through provision of services and goods (very little civil works, primarily rehabilitation, is envisioned). "Transportability" of what is learned or done for refugees, and "integration" of GLIA-financed activities with the national program will determine program content. Activities will be closely monitored and evaluated using linked behavioral and biological surveillance surveys and sentinel sites so that if successful GLIA countries and donors will support replication. Over the four year period a) UNHCR sites (principally refugee camps are estimated at US$5.0 million, and b) surrounding areas, IDPs, and returnees are estimated at US$3.0 million. UNHCR, which has HIV/AIDS programs underway and will be scaling up existing programs or supporting portions of new GLIA areas, will be responsible for refugee sites; regarding affected surrounding areas these will be administered by the national AIDS Commissions/Secretariats (NAC/NAS) within the national HIV/AIDS-MAP framework (unless the GLIA country and UNHCR agree it should take on additional tasks in affected areas); returnees will be the shared responsibility of UNHCR and the NAC/NAS; while responsibility for IDPs will be decided upon on a case-by-case basis. A Memorandum of Understanding between GLIA and UNHCR will be presented to the Council of Ministers at its next session. A Management Contract between GLIA and the UNHCR will set the terms and conditions for financing UNHCR activities. This Management Contract has been drafted and will be submitted to IDA for no-objection. Site selection was agreed on during project preparation and programs designed using a standardized instrument for situational analysis and development of HIV/AIDS program action plans. For the first project year a maximum of two such sites/catchment areas were chosen in each GLIA country and work plans were prepared in August 2004. Additional sites can be added in subsequent years using the same methodology, and will be included in annual workplans submitted to the Council of Ministers for approval. The approved sites that satisfactorily implement first year plans will be continued. Such annual plans will be submitted to the World Bank for no-objection on a consolidated basis. Component 2: Support to HIV/AIDS related Networks (US$3.0 million). The transport sector and PLWA are two high priority regional groups which have been the subject of exchanges among GLIA countries, conferences, and informal linkages. In the case of transport, GLIA has conducted pilot programs ("Safari Safis" program in 2001-2002). Transport networking would focus on a) long-haul workers and those communities and groups associated with them, and b) on two principal transmission corridors, namely (i) Mombasa-Nairobi-Kampala-Kigali-Bujumbura-Bukavu-Goma, and (ii) Dar es Salaam- Dodoma-Kigali-Bujumbura-Bukavu-Goma. Subregional PLWHA network support would provide important reinforcement of national and under-funded regional advocacy efforts to reduce stigma of those infected and affected, engage in the sharing and testing of PLWHA support practices by NGOs, CBOs, and the private sector for this vulnerable population. Regional conferences have created a "regional consciousness" among PLWAs that they are not alone, and many cross-country contacts. These need to be consolidated and strengthened. The approach in both instances will be based on a BP/UNITAR methodology ("AIDS Competence"). Existing networks will be strengthened and new ones promoted by a) developing the management capacity of the networks and selected lead member organizations in planning, financial management, resource mobilization and M&E via the training-of trainers, b) developing HIV/AIDS learning capacity and transfer of knowledge between network members. An intermediary institution(s) will be contracted to: a) provide management training to network trainers-of-trainees, b) train national facilitators in techniques of organization self-assessment, knowledge capturing and knowledge sharing, c) assist in piloting knowledge rooms along the transport corridors, and d) M&E. Based on agreed criteria, GLIA countries have gone through the process of identifying those organizations which should be included in the networking pool. Component 3: Support to Regional health-sector collaboration (US$3.0 million). National HIV/AIDS related health-sector information exchange, through which policies and approaches can be discussed, and in future coordinated by and for key health-sector stakeholders, will result in better use of scarce human and financial resources. Five areas of such concentration have been identified: (i) an inventory of effective interventions and sharing of information, (ii) review of protocols, materials and training opportunities for prevention and treatment, (iii) information exchange on refugee, IDP, returnee HIV/AIDS health-related programs, (iv) transport sector HIV/AIDS strategy coordination and piloting of targeted transport packages along two main regional roads (at sites identified for the network component intervention), (v) information exchange on drug policies and procurement. Component 4: GLIA/MAP management, capacity strengthening, monitoring and evaluation, and reporting (US$6.0 million). GLIA will require institutional strengthening so that it can coordinate resources made available from all sources, and coordinate regional HIV/AIDS approaches. This component covers three activities: (a) administration and management including support for the core professional staff, the fiduciary management agent, allocations to GLIA Country Focal Points, and operating expenses for GLIA operations, (b) capacity strengthening and policy discussion/technical support, including fiduciary, management and advocacy training of those involved in GLIA which is not addressed under Components 1-3 (such as regional training of GLIA Country Focal Points and national teams), and policy discussion/development/technical support for other cross-cutting issues (such as gender considerations in HIV/AIDS mobile population programs) and (c) monitoring and evaluation, and reporting, covering those aspects not financed under Components 1-3. A.4. Project Location and salient physical characteristics relevant to the safeguard analysis: Project covers the border regions of the Great Lakes countries of Burundi, Democratic Republic of the Congo, Kenya, Rwanda, Tanzania and Uganda. B. Check Environmental Category A [ ], B [X], C [ ], FI [ ] The project has been categorized as B due to the potential environmental and social impacts that might result from unsafe medical waste management and construction /rehabilitation activities that might take place under the project. Comments: C. Safeguard Policies Triggered Yes No Environmental Assessment (OP/BP/GP 4.01) [x ] [ ] Natural Habitats (OP/BP 4.04) [ ] [x ] Pest Management (OP 4.09) [ ] [ x] Cultural Property (draft OP 4.11 - OPN [ ] [x ] 11.03-) Involuntary Resettlement (OP/BP 4.12) [x ] [ ] Indigenous Peoples (OD 4.20) [ ] [x ] Forests (OP/BP 4.36) [ ] [x ] Safety of Dams (OP/BP 4.37) [ ] [x ] Projects in Disputed Areas (OP/BP/GP 7.60)* [ ] [x ] Projects on International Waterways [ ] [x ] (OP/BP/GP 7.50) * By supporting the proposed project, the Bank does not intend to prejudice the final determination of the parties' claims on the disputed areas Section II ­ Key Safeguard Issues and Their Management D. Summary of Key Safeguard Issues. D.1. Describe any safeguard issues and impacts associated with the proposed project. Identify and describe any potential large scale, significant and/or irreversible impacts. Potential safeguard issues under the proposed project relate to (i) unsafe medical waste management which - if left unattended - would contribute to water, soil and air pollution as well as to an increase in exposure to HIV/AIDS among health care workers, municipal staff dealing with waste management, and scavengers at open dump sites; and (ii) the possible construction/rehabilitation of facilities which would contribute to a loss of vegetation, soil erosion, soil and water pollution. D.2 Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area. Future project activities will not have long-term and/or indirect impacts. D.3. Describe the treatment of alternatives (if relevant) The discussion of alternatives was found to be irrelevant given that this project will complement ongoing national HIV/AIDS activities. D.4. Describe measures taken by the borrower to address safeguard issues. Provide an assessment of borrower capacity to plan and implement the measures described. The participating GLIA countries have prepared an Environmental and Social Management Framework (ESMF) and a Policy Framework for Compensation (PFC) which will be applied to future GLIA activities. D.5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. Key stakeholders will include refugees, displaced persons, returnees, and persons living with HIV/AIDS. They will benefit from project support for an improvement in HIV/AIDS prevention, care, treatment, and mitigation approaches in widely scattered areas in virtually all GLIA countries. To ensure that the environmental and social aspects of the project activities are addressed during implementation, a consultant visited representatives of government ministries, environmental management agencies, National Aid Commissions, UNHCHR, UNAIDS to discuss appropriate measures to address these aspects. The outcome of these discussions are reflected in the ESMF and the PFC referred to above. Both documents have been approved by the respective agencies in the GLIA countries and have been disclosed to the public in-country on September 28, 2004. The ESMF and the PFC have been approved by the Bank and disclosed at the Bank's Infoshop on October 4, 2004. F. Disclosure Requirements Date Environmental Assessment/Audit/Management Plan/Other: Date of receipt by the Bank 09/08/04 Date of "in-country" disclosure 09/28/04 Date of submission to InfoShop 10/04/04 For category A projects, date of distributing the Executive Summary of the EA to the Executive Directors NA Resettlement Action Plan/Framework/Policy Process: Date of receipt by the Bank 09/08/04 Date of "in-country" disclosure 09/28/04 Date of submission to InfoShop 10/04/04 Indigenous Peoples Development Plan/Framework: Date of receipt by the Bank NA Date of "in-country" disclosure NA Date of submission to InfoShop NA Pest Management Plan: Date of receipt by the Bank NA Date of "in-country" disclosure NA Date of submission to InfoShop NA Dam Safety Management Plan: Date of receipt by the Bank NA Date of "in-country" disclosure NA Date of submission to InfoShop NA If in-country disclosure of any of the above documents is not expected, please explain why. Section III ­ Compliance Monitoring Indicators at the Corporate Level (To be filled in when the ISDS is finalized by the project decision meeting) OP/BP 4.01 - Environment Assessment: Yes No Does the project require a stand-alone EA (including EMP) report? X If yes, then did the Regional Environment Unit review and approve the X EA report? Are the cost and the accountabilities for the EMP incorporated in the X credit/loan? OP/BP 4.04 - Natural Habitats: Yes No Would the project result in any significant conversion or degradation NA of critical natural habitats? If the project would result in significant conversion or degradation of other (non-critical) natural habitats, does the project include mitigation NA measures acceptable to the Bank? OP 4.09 - Pest Management: Yes No Does the EA adequately address the pest management issues? NA Is a separate PMP required? NA If yes, are PMP requirements included in project design? NA Draft OP 4.11 (OPN 11.03) - Cultural Property: Yes No Does the EA include adequate measures? NA Does the credit/loan incorporate mechanisms to mitigate the potential NA adverse impacts on physical cultural resources? OD 4.20 - Indigenous Peoples: Yes No Has a separate indigenous people development plan been prepared in NA consultation with the Indigenous People? If yes, then did the Regional Social Development Unit review and NA approve the plan? If the whole project is designed to benefit IP, has the design been NA reviewed and approved by the Regional Social Development Unit? OP/BP 4.12 - Involuntary Resettlement: Yes No Has a resettlement action plan, policy framework or policy process X been prepared? If yes, then did the Regional Social Development Unit review and X approve the plan / policy framework / policy process? OP/BP 4.36 ­ Forests: Yes No Has the sector-wide analysis of policy and institutional issues and NA constraints been carried out? Does the project design include satisfactory measures to overcome NA these constraints? Does the project finance commercial harvesting, and if so, does it NA include provisions for certification system? OP/BP 4.37 - Safety of Dams: Yes No Have dam safety plans been prepared? NA Have the TORs as well as composition for the independent Panel of NA Experts (POE) been reviewed and approved by the Bank? Has an Emergency Preparedness Plan (EPP) been prepared and NA arrangements been made for public awareness and training? OP 7.50 - Projects on International Waterways: Yes No Have the other riparians been notified of the project? NA If the project falls under one of the exceptions to the notification requirement, then has this been cleared with the Legal Department, and NA the memo to the RVP prepared and sent? What are the reasons for the exception? NA Please explain: NA Has the RVP approved such an exception? NA OP 7.60 - Projects in Disputed Areas: Yes No Has the memo conveying all pertinent information on the international aspects of the project, including the procedures to be followed, and the NA recommendations for dealing with the issue, been prepared, cleared with the Legal Department and sent to the RVP? Does the PAD/MOP include the standard disclaimer referred to in the NA OP? BP 17.50 - Public Disclosure: Yes No Have relevant safeguard policies documents been sent to the World X Bank's Infoshop? Have relevant documents been disclosed in-country in a public place in a form and language that are understandable and accessible to project- X affected groups and local NGOs? All Safeguard Policies: Yes No Have satisfactory calendar, budget and clear institutional responsibilities been prepared for the implementation of the safeguard X measures? Have safeguard measures costs been included in project cost? X Will the safeguard measures costs be funded as part of project X implementation? Does the Monitoring and Evaluation system of the project include the X monitoring of safeguard impacts and measures? Have satisfactory implementation arrangements been agreed with the borrower and the same been adequately reflected in the project legal X documents? Signed and submitted by: Name Date Task Team Leader: November 2, Richard Seifman 04 Project Safeguards Specialist Edeltraut Gilgan-Hunt 1: Project Safeguards Specialist Kristine Schwebach 2: Project Safeguards Specialist 3: Approved by: Name Date Regional Safeguards November 3, Thomas E. Walton Coordinator: 04 Comments: Sector Manager: November 2, Keith Hansen 04 Comments: