The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) Philippines COVID-19 Emergency Response Project (P173877) EAST ASIA AND PACIFIC | Philippines | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 4 | ARCHIVED on 24-Oct-2021 | ISR47913 | Implementing Agencies: Department of Health, Republic of the Philippines Key Dates Key Project Dates Bank Approval Date: 22-Apr-2020 Effectiveness Date: 06-May-2020 Planned Mid Term Review Date: 01-Feb-2022 Actual Mid-Term Review Date: Original Closing Date: 29-Dec-2023 Revised Closing Date: 29-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To strengthen the Philippines' capacity to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthening Emergency COVID-19 Health Care Response:(Cost $481.00 M) Strengthening Laboratory Capacity at National and Sub-National Level to Support Emerging Infectious Diseases (EIDs) Prevention, Preparedness, and Response:(Cost $11.50 M) Implementation Management and Monitoring and Evaluation:(Cost $7.50 M) Contingent Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating High Substantial Implementation Status and Key Decisions This implementation and results report reflects findings of the implementation support mission held from July 2021, with follow-up meetings up to September 10, 2021. Progress towards the achievement of project development objective (PDO) is upgraded to satisfactory. There has been significant progress in the achievement of the majority of PDO and intermediate results indicators. However, there has been significant delays in procurement of civil works to support isolation rooms, quarantine facilities and laboratory facilities. Overall implementation progress is being downgraded to moderately satisfactory, largely due to the significant delays in procurement of civil works under Component 1 and Component 2. However, it is noted that the Department of Health continues to accelerate the pace of project implementation . The vaccination deployment under the project has progressed well, with 4.73 million doses of vaccines having arrived in the 10/24/2021 Page 1 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) Philippines. Project-financed vaccines have been deployed in all 17 regions across the country, including BARMM. End-to-end logistics supported by Zurich Pharma Corporation progressed well. Furthermore, most medical equipment and supplies under the project have been procured and delivered to frontline health facilities. Cumulative disbursement of the original loan and the AF is at 41%. Total disbursement of the original loan reached 75%; it includes US$30 million reallocated for Moderna vaccine purchase. The uncommitted amount of the original loan remains for civil works for isolation rooms, quarantine facilities, and laboratories. Total disbursement of the additional loan stands at 34%. MPA Program Development Objective MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body The implementation of the MPA-funded projects continues to progress well. As of October 18, 2021, 87 MPA-projects had been approved providing a total commitment of US$4.2. However, one operation (Guatemala) was cancelled in mid-September, at the request of the Government. Therefore, there are now 86 MPA active operations. Disbursements during the past month have increased at a rapid pace. Fifty-four (54) country projects or 63% of projects approved have reached 70-100% disbursements (reasons for 100+% disbursements relate to fluctuations between the Euro and the SDR against the US$). The projects benefit around 3.7 billion people or 50% of the global population. Of the 86 approved projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-four (84) or 98% of projects approved are disbursing. Total disbursements as of October 18, 2021, amount to US$3.1 billion or 73% of overall commitments. Streamlined procedures, delegated approval coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Several projects have/are being restructured to include vaccine related procurement. Implementation is being guided by Bank teams working in parallel in other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts in countries. Implementation continues to face challenges as many countries are still under different levels of lockdown or mobility restrictions and counterparts and Bank teams are operating from home or partially from home. Also, countries are dealing with new waves of infections with the Delta variant spreading rapidly among populations. Most Bank teams continue to conduct implementation support missions virtually, which is challenging for both Bank teams and counterparts. This “virtual” world poses connectivity challenges as internet is not reliable in many countries, especially IDA countries. Notwithstanding challenges, the MPA is on track to achieving its PrDO – to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements in just over 19 months attest to the strong implementation efforts of the Bank response thanks to the commitment of counterparts supported by Bank country teams. The Additional Financing (MPA AF-V) to the COVID-19 Strategic Preparedness and Response Program utilizing the Multiphase Programmatic Approach (“Global COVID-19 MPA”) was approved by the Board on October 13, 2021. The AF-V is significantly expanding Bank support to client countries for COVID-19 vaccination, with the aim to support vaccination of 1 billion people globally. The AF-V was approved with an envelope of US$12 billion ($6 billion from IDA and $6 billion from IBRD) in financing. This financing is critical to expand affordable and equitable financing for vaccine purchase and deployment. The AF-V is expected to enable vaccination for up to 750 million people, with potential surge capacity for an additional 250 million people in the poorest countries (depending on the delivered price of approved vaccines) while scaling support to strengthen immunization delivery, with design flexibility at the country level. The AF-V is a scale-up of planned vaccination activities already anticipated and supported under the Global COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. As of October 18, 2021, the Bank has approved 64 operations to support vaccine procurement and rollout in 61 countries amounting to $5.8 billion. The 64 AF-V operations approved, include 4 operations that involved restructuring of parent projects (North Macedonia, Philippines and 10/24/2021 Page 2 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Of the 64 approved operations: (i) 35 are in Africa – 16 in AFE and 19 in AFW; (ii) 6 in East Asia; (iii) 7 in Europe and Central Asia; (iv) 5 in Latin America and the Caribbean; (v) 5 in Middle East and North Africa; and (vi) 6 in South Asia. Twenty-eight (28) projects are disbursing. Total disbursements as of October 18, 2021, under these projects amount to US$719.83 million or 12% of overall commitments. As with the MPA operations, streamlined procedures, delegated approval, coupled with flexible project design and intensified efforts across the Bank contributed to the rapid design and processing of the operations. Fifty-eight (58) loan/financing agreements have already been signed. Also, fifty-one (51) loan/financing agreements have become effective; several others are expected to become effective in the coming days/weeks. Implementation of the AF-V operations, as with MPA operations is facing challenges as many countries are still under different levels of lockdown or mobility restrictions and counterparts and Bank teams are operating from home. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial High Substantial Macroeconomic Substantial Moderate Moderate Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Moderate Substantial Substantial Institutional Capacity for Implementation and Substantial High Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Substantial Substantial Other Substantial Substantial Substantial Overall Substantial High Substantial Results PDO Indicators by Objectives / Outcomes To strengthen Philippines' capacity to prevent, detect and respond to the threat posed by COVID-19 IN01029434 ►Percentage of hospitals with personal protective equipment and infection control products and supplies according to DOH requirements, without stock-outs in preceding one month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 55.00 74.00 81.00 90.00 Date 31-Mar-2020 31-Mar-2020 30-Sep-2021 29-Dec-2023 This indicator will help track the performance of 70 DOH hospitals (level 2 and level 3 hospitals) across Comments: the country to ensure that they have personal protective equipment and infection control products and supplies according to DOH requirements, without stock-outs. DOH has been preparing guidance notes of 10/24/2021 Page 3 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) personal protective equipment and infection control products and supplies as minimum standard that each hospital needs to make available to address COVID-19. IN01029435 ►Percentage of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents, without stock-outs in preceding one month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 14.00 71.00 90.00 Date 31-Mar-2020 31-Mar-2020 30-Sep-2021 29-Dec-2023 This indicator tracks the performance of designated laboratories to ensure that they have COVID-19 diagnostic equipment, test kits, and reagents, without stock-outs. The denominator is the number of existing DOH-operated laboratories, which include the national reference laboratory – Research Institute Comments: for Tropical Medicine (RITM) as well as the following six sub-national and public health laboratories (i) Lung Center of the Philippines (QC); (ii) San Lazaro Hospital (Manila); (iii) Baguio General Hospital (Baguio); (iv) Vicente Sotto Memorial Medical Center (Cebu); (v) Caraga Regional Hospital (Surigao City); (vi) Southern Philippines Medical Center (Davao). IN01029436 ►Number of acute healthcare facilities with isolation capacity according to DOH-established standards (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 30.00 30.00 30.00 60.00 Date 31-Mar-2020 31-Mar-2020 30-Sep-2021 29-Dec-2023 14 hospitals are under construction, 12 contracts were awarded. This indicator helps tracks performance of 39 DOH hospitals and 45 LGU hospitals to ensure that they meet DOH established standards of isolation capacity to manage Severe Acute Respiratory Infections Comments: (SARI) patients. The standards will be based on the standard design of isolation facility in managing SARI patients including intensive care to be prepared by DOH. IN01029437 ►Share of project-targeted health workers received COVID vaccine (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 92.90 80.00 Date 13-Jan-2021 31-Mar-2021 30-Sep-2021 29-Dec-2023 There are 1,167,641 HCW completely vaccinated out of 1,302,639 (only in regions that deploy Moderna). Comments: IN01029438 ►Share of project-targeted population given full dose of COVID-19 vaccination (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 35.80 70.00 Date 13-Jan-2021 31-Mar-2021 30-Sep-2021 29-Dec-2023 Summary of regions with Moderna only. Comments: Intermediate Results Indicators by Components 10/24/2021 Page 4 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) Strengthening Emergency COVID-19 Health Care Response IN01029441 ►Standard design for hospital isolation and treatment centers to manage Severe Acute Respiratory Infections (SARI) patients is finalized (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-Mar-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 This indicator helps ensure that the Government has produced a standard design for hospital isolation and treatment centers to manage Severe Acute Respiratory Infections (SARI) patients that will be used by Comments: health facilities nationally. The DOH is currently preparing the standard design. IN01029444 ►Number of ventilators provided to hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 190.00 500.00 300.00 Date 31-Mar-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 This indicator helps track the number of ventilators, which is essential medical equipment supported by Comments: the project, that have been distributed to health facilities. IN01029447 ►Number of health staff trained in infection prevention and control per DOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 14,757.00 13,862.00 15,000.00 Date 03-Apr-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 Beginning August 2021, a new reliable data source is used (DOH records), thus the variance with the previous value. The data collection started only recently and can now be updated regularly. The former data was from a WHO report in November 2020. Comments: The indicator will help ensure that adequate number of health staff are trained in infection prevention and control per DOH-approved protocols in DOH hospitals as well as provincial hospitals. DOH proposed that the health staff to receive training are from 39 DOH Level-3 hospitals and 8 DOH Level-2 hospitals. IN01029448 ►Share of hospitals designated as vaccination sites in project areas having adequate and functioning cold chain equipment (CCE) maintaining the temperature required for the COVID-19 vaccine assigned (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 100.00 Date 13-Jan-2021 31-Mar-2021 30-Sep-2021 29-Dec-2023 122 hospitals with at least one functioning CCE in selected regions Comments: IN01029449 ►Share of project-targeted vaccinated population who rated as satisfactory the COVID-19 vaccination service received (Percentage, Custom) 10/24/2021 Page 5 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 97.50 80.00 Date 13-Jan-2021 31-Mar-2021 30-Sep-2021 29-Dec-2023 First survey is ongoing Comments: IN01029450 ►Share of project-targeted population reporting adverse event following immunization (AEFI) having received additional care and free treatment (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 51.80 80.00 Date 13-Jan-2021 31-Mar-2021 30-Sep-2021 29-Dec-2023 5 out of 21 AEFI patients received free treatment as reported by the health facility. The rest were billed but Comments: for further validation for PhilHealth coverage. IN01029451 ►National COVID-19 vaccination tools developed (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 18-Jan-2021 31-Mar-2021 30-Sep-2021 29-Dec-2023 The LGUs have their own systems for registration and monitoring Comments: IN01029452 ►Eligibility for vaccination criteria include barangay health workers (BHWs) among priority group (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 02-Feb-2021 31-Mar-2021 30-Sep-2021 29-Dec-2023 Part of A1 group of the NDVP Comments: Strengthening Laboratory Capacity at National and Sub-National Level IN01029439 ►Daily capacity of a designated national laboratory (RITM) in conducting COVID-19 diagnostic tests (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 300.00 1,010.00 517.00 1,200.00 Date 31-Mar-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 The decline is due to the shift of function of the national laboratory to ensuring the quality assurance of Comments: laboratories. 10/24/2021 Page 6 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) The indicator tracks daily capacity of a designated national laboratory (RITM) in conducting COVID-19 diagnostic tests, with the expectation that the COVID-19 testing capacity will increase overtime with project support. RITM has been selected by DOH to represent a national laboratory for this indicator. IN01029442 ►Daily capacity of a designated sub-national laboratory (Davao) in conducting COVID-19 diagnostic tests (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 533.00 1,281.00 500.00 Date 30-Mar-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 This indicator tracks daily capacity of a designated sub-national laboratory in Davao (Southern Philippines Medical Center) in conducting COVID-19 diagnostic tests. The DOH has selected Davao laboratory to Comments: represent sub-national laboratories for this indicator. IN01029445 ►Daily capacity of a designated sub-national laboratory (Cebu) in conducting COVID-19 diagnostic tests (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 660.00 898.00 500.00 Date 03-Apr-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 This indicator tracks daily capacity of a designated sub-national laboratory in Cebu (Vicente Sotto Memorial Medical Center) in conducting COVID-19 diagnostic tests. The DOH has selected Cebu Comments: laboratory to represent sub-national laboratories for this indicator. Implementation Management and Monitoring and Evaluation IN01029440 ►M&E system established to monitor project activities (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 03-Apr-2020 31-Mar-2021 30-Sep-2021 30-Jun-2020 This indicator is to ensure that DOH has established an M&E system to monitor, track progress, and Comments: evaluate project activities. DOH has prepared the Project M&E System Manual and submitted to the Bank. IN01029443 ►Functional asset management system is in place, independently reviewed on 6-monthly basis (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 03-Apr-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 Contract is awarded and is pending signature by the consultancy firm. Notice to Proceed is expected imminently. Comments: The purpose of this indicator is to ensure that there is a functional asset management system in place, given that the project will provide significant support in medical equipment and supplies to health facilities 10/24/2021 Page 7 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) across the country. It is important that there is an independent review of assets supported by the project on 6-monthly basis. IN01029446 ►Percentage of grievances resolved to the satisfaction of the complainant within timeframe specified in the GRM for stakeholders (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 80.00 Date 06-Nov-2020 31-Mar-2021 30-Sep-2021 29-Dec-2023 One report has been received so far and is currently being validated. Comments: Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173877 IBRD-91050 Effective USD 100.00 100.00 0.00 74.75 25.25 75% P173877 IBRD-92200 Effective USD 500.00 500.00 0.00 171.98 328.02 34% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173877 IBRD-91050 Effective 22-Apr-2020 28-Apr-2020 06-May-2020 29-Dec-2023 29-Dec-2023 P173877 IBRD-92200 Effective 11-Mar-2021 19-Mar-2021 31-Mar-2021 29-Dec-2023 29-Dec-2023 Cumulative Disbursements 10/24/2021 Page 8 of 9 The World Bank Implementation Status & Results Report Philippines COVID-19 Emergency Response Project (P173877) PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History Level 2 Approved on 29-Dec-2020 ,Level 2 Approved on 10-Sep-2021 Related Project(s) P175953-Philippines COVID-19 Emergency Response Project Additional Financing ,P177884-Philippines COVID-19 Emergency Response Second Additional Financing 10/24/2021 Page 9 of 9