OFFICIAL
DOCUMENTS
The World Bank                                    1818 H Street N.W.        (202) 473-1000
INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT  Washington, D.C. 20433  Cable Address: INTBAFRAD
INTERNATIONAL DEVELOPMENT ASSOCIATION             U.S.A.                    Cable Address: INDEVAS
Dated               3     ,2015
H.E. Dr. Naglaa El-Ehwany
Minister of International Cooperation
Ministry of International Cooperation
Cairo, Arab Republic of Egypt
Re: Egypt: Health Insurance Systems Development Project
(Revised as Health Care Quality Improvement Project)
(Loan. No. 7828-EG)
Amendment to the Loan Agreement and
Cancellation of Project Agreement and Subsidiary Loan Agreement
Excellency:
We refer to the Loan Agreement, dated March 15, 2010, between the Arab Republic of Egypt
("Borrower") and the International Bank for Reconstruction and Development ("Bank") (Loan
Agreement); the Project Agreement, dated March 15, 2010, between the International Bank for
Reconstruction and Development ("Bank") and the Health Insurance Organization ("Project
Implementing Entity") (Project Agreement); and the Subsidiary Loan Agreement, dated June 29, 2010
between the Arab Republic of Egypt and Health Insurance Organization (Subsidiary Loan Agreement),
for the above-mentioned Project (the Project). We also refer to your letter, dated and February 10, 2014,
requesting the Bank to restructure the Project and amending the Agreements for the Project for
purposes, inter alia, of changing name and the project objectives, components, implementing entity,
results indicators, and disbursement categories, as well as cancelling the Project Agreement and the
Subsidiary Loan Agreement, and extending the Closing Date from June 30, 2015 to June 30, 2017.
We are pleased to inform you that, after due consideration, the Bank concurs with the request.
Consequently, the Loan Agreement, Project Agreement and Subsidiary Loan Agreement are amended
as set forth below:
1.     Proiect Agreement
The Project Agreement is hereby cancelled and repealed.
2.     Subsidiary Loan Agreement
The Subsidiary Loan Agreement is hereby cancelled and repealed.
3.     Proiect Monitoring Indicators
The performance monitoring indicators for the Project attached to supplemental letter no.2 of
March 15, 2010, are hereby cancelled and repealed.
4.     Loan Apreement
A.     The Loan Agreement is amended and restated (Amended and Restated Loan
Agreement) as set out in attachment I to this letter of amendment.


-2-
B.     For purposes of paragraph A of Section II of Schedule 2 to the Amended and Restated
Loan Agreement, the performance monitoring indicators for evaluating and monitoring
the progress of the Project are set out in Attachment 2 to this letter of amendment.
C.     For the purpose of effectiveness of this Amended and Restated Loan Agreement, the
Borrower shall: (a) furnish evidence satisfactory to the Bank that all necessary
constitutional procedures have been taken by the Borrower in respect of the said
Agreement; and (b) furnish to the World Bank an opinion acceptable to the Bank from
the Borrower's State Council and Ministry of Justice showing that said Agreement has
been duly authorized or ratified by the Borrower and is legally binding on the Borrower
in accordance with its terms.
Please confirm the Borrower's agreement to the foregoing by having an authorized official of
the Borrower sign and date two copies of this letter of amendment and the enclosed copy of the
Amended and Restated Loan Agreement, and returning it to the World Bank. Upon receipt by the World
Bank of the countersigned copies and the documents referred to in paragraph 4.C. above, this letter of
amendment and the Amended and Restated Loan Agreement shall come into effect on the date the Bank
dispatches to the Borrower notice of acceptance of the evidence required pursuant to paragraph 4.C.
above. This letter of amendment and the Amended and Restated Loan Agreement and all the obligations
of the parties under them shall terminate if they have not entered into effect by the date 180 days after
the date of this letter of amendment and the Amended and Restated Loan Agreement, unless the World
Bank shall have established a later date for such purpose.
Sincerely,
INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT
Poonam Gupta
Acting Country Director for Egypt
Middle East and North Africa Region
AGREED
ARAB REPUBLIC OF EGYPT
By:      24.-     1
Name:                A-AAWa-     h-L  -Eku.L
Title: K/PITJ6'4U                A/    I        ,)   a~
Date:     9-         -
Attachments:  1. Amended and Restated Loan Agreement.
2. Performance Monitoring Indicators.