Integrated Safeguards Data Sheet (Initial) Report No: AC787 Section I - Basic Information Date ISDS Prepared/Updated: 04/15/2004 A. Basic Project Data (from PDS) I.A.1. Project Statistics Country: GUINEA-BISSAU Project ID: P073442 Project: HIV/AIDS GLOBAL MITIGATION SUPPORT Task Team Leader: Christian Fauliau PROJECT Authorized to Appraise Date: March 15, 2004 IBRD Amount ($m): Bank Approval: June 1, 2004 IDA Amount ($m): IDA GRANT FOR HIV/AIDS: 7 Managing Unit: AFTS4 Sector: Health (100%) Lending Instrument: Specific Investment Loan (SIL) Theme: Other communicable diseases (P) Status: Lending I.A.2. Project Objectives (From PDS): The project will support the medium-term strategy of the Government to expand and accelerate the national response to HIV/AIDS by (i) reducing the spread of HIV/AIDS infection; (ii) increasing access to treatment for STD and HIV/AIDS; and iii) decreasing the socio-economic impacts of HIV/AIDS at the individual, household, and community levels. Specifically, the project will: l fund projects led by civil society, including the private sector, and carried out in urban and rural communities, which cover HIV/AIDS related prevention, advocacy, public awareness creation and care for orphans and PLWHA, focusing on the most vulnerable groups; l strengthen delivery of health services providing prevention, care and treatment services, giving priority to the five regions with highest HIV/AIDS prevalence rates. Such services would include voluntary testing and counseling services and treatment of STDs and opportunistic infections related to HIV/AIDS; l enable Government at the national and regional levels to carry out programs advocating prevention and facilitating access to care for its own staff and communities; l strengthen institutional capacity for planning, delivering and monitoring of HIV/AIDS response interventions through all levels of Government and its line ministries, civil society and the private sector, with a focus on vulnerable groups. I.A.3. Project Description (From PDS): The project is designed within a multi-sector framework, under the Multi-Country AIDS Program (MAP) for Africa, which addresses HIV/AIDS in a broad context. It will support the Government in applying an expanded response to HIV/AIDS through: l funding projects led by civil society, including the private sector, and carried out in urban and rural communities, which cover HIV/AIDS related prevention, advocacy, public awareness creation and care for orphans and PLWHA, focusing on the most vulnerable groups; l strengthening delivery of health services providing prevention, care and treatment services, giving priority to the five regions with highest HIV/AIDS prevalence rates. Such services 2 ISDS would include voluntary testing and counseling services and treatment of STDs and opportunistic infections related to HIV/AIDS; l enabling Government at the national and regional levels to carry out programs advocating prevention and facilitating access to care for its own staff and communities; l strengthening institutional capacity for planning, delivering and monitoring of HIV/AIDS response interventions through all levels of Government and its line ministries, civil society and the private sector, with a focus on vulnerable groups. The project will be implemented through three components as follows: Part A. Community and Civil Society Initiatives, and Capacity Building l social mobilization and community level responses to HIV/AIDS l expanding and strengthening HIV/AIDS activities of communities NGOs, CBOs, private sector, religious sector, and PLWHA Funds will be specifically set aside for two groups: Orphans, whose numbers are increasing as the epidemic progresses. The program would target all orphans, as differentiating orphans by causes would be difficult and inhumane. PLWHAs, who have decreased productive capacity, which further reduces their resources. It is essential to help families avoid the poverty trap and adjust available technologies in the agricultural and private sectors to address this limitation and to create adapted sources of revenue. Part B. Government Multi-sector Response l strengthen prevention, care, support, and mitigation of the HIV/AIDS impact through public sector programs and activities l support public sector institutions to protect their own personnel from the impact of HIV/AIDS and integrate HIV/AIDS activities into their core business. This component will support: The Ministry of Health ­ which will receive the largest share of funds under this component. The ministry has a unique role in combating the epidemic, as it is often the only source of health care in rural areas. This support will partially finance the Ministry's HIV/AIDS work plan. All other Ministries and Government Agencies ­ ministries with advanced work plans and responsibility for the highest priority areas (education, health, agriculture, interior and army forces, youth and sport) will receive comprehensive support during the first year. Others will receive limited support focusing mainly on protecting their own personnel. Part C. Institutional Development for Program Management The project will support the National AIDS Council (NAC) and its Executive Secretariat (NAS), including its regional components and focal points, to fulfill its national HIV/AIDS coordination mandate. The broad responsibilities assigned to the NAC evolve around advocacy, providing leadership for the multi-sector response, coordination, and monitoring and evaluation. Indicative Project Costs Source Millions of USD Community and Civil Society 9.50 Initiatives and Capacity Building Government Multi-sector Response 7.00 Institutional Development for 2.50 3 ISDS Program Management Total Project Cost 19.00 I.A.4. Project Location: (Geographic location, information about the key environmental and social characteristics of the area and population likely to be affected, and proximity to any protected areas, or sites or critical natural habitats, or any other culturally or socially sensitive areas.) The project will cover the entire country, with a focus on geographical areas of greatest HIV prevalence, and highly vulnerable groups to HIV/AIDS. B. Check Environmental Classification: B (Partial Assessment) Comments: The project has been classified as a B because of the potential environmental and social impacts related to medical waste management under the project. In addition to financing the development and implementation of health care management plan for activities related to HIV prevention and TB control, the project will support the formulation of the national policy and guidelines of health care waste management and assist in the preparation of legislation and to the enforcement of the legislation. In February 2002, regulatory agencies, health care facilities, litter gatherers, and community organizations were consulted and identified issues include: lack of appropriate selection of health care waste, carelessness and lack of qualification of the medical staff, mingling of health care waste with normal household litter, insufficient quantities of collection baskets and provisional litter containers, lack of security equipment for cleaning staff, and no efficient waste treatment system. The project is allocating US$370,000.00 for the Medical Waste Management Program (MWMP) implementation in the five pilot regions. C. Safeguard Policies Triggered (from PDS) (click on for a detailed desciption or click on the policy number for a brief description) Policy Triggered Environmental Assessment (OP 4.01, BP 4.01, GP 4.01) Yes No TBD Natural Habitats (OP 4.04, BP 4.04, GP 4.04) Yes No TBD Forestry (OP 4.36, GP 4.36) Yes No TBD Pest Management (OP 4.09) Yes No TBD Cultural Property (OPN 11.03) Yes No TBD Indigenous Peoples (OD 4.20) Yes No TBD Involuntary Resettlement (OP/BP 4.12) Yes No TBD Safety of Dams (OP 4.37, BP 4.37) Yes No TBD Projects in International Waters (OP 7.50, BP 7.50, GP 7.50) Yes No TBD Projects in Disputed Areas (OP 7.60, BP 7.60, GP 7.60)* Yes No TBD Section II - Key Safeguard Issues and Their Management D. Summary of Key Safeguard Issues. Please fill in all relevant questions. If information is not available, describe steps to be taken to obtain necessary data. II.D.1a. Describe any safeguard issues and impacts associated with the proposed project. Identify and describe any potential large scale, significant and/or irreversible impacts. The key safeguard issues relate to the management of health care waste (laboratory, chimicals supplies and 4 ISDS obsolete medication) and its safe disposal. Issues Procedures are almost inexistent. The presence of waste which is potentially infected with the VIH virus increases the health risks of mismanagement, and prompts a renewed concern with safe management and disposal procedures. Issues have been addressed in the MWMP. II.D.1b. Describe any potential cumulative impacts due to application of more than one safeguard policy or due to multiple project component. None II.D.1c Describe any potential long term impacts due to anticipated future activities in the project area. Currently, the environment as well as local communities are exposed to environmental and public health risks due to haphazard disposal of health care center wastes as no appropriate procedures exits. The implementation of training in safe disposal of hazardous waste and the strengthening of the physical capacity of the health system to appropriately dispose of such waste in accordance with international guidelines is expected to have a positive impact. II.D.2. In light of 1, describe the proposed treatment of alternatives (if required) The proposed MWMP is technically sound and no other financially viable alternatives exist. II.D.3. Describe arrangement for the borrower to address safeguard issues A medical waste management plan has been prepared and has been disclosed. A workshop to inform stakeholders is planned as part of project launch activities. II.D.4. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. Government has engaged in a wide-ranging set of consultations in preparing the National Strategy, including with PLWHAs. This has been financially supported through the PHRD grant. In addition, UN Agencies have supported a part of the cost of this participatory approach by financing some regional workshops. The first year's draft work program has been elaborated at the regional levels with extensive involvement of community representatives. Communities are already aware that they have an important role to play in the regional planning, implementation and monitoring of activities. They also know that they are eligible to receive grants for subprojects of their own design. All line Ministries may access support from the project for their own HIV/AIDS programs according to eligibility criteria. For each ministry, a focal point has been designated who has been part of the Government's preparation team of the project. Each focal point is responsible for developing action plans for their respective ministry in consultation with their colleagues and is responsible for its implementation and monitoring. E. Safeguards Classification (select in SAP). Category is determined by the highest impact in any policy. Or on basis of cumulative impacts from multiple safeguards. Whenever an individual safeguard policy is triggered the provisions of that policy apply. [ ] S1. ­ Significant, cumulative and/or irreversible impacts; or significant technical and institutional risks in management of one or more safeguard areas [X] S2. ­ One or more safeguard policies are triggered, but effects are limited in their impact and are technically and institutionally manageable [ ] S3. ­ No safeguard issues [ ] SF. ­ Financial intermediary projects, social development funds, community driven development or similar 5 ISDS projects which require a safeguard framework or programmatic approach to address safeguard issues. 6 ISDS F. Disclosure Requirements Environmental Assessment/Analysis/Management Plan: Expected Actual Date of receipt by the Bank 4/15/2003 4/15/2003 Date of "in-country" disclosure 12/15/2003 12/15/2003 Date of submission to InfoShop 12/20/2003 1/27/2004 Date of distributing the Exec. Summary of the EA to the Executive Not Applicable Not Applicable Directors (For category A projects) Resettlement Action Plan/Framework: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Not Applicable Not Applicable Date of submission to InfoShop Not Applicable Not Applicable Indigenous Peoples Development Plan/Framework: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Not Applicable Not Applicable Date of submission to InfoShop Not Applicable Not Applicable Pest Management Plan: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Not Applicable Not Applicable Date of submission to InfoShop Not Applicable Not Applicable Dam Safety Management Plan: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Not Applicable Not Applicable Date of submission to InfoShop Not Applicable Not Applicable If in-country disclosure of any of the above documents is not expected, please explain why. Signed and submitted by Name Date Task Team Leader: Christian Fauliau 02/13/2004 Project Safeguards Specialists 1: Serigne Omar Fye/Person/World Bank 04/14/2004 Project Safeguards Specialists 2: Project Safeguards Specialists 3: Approved by: Name Date Regional Safeguards Coordinator: Thomas E. Walton 04/14/2004 Sector Manager Mary A. Barton-Dock 04/14/2004