ZAMBIA NATIONAL PU BLIC HE ALTH INSTITU TE MINISTRY OF HE ALTH E NVIRONM E NTAL AND SOCIAL IM PACT ASSE SSM E NT July 2019 Africa CDC Regional Investment Financing Program (P167916) Table of Contents LIST OF FIGURES ................................................................................................................................................ IV ABBREVIATIONS AND ACRONYMS ..................................................................................................................... V EXECUTIVE SUMMARY ....................................................................................................................................... 1 1. INTRODUCTION............................................................................................................................................ 12 1.1 B ACKGROUND AND R ATIONALE FOR THE PROJECT ........................................................................................... 12 1.2 AFRICA CENTRES FOR DISEASE CONTROL AND PREVENTION R EGIONAL I NVESTMENT FINANCING PROGRAM (ACDCP) ... 16 1.2.1 Project Development Objective................................................................................................... 17 1.2.2 Project Components ................................................................................................................... 17 1.2.3 Component 1: Governance, Advocacy, and Operational Frameworks .......................................... 17 1.2.4 Component 2: Public Health Assets............................................................................................. 18 1.2.5 Component 3: Human-Resources Development........................................................................... 19 1.2.6 Cross cutting Component: The Contingent Emergency Response Component .............................. 20 1.2.7 Access to the Laboratory / Office Complex and Sample Transportation ....................................... 20 1.3 PROJECT ENVIRONMENTAL AND SOCIAL I MPACT ASSESSMENT (ESIA) M ETHODOLOGY ............................................... 21 1.4 CONSTRUCTION COST AND PROPOSED I MPLEMENTATION T IMEFRAME .................................................................... 22 2. DESCRIPTION OF THE PROJECT ..................................................................................................................... 24 2.1 LOCATION ................................................................................................................................................. 24 2.2 NATURE OF THE I NFRASTRUCTURE .................................................................................................................. 27 2.3 T HE PROPOSED B IOSAFETY LEVEL 3 LABORATORY ............................................................................................... 30 2.3.1 Raw Materials for construction of the lab and construction phase activities ..................................... 31 2.3.2 Resources needed at Operational Phase .......................................................................................... 33 2.3.3 Expected Types and Quantities of Wastes........................................................................................ 34 2.3.4 Approaches for Management of General and Health Care Solid Waste from the proposed BSL3 lab.. 45 2.3.5 Medical Wastewater Management Approach for the proposed BSL3 lab.......................................... 53 2.3.6 Surveillance and Maintenance of the Wastewater Treatment System .............................................. 56 3. LEGAL AND POLICY FRAMEWORK................................................................................................................. 57 3.1 I NSTITUTIONAL FRAMEWORK ......................................................................................................................... 57 3.2 R EVIEW OF R ELEVANT NATIONAL R EGULATORY FRAMEWORK ............................................................................... 57 3.3 R EVIEW OF R ELEVANT POLICY FRAMEWORK ...................................................................................................... 62 3.3.1 National Health Policy ..................................................................................................................... 62 3.3.2 National Policy on Environment....................................................................................................... 62 3.4 WORLD B ANK OPERATIONAL POLICIES ............................................................................................................ 62 3.5 I NTERNATIONAL AND R EGIONAL CONVENTIONS ................................................................................................. 63 3.6 T HE WORLD B ANK GROUP EHS AND WHO B IOSAFETY MANUALS ......................................................................... 64 4. DESCRIPTION OF THE BASELINE ENVIRONMENT........................................................................................... 66 4.1 LOCATION ................................................................................................................................................. 66 4.2 PHYSICAL ENVIRONMENT .............................................................................................................................. 67 4.2.1 Climate ........................................................................................................................................... 67 4.2.2 Air Quality....................................................................................................................................... 69 4.2.3 Soils and Land use ........................................................................................................................... 69 4.2.4 Landscape and Topography............................................................................................................. 70 4.2.5 Ground and Surface Water .............................................................................................................. 72 4.2.6 Geology........................................................................................................................................... 73 4.2.7 Noise Levels .................................................................................................................................... 73 4.3 E COLOGICAL R ESOURCES .............................................................................................................................. 74 4.3.1 Fauna.............................................................................................................................................. 74 i 4.3.2 Flora ............................................................................................................................................... 74 4.4 SOCIAL, ECONOMIC AND CULTURAL I SSUES ....................................................................................................... 76 4.4.1 Administration ................................................................................................................................ 76 4.4.2 Land Tenure .................................................................................................................................... 76 4.4.3 Culture and Traditional Establishments in the Project Area .............................................................. 76 4.4.4 Economic Activity ............................................................................................................................ 77 4.4.5 Built Environment............................................................................................................................ 78 5. PROJECT ALTERNATIVES ............................................................................................................................... 79 5.1 NO PROJECT ALTERNATIVE ............................................................................................................................ 79 5.2 SITE ALTERNATIVES ..................................................................................................................................... 79 5.3 DESIGN ALTERNATIVE .................................................................................................................................. 79 5.4 CONSTRUCTION M ATERIALS ALTERNATIVE ........................................................................................................ 79 5.5 WATER SOURCE ALTERNATIVES ...................................................................................................................... 80 5.6 ALTERNATIVE ENERGY SOURCE ...................................................................................................................... 80 5.7 SOLID WASTE TREATMENT OPTIONS ................................................................................................................. 81 5.8 WASTEWATER MANAGEMENT ALTERNATIVES .................................................................................................... 81 5.8.1 Wastewater Management 1st Alternative ...................................................................................... 81 5.8.2 Waste Water Management 2nd Alternative.................................................................................... 82 6. STAKEHOLDER CONSULTATIONS ANDINFORMATION DISCLOSURE .............................................................. 84 7. ENVIRONMENTAL AND SOCIAL IMPACTS AND MITIGATION MEASURES ...................................................... 87 7.1 POSITIVE I MPACTS ...................................................................................................................................... 87 7.2 CONSTRUCTION PHASE NEGATIVE I MPACTS ...................................................................................................... 89 7.2.1 Negative Physical Environment........................................................................................................ 89 7.2.2 Negative impacts on Biological Environment ................................................................................... 91 7.2.3 Negative impacts on socio-economic Environment........................................................................... 92 7.3 OPERATIONS AND MAINTENANCE PHASE IMPACTS AND MITIGATION MEASURES ........................................................ 97 8. ENVIRONMENTAL AND SOCIAL MANAGEMENT PLAN (ESMP) .................................................................... 113 8.1 I NSTITUTIONAL ARRANGEMENTS FOR M ANAGEMENT OF ENVIRONMENTAL AND S OCIAL R ISKS ASSOCATED WITH THE BSL3 LABORATORY................................................................................................................................................. 113 8.1.1 ZNPHI............................................................................................................................................ 113 8.1.2 Project Implementation Unit (PIU) ................................................................................................. 113 8.1.3 The Biosafety Committee............................................................................................................... 114 8.1.4 Biosafety and biosecurity Officer ................................................................................................... 114 8.1.5 Project Supervision Engineer.......................................................................................................... 115 8.1.6 Contractor..................................................................................................................................... 116 8.1.7 Zambia Environment Management Authority ................................................................................ 116 8.2 M ITIGATION M EASURES PLAN ..................................................................................................................... 116 8.3 ENVIRONMENTAL AND S OCIAL M ONITORING .................................................................................................. 128 8.4 CAPACITY DEVELOPMENT AND T RAINING ....................................................................................................... 134 8.6 GRIEVANCE REDRESS AND CHANCE FIND PROCEDURES ..................................................................................... 134 8.6.1 Grevance redress mechanism ........................................................................................................ 134 8.6.2 Chance finds procedure ................................................................................................................. 136 8.7 R EPORTING R EQUIREMENTS ........................................................................................................................ 137 REFERENCES ................................................................................................................................................... 139 ANNEX 1: PROJECT SCREENING AND GUIDANCE ON ENVIRONMENTAL IMPACT ASSESSMENT................ 141 ANNEX 2: LAND ACQUISITION DOCUMENTS............................................................................................ 142 ANNEX 3: GOOD LABORATORY PRACTICES, SAFETY AND DESIGN FOR BSL 3 LABORATORY..................... 145 ii ANNEX 4: LABORATORY SECURITY AND EMERGENCY RESPONSE GUIDANCE AT ZNPHI BSL-3 FACILITY ... 149 ANNEX 5: STAKEHOLDER CONSULTATIONS.............................................................................................. 156 ANNEX 6: MINUTES OF THE PUBLIC STAKEHOLDER CONSULTATION ....................................................... 169 ANNEX 7: PROTOCOL FOR TRANSPORTATION OF INFECTIOUS SUBSTANCES ........................................... 200 ANNEX 8: OVERVIEW OF THE MANCHINCHI SEWERAGE TREATMENT PLANT .......................................... 218 iii LIST OF FIGU RE S Figure 1: Africa CDC Operating Framework .........................................................................................12 Figure 2: Map showing the location of Chongwe District in Lusaka province .......................................24 Figure 3: Sign post showing the location of Silver Rest at the junction with Great East Road ...............25 Figure 4: Silver Rest junction with the Great East Road .......................................................................25 Figure 5: Satellite map showing location of the project site.................................................................26 Figure 6: Conceptual Design of the Proposed Complex........................................................................28 Figure 8: Managment of General and Healthcare Waste .....................................................................46 Figure 10: ZAMRA – Building Housing the two Incinerators ................................................................48 Figure 11: An Inciner8 Incinerator at ZAMRA.......................................................................................49 Figure 12: Incinerator flue-gas stack....................................................................................................50 Figure 13: Inciner8 Capacity................................................................................................................50 Figure 19: Average Sunshine Hours for Lusaka....................................................................................68 Figure 20: Average Precipitation for Lusaka ........................................................................................68 Figure 22 Typical Soils at the Project Site ............................................................................................70 Figure 23 Topography of Lusaka and Chongwe....................................................................................71 Figure 24 Chalimbana Stream on the Eastern Boundary of the Project Site .........................................72 Figure 25 Vegetation around the Chalimbana Stream .........................................................................75 Figure 26 Distribution of grass vegetation around the project site ......................................................75 Figure 27 UNZA farm South West of the Project site ...........................................................................76 Figure 28 Rural household structures for the Caretaker within the Project Site ...................................77 Figure 29 Screens..............................................................................................................................222 Figure 30 Comminutor......................................................................................................................223 Figure 31 Bio Filter............................................................................................................................225 Figure 32 Dried Sludge ......................................................................................................................226 iv ABBRE VIATIONS AND ACRONY M S 7NDP Seventh National Development Plan BSL3 Biosafety Level 3 CDC Center for Disease Control CSO Central Statistical Office EMA Environmental Management Act ESIA Environmental and Social Management Plan EQA External Quality Assurance ESF Environmental Social Framework ESIA Environmental Social Management Plan G RZ G overnment of the Republic of Zambia HIV Human Immunodeficiency V irus IDA International Development Association MOH Ministry of Health PCN Project Concept Note PDO Project Development Objective PHEOC Public Health Emergency Operations Center PPE Personal Protective Equipment RCC Regional Collaboration Centers SADC Southern Africa Development Community SA-RCC Southern Africa Regional Collaboration Centers ZEMA Zambia E nvironmental Management Agency ZNPHI Zambia National Public Health Institute v E XE CU TIVE SU M M ARY Background The G overnment of Zambia has established the Zambia National Public Health Institute (ZNPHI) as a specialised technical arm of the Ministry of Health responsible for protecting the Public Health security of the country. Zambia also serves as host country for the Africa Centres for Disease Control and Prevention (Africa CDC) Southern Africa Regional Collaborating Center (SA-RCC), which coordinates public health and disease prevention strategies among ten regional Member States (Angola, Botswana, eSwatini, Lesotho, Malawi, Mozambique, Namibia, South Africa, Zambia and Zimbabwe). The ZNPHI through the Ministry of Health has received support from The World Bank through the Africa Centres for Disease Control (CDC) Regional Investment Financing Program (ACDCP). The ACDCP is providing support to three entities: the Africa CDC headquarters; Ethiopia as host country for Africa CDC; and Zambia National Public Health Institute (ZNPHI) and Southern Africa Regional Collaborating Centre (SA-RCC) in Lusaka, Zambia. In the Zambian component of the Africa CDC financing program, ZNPHI proposes to construct, equip, staff and operate a four-storey purpose-built laboratory and office complex that will comprise a Biosafety Level 3 (BSL-3) Laboratory suite, Public Health Emergency Operations Centre (PHEOC), Information Communication and Technology (ICT) suite, Proficiency Panel Production Center, Biomedical Equipment Maintenance Center, training facilities, Conference facilities and office accommodation to enable it meet both national and regional public health responsibilities. This will provide additional capacity to fulfil obligations in line with the International Health Regulations (IHR) 2005 core capacities, the 2017-2021 Zambia National Health Strategic Plan, and vision of the Africa CDC for strong institutions that support national, regional and international partnerships for disease control and public health security. The laboratory and office complex will be a fix ed asset owned by the G overnment of the Republic of Zambia (G RZ) under the Ministry of Health (MOH). The main infrastructure is envisioned to be a four-storey building of an inverted “T” shape, with accessory two-storey arc-shaped blocks at its rear. The front of the building will connected through a central circular façade that will serve as the primary public entrance into the complex . The two rectangular blocka wil accommodate the offices, training/seminar rooms, ICT suite, conference facilities and library/resource center. The top two floors of the circular area will house the PHEOC (one floor each for national and regional). The stem of the inverted “T” will be the main laboratory block, with the BSL-3 suite occupying the uppermost floor, while other support laboratories will be on the lower three floors. These will support functions including V irology, Bacteriology, Immunology/Vaccinology, V ector biology & Parasitology, a Molecular biology suite, Chemistry, Haematology, Tox icology and and proficiency testing panel production center to support quality assurance programs. The arch-shaped blocks will house the Biorepository and animal health laboratory facilities. Other accessory features will include a biomedical equipment maintenance center, power substation, onsite industrial autoclave and shredder unit, and waste management system (for both liquid and solid biomedical and domestic waste). Need for the Project Zambia currently does not have a dedicated public health laboratory and relies on clinical laboratories which are primarily mandated to support clinical management of patients. The proposed project will address this gap by providing financial and technical assistance for construction, equipping and staffing 1 of a dedicated National Public Health Laboratory at Biosafety Level (BSL3), with associated ICT support for data management and security. Objectives of the Project The project objective is to establish resilient public health security capacity, infrastructure and human resource capacity and systems for Zambia and the SA-RCC region, encompassing:  Surveillance and disease intelligence,  Effective preparedness and efficient management of public health emergencies and events,  Efficient Public Health Laboratory Networks,  Public Health and scientific workforce development  G eneration, management and dissemination of scientific data to support evidence-based formulation of national and regional policies, strategies and programs for public health actions. ESIA Study Objectives The main objective of this ESIA study is to identify and assess impacts resulting from the proposed project to the biophysical social and economic environment. Anticipated positive and negative impacts from the proposed project have been assessed in accordance with the Environmental Impact Assessment Regulations established under the Environmental Management Act (EMA), World Bank Safeguards Policies and WHO Laboratory Biosafety Manual. ESIA Methodology and Approach A detailed study for the ESIA was undertaken in light of the legislative requirements of the Environmental Impact Assessment Regulations of Zambia. During the ESIA study, the key focus was to identify potential environmental, social and cultural impacts of the proposed project and highlight possible mitigation measures for these impacts. The study procedure involved desk review, field visits and observation to collect field baseline date, interviews with stakeholders, photography, geo- referencing and design of an environmental management plan. Field site surveys formed part of the preparation of the ESIA report. The main objective of this activity was to carry out on-site field assessments of the ex pected effects of the planned developments on the physical, biological and socio- economic environment. Besides, project affected groups were consulted to get their concern about the project and their concerns have been addressed in the proposed mitigation measures. Legal, Policy and Administrative Framework The proposed project activities touch on many regulatory instruments which need compliance with. Presented below is some the key Zambian legislation relevant to the project and requiring legal compliance will be applicable.  Environmental Management Act, 2011  Environmental Impact Assessment Regulations, 1997  National Health Research Act, 2013  Public Health Act, 1995  The Medicines and Allied Substances, 2013 The World Bank Safeguards Policies, namely OP/BP 4.01 and OP 4.11 are applicable to this project and hence have been triggered. Air emissions from incineration of decontaminated wastes and effluents from the Zambia BSL3 laboratory should comply with the requirements of the World Bank G roup Environment Health and Safety G uidelines including the G eneral G uidelines and G uidelines for 2 Healthcare Facilities and Waste Management. The project will also comply with G ood International Industry Practices (G IIP) such as WHO guidelines for healthcare facilities and laboratory biosafety. The Baseline Environment The BSL3 lab will be located approx imately 26km from Lusaka central business district along Palabana road in Silver Rest, Chongwe district. The project site is approx imately 4.8km at the terminal end of the newly tarred Silverest road from Silverest primary school on G reat East Road. The tarred road leading to the project site branches off from the G reat East road (T2) at Silverest primary school, 9km from the airport roundabout. The central G PS coordinates for the 10- hectare project site are; Latitude 15°23’ 38 South and Longitude 28°28 41’ East. Air quality in the project area is generally good although pollutants generated by vehicle ex haust emissions and dust raised by traffic passing through the area contributes to deterioration of the ambient air quality, especially when local inversions are ex perienced. Apart from vehicular traffic, other sources of air pollution include the burning of fuel (wood and charcoal) in townships and informal settlements and the burning of bush and scrub as well as charcoal burning in surrounding areas around Silver Rest, especially during the dry season. Increases in fugitive dust levels, particularly under hot and dry conditions, also periodically results in the deterioration of air quality. The project site is found in an upcoming mix ed-use area with infrastructural developments such as Silver Rest G ardens, subsistence and commercial farms and government institutions. In the eastern part of the proposed site, the main sources of livelihood include subsistence agriculture (crops, livestock), charcoal burning and selling, trading, beer brewing, and “wild” natural resources, including trees, grasses, nuts, fruits, and medicinal plants. The most ubiquitous activity is agriculture - virtually all households in the village grow crops. The Project site is located in close prox imity with different social receptors police post (located approx imately 1km from the proposed site location), north east of the site, also located 5.17km in the north direction of the site is Silver Rest primary school and Silver Rest gardens residential estate is located 3.4 km, north of the site. Project alternatives Various project alternatives were taken into account including no project alternative. The no action alternative was not preferred as Zambia currently lacks a dedicated public health laboratory system and relies on the already overloaded clinical laboratories whose core mandate is to provide diagnostic services to support the clinical management of patients in hospitals. The alternative analysis has therefore focused on analysis of options for medical waste management, water supply, energy supply, and project site. the ZNPHI shall have a central autoclaving system for sterilisation of health care solid waste. Health care solid waste from the BSL -3 laboratory will be initially autoclaved within the laboratories as per BSL -3 biosafety requirements. The sterilised solid waste will then be conveyed to the central solid waste autoclaving system for secondary autoclaving. From the central autoclaving system, sterilised solid waste will be shredded to reduce on the volume. The shredded waste, now rendered as safe as domestic waste, will be held temporarily until scheduled for transport to the designated (Chunga) landfill. Where required, ZNPHI will outsource incineration services from ZAMRA. The ZAMRA incinerators are capable of handling medical and pharmaceutical wastes. As per current practice, the ash from the incinerators will be transported by trucks and disposed of at the Chunga landfill site. The BSL3 lab complex will have two separate wastewater networks for management of healthcare waste effluent and domestic waste effluent. The medical wastewater will be collected into a leak proof storage tank whose filling capacity will be auto monitored so as not to ex ceed ¾ full. The wastewater will then be steam sterilised using the liquid cycle of the autoclave connected to the storage tank. The autoclaved wastewater will then be discharged 3 into the solid particle filtration system to allow solid particles to be filtered out of the waste water as it flows through the system. The filtered waste water will be collected in the retention tanks which will be vacuum tanked by licenced waste collectors for further treatment at the offsite municipal sewage treatment site (Manchinchi Wastewater Treatment Plant) at regular intervals. The domestic waste water network will have several inspection chambers as it leads to the sedimentation tanks. A layer of accumulated solids or sludge will form at the bottom of the sedimentation tank as the waste water slowly flows through it thereby providing a level of purification prior to discharge. The sludge at the bottom of the sedimentation tanks will be periodically removed during routine maintenance and will be disposed of at Manchinchi Wastewater Treatment Plant site. The preferred source of energy use in the BSL-3 facility is from the national grid. However, the project will install a stand by generator for the facility for emergency purposes only. The preferred source of water for this project is borehole water with plans by the project to drill a borehole to provide water for the BSL-3 facility. Pipe water from the water utility was rejected due to the lack of a water supply system. International best practices will be considered in designing the lab. The BSL-3 laboratory which is going to be constructed at ZNHIP would be designed and operated in accordance with guidance established by reputable international organizations (CDC 1999, NIH 2001, WHO 2004). Public Consultation and Information Disclosure The study team consulted with stakeholders including government authorities, the community and relevant organizations involved directly and indirectly with the proposed project in order to seek their views on the impacts (adverse and beneficial) of the proposed project on the environment and socio- economic characteristics of the project area. The ESIA team conducted a stakeholder mapping and analysis in order to identify potential stakeholders and their level of interest as regards the project. Consultations with identified stakeholders were carried out through key stakeholder/informant engagements and public meetings. This was done in june 2018, November/December 2018 (Annex 5) and July 2019 (Annex 6). Feedback from the consultations was incorporated in developing project mitigation measures. On 16 th July 2019, a public consultative and disclosure meeting on the project was held at the Ministry of Health Headquarters and attended by a wide representation of stakeholders including community members, local leaders, cooperating partners, MOH senior leadership, NG O, and government agencies (Annex 6). The meeting was chaired by the Honourable Minister of Health Dr Chitalu Chilufya and the area Chiefdom, the Busoli royal establishment (BRE), was represented by Princess Cholwe Nkomeshya. Following description of the various aspects of the project by the ZNPHI Director Dr V ictor Mukonka, an open question and answer session was held, durimg which the stakeholders sought clarity on a number of issues. These centered mainly around security and safety matters, institutional relationships/roles, and benefits of the projet to the local community and the nation at large. Overall there was acceptance and support for the project. This position was also echoed by the BRE through Princes Cholwe, who pledged full support and ex pressed gratitude to the G overnment for considering to set up the infrastructure and investment in the Busoli Chiefdom. Environmental and Social Impacts and Mitigation Measures The major environmental and social impacts that are likely to arise from the construction and operational phases as well as mitigation measures for the riks are summarized in the table following: 4 Adv erse Impacts and M itigation M easures (Construction Phase) E nvironmental / Social Impact M itigation M easures Traffic Congestion Provide and implement a traffic management plan Provision temporary road signs or notices to indicate ongoing works. Effecting traffic controls to avoid congestion and accidents on construction site and associated roads. Choosing suitable traffic routes to reduce the impact in the neighbourhood. Ensuring no interference with traffic through traffic control, designated parking, speed limits and hiring a banksman. Site Related Oil Spills Employee awareness on company procedures for dealing with spills and leaks from oil storage tanks. Containment of leaks. Provision of absorbent material Maintenance of contractor’s plant Provision of relevant emergency numbers Soil Related Impacts Stock piling of soil for reuse Provision temporary drainage channels or holding ponds as a precautionary measure Restoration of the ground by planting adequate grass cover and trees. Planning emergency response measures in case of accidental oil spills. Impact on Water Resources Provide a waste management plan Proper solid and liquid wastes disposal mainly from the construction camps, sites and offices. Ensuring proper measures are in place for collection and disposal of spilled oils and lubricants. Influx/Inmigration Hiring unskilled construction and skilled (if available) labour from the local population as far as possible. Use of manual labour during ex cavation and construction works where possible. Prepare a labour influx plan to manage labour influx Sensitizing workers and the surrounding community on awareness, prevention and management of HIV/AIDS. Enforcing and maintaining a code of conduct for employees Air Quality Use of persomal protective clothing (PPE) like dust masks on construction crew. Regular water spraying of murram and earth roads and construction site Operated and maintenance of contractor’s plant in compliance with relevant vehicle emission standards and manufacturer’s specification to minimize air pollution. Noise Pollution Use of persomal protective clothing (PPE) like dust masks on construction crew. Avoiding night time construction when noise is loudest near residential areas. No discretionary use of noisy machinery within 50 m of residential areas and near institutions or use of manual labour in these sections. Good maintenance and proper operation of construction machinery. Where possible, ensure non mechanized construction to reduce the use of machinery Impact on flora and fauna Re-planting the indigenous vegetation as much as possible once work is completed. Sparing the vegetation that must not necessarily be removed. Provide a waste management plan Promoting non-mechanized methods of construction. Ensure that the employees on site are aware of the company procedures 5 E nvironmental / Social Impact M itigation M easures for dealing with spills and leaks from oil storage tanks Provision of dustbin and sanitation facilities. Public Health & Safety Ensuring proper maintenance and operation of Contractors’ machinery to mitigate noise and dust impacts. Providing crossing areas for access to pedestrians to minimise accidents. Provide workers with adequate drinking water and breaks. Drain all pools of standing water to minimize or altogether eliminate mosquito breeding sites. Provide a waste management plan. Cordon off trenches and working areas with a reflective tape to ensure safety of pedestrians and provide crossing areas HIV & AIDS Impacts Sensitizing workers and the surrounding communities on awareness, prevention and management of HIV/AIDS. Provide an on-site clinic to provide VCT services to construction crew. Gender empowerment Ensuring equitable distribution of employment opportunities between men and women Providing toilets and bathrooms for both male and female workers on site Child Labour and Protection Provide and implement a child protection strategy Ensuring no children are employed on site in accordance with national labour laws Ensuring that any child sex ual relations offenses among contractors' workers are promptly reported to the police Gender Equity, Sex ual Harassment Provide and implement a gender based violence strategy, which will include: Gender mainstreaming in employment at the worksite with opportunities provided for females to work, in consonance with local laws and customs Grievance redress mechanisms including non-retaliation. Provide and implement an employee code of conduct The works contractor should be required, under its contract, to prepare and enforce a No Sex ual Harassment and Non-Discrimination Policy, in accordance with national law where applicable. Liability for loss of life, injury or Provision of PPE. damage to private property Training workers on the operation of the machinery and equipment Ensuring there are adequate warning and directional signs. Ensuring that the prepared code of conduct for staff is followed to prevent accidents. Developing a site safety action plan. Cordoning off unsafe areas Provision of first Aid kit within the construction site. Recording of all injuries that occur on site in the incident register, corrective actions for their prevention are instigated as appropriate. Compliance with the Workmen's Compensation Act, ordinance regulations and union agreements. Ecological impact (It is anticipated To minmise this, ZNPHI will ensure all vegetation clearance are that small scale vegetation clearing restricted to the project footprint activities during the construction phase of the project may result in loss of flora and fauna). Ex cavation activities during As much as possible ex cavated soil will be re-used on the site as construction phase of the project backfill and will be compacted to make it stable. All cut slopes, may lead to soil instability and embankments, and other erosion- prone working areas will be erosion at the project site while stabilized to any feasible ex tent movement of construction equipment and machinery would lead to compaction of top soil. 6 Adv erse Impacts (Operation Phase) E nvironmental / Social Impact M itigation M easure Wastewater generated by the ZNPHI shall ensure effective solid waste management and wastewater facility during the operational from the laboratories will be collected and channeled to a collection phase has potential to pollute tank linked to decontamination and disinfection equipment for primary surface and groundwater through treatment. The decontaminated and disinfected waste water will then surface drainage regimes and be channeled into the interceptor tanks for secondary treatment before infiltrating the underlying aquifer. being transported to a waste water treatment facility. In addition, ZNPHI developed an Infection Prevention, Control and Waste Management Plan (IPCWMP) Impacts associated with Ensure the BSL-3 Facility is designed in accordance with the design inadequate BSL-3 Facility Design requirements provided by WHO Laboratory Biosafety Manual) leading to among others: (Human Health Risks, Occupational Health and Safety Risks, Community Health and Safety Risks, Environmental Risks) Impacts associated with NON- Ensure that the BSL-3 Facility is commissioned as per the Commissioning of the BSL-3 requirements and in accordance with the design requirements provided Facility design leading to among by WHO Laboratory Biosafety Manual). others: - (Human Health Risks, Occupational Health and Safety Risks, Community Health and Safety Risks, Environmental Risks) Impacts associated with NON- Ensure that the BSL-3 Facility is commissioned as per the CE RTIFICATION of the BSL-3 requirements and in accordance with the design requirements provided Facility design leading to among by WHO Laboratory Biosafety Manual). others:- Ensure that on an annual basis, RE -CE RTIFICATION of the BSL-3 Facility is undertaken by an independent ex pert. (Human Health Risks, Occupational Health and Safety Risks, Community Health and Safety Risks, Environmental Risks) Impact associated with Workers’ Provide training to workers in the BSL-3 and ensure they have proper Chemical Ex posure leading to knowledge of the tox ic effects of these chemicals, the routes of Occupational Health and Safety ex posure and the hazards that may be associated with handling and Risks, storage. Material safety data sheets or other chemical hazard information should be available from chemical manufacturers and/or suppliers. These should be accessible in laboratories where these chemicals are used, e.g. as part of a safety or operations manual. Ensure that there are Biological Safety Cabinets (BSCs) (Class III) in the BSL-3 designed to protect the operator, the laboratory environment and work materials from ex posure to infectious aerosols and splashes that may be generated when manipulating materials containing infectious agents, such as primary cultures, stocks and diagnostic specimens. Impacts associated with inadequate Develop a solid waste management plan for infectious and harzadious management of infectious solid solid wastes with WHO Laboratory Biosafety Manual waste from the the BSL-3 Facility Autoclave all infectious and harzadious solid wastes to among others:- Incinerate infectious and harzadious solid wastes in an incinerator that meets the specifications for incinerating wastes from BSL-3 facility (Human Health Risks, Provide training for workers handling for infectious and harzadious Occupational Health and Safety solid wastes Risks, Community Health and 7 E nvironmental / Social Impact M itigation M easure Safety Risks, Environmental Risks) Provide PPE for workers handling for infectious and harzadious solid wastes Impacts associated with inadequate Develop a liquid waste management plan for infectious and harzadious management of infectious solid wastes in accordance with WHO Laboratory Biosafety Manual effluent/liquid waste from the the Autoclave all infectious and harzadious liquid wastes BSL-3 Facility leading to among Provide training for workers handling for infectious and harzadious others:- liquid wastes Provide PPE for workers handling for infectious and harzadious liquid (Human Health Risks, wastes Occupational Health and Safety Risks, Community Health and Safety Risks, Environmental Risks) Impacts associated with inadequate All items within BSCs, including equipment, should be surface- disinfection of BSL-3 Facility decontaminated and removed from the cabinet when work is leading to among others:- completed, since residual culture media may provide an opportunity for microbial growth. The interior surfaces of BSCs should be Occupational Health and Safety decontaminated before and after each use. Risks) The work surfaces and interior walls should be wiped with a disinfectant that will kill any microorganisms that might be found inside the cabinet. At the end of the work day, the final surface decontamination should include a wipe-down of the work surface, the sides, back and interior of the glass. A solution of bleach or 70% alcohol should be used where effective for target organisms. A second wiping with sterile water is needed when a corrosive disinfectant, such as bleach, is used. BSCs must be decontaminated before filter changes and before being moved. The most common decontamination method is by fumigation with formaldehyde gas. BSC decontamination should be performed by a qualified professional. Impacts associated with specimen To avoid accidental leakage or spillage, secondary containers, such as ex posure of BSL-3 Facility leading box es, should be used, fitted with racks so that the specimen containers to among others:- remain upright. The secondary containers may be of metal or plastic, should be autoclavable or resistant to the action of chemical Occupational Health and Safety disinfectants, and the seal should preferably have a gasket. They should Risks) be regularly decontaminated. The facility should designate a Receipt of specimens room or area designated for this purpose. Personnel who receive and unpack specimens should be aware of the potential health hazards involved, and should be trained to adopt standard precautions (2), particularly when dealing with broken or leaking containers. Primary specimen containers should be opened in a biological safety cabinet. Disinfectants should be available. Every laboratory that works with infective microorganisms should institute safety precautions appropriate to the hazard of the organisms and the animals being handled. Impacts associated with Develop a Contigency Plan Procedure for the BSL-Facility E mergency Hazards from the Provide First-aid kit, including universal and special antidotes BSL-3 Facility design leading to Provide Appropriate fire ex tinguishers, fire blankets among others: - Full protective clothing (one-piece coveralls, gloves and head covering (Human Health Risks, – for incidents involving microorganisms in Risk Groups 3) Occupational Health and Safety Full-face respirators with appropriate chemical and particulate filter Risks, Community Health and canisters Safety Risks, Environmental Risks) Room disinfection apparatus, e.g. sprays and formaldehyde vaporizers Hazard area demarcation equipment and notices Impacts associated with Fire Fire-fighting equipment should be placed near room doors and at Hazards from the BSL-3 Facility strategic points in corridors and hallways. This equipment may include design leading to among others: - hoses, buckets (of water or sand) and a fire ex tinguisher. Fire ex tinguishers should be regularly inspected and maintained, and their 8 E nvironmental / Social Impact M itigation M easure (Human Health Risks, shelf-life kept up to date. Occupational Health and Safety Close cooperation between safety officers and local fire prevention Risks, Community Health and officers is essential. Safety Risks, Environmental Risks) The assistance of local fire prevention officers in the training of laboratory staff in fire prevention, immediate action in case of fire and the use of fire-fighting equipment is desirable. Fire warnings, instructions and escape routes should be displayed prominently in each room and in corridors and hallways. Impacts associated with Electrical It is essential that all electrical installations and equipment are Hazards from the BSL-3 Facility inspected and tested regularly, including earthing/grounding systems. design leading to among others: - Circuit-breakers and earth-fault-interrupters should be installed in appropriate laboratory electrical circuits. (Human Health Risks, All laboratory electrical equipment should be earthed/grounded, Occupational Health and Safety preferably through three-prong plugs. Risks, Community Health and All laboratory electrical equipment and wiring should conform to Safety Risks, Environmental Risks) national electrical safety standards and codes. Impacts associated with Noise Where noise levels cannot be abated and where laboratory personnel Hazards from the BSL-3 Facility routinely ex perience ex cessive ex posures, a hearing conservation design leading to among others: - programme that includes the use of hearing protection while working Occupational Health and Safety in hazardous noise and a medical monitoring programme to determine Risks. the effect of noise on the workers should be instituted. Noise measurement surveys be conducted to determine the noise hazard. Where warranted by data, engineering controls such as enclosures or barriers around noisy equipment or between noisy areas and other work areas, can be considered Impacts associated with Ionizing To limit the harmful effects of ionizing radiation, the use of radioisotopes Radiation Hazards from the BSL-3 should be controlled and should comply with relevant national standards. Facility leading to among others: - Protection from radiation is managed on the basis of four principles: Minimizing the time of radiation ex posure Occupational Health and Safety Max imizing the distance from the radiation source Risks. Shielding the radiation source Substituting the use of radionuclides with non-radiometric techniques. Mark radiation containers with the radiation symbol, including radionuclide identity, activity and assay date Use radiation meters to monitor working areas, protective clothing and hands after completion of work. Use appropriately shielded transport containers Rem ove radioactive waste frequently from the working area. Maintain accurate records of use and disposal of radioactive materials. Screen dosimetry records for materials ex ceeding the dose limits. Establish and regularly ex ercise emergency response plans. In emergencies, assist injured persons first. Clean contaminated areas thoroughly. Request assistance from the safety office, if available. Write and keep incident reports. Impacts associated with transport Use the protocol for transporation and shipment of specimen and of infectious samples and wastes in accordance with the United Nations Model Regulations on specimens (including wastes) to the Transport of Dangerous Goods (40) and local country laws (Annex and from the the BSL-3 Facility 7). leading to among others:- Provide training to workers in the BSL-3 and ensure they have proper knowledge of the tox ic effects of these chemicals, the routes of (Human Health Risks, ex posure and the hazards that may be associated with handling and Occupational Health and Safety storage. Risks, Community Health and Material safety data sheets or other chemical hazard information should Safety Risks, Environmental Risks) be available from chemical manufacturers and/or suppliers. These should be accessible in laboratories where these chemicals are used, e.g. as part of a safety or operations manual. Laboratory personnel must ship infectious substances according to 9 E nvironmental / Social Impact M itigation M easure applicable transport regulations. Develop a Spill Clean Up Procedure Impacts associated with inadequate Develop laboratory biosecurity measures based on a comprehensive or lack of bio-security system programme of accountability for pathogens and tox ins that includes an program for the BSL-3 Facility updated inventory with storage location, identification of personnel leading to among others:- with access, description of use, documentation of internal and ex ternal transfers within and between facilities, and any inactivation and/or (Human Health Risks, disposal of the materials. Occupational Health and Safety Develop institutional laboratory biosecurity protocol for identifying, Risks, Community Health and reporting, investigating and remediating breaches in laboratory Safety Risks, Environmental Risks) biosecurity, including discrepancies in inventory results Define the involvement and roles and responsibilities of public health and security authorities in the event of a security infraction. Undertake laboratory biosecurity training, distinct from laboratory biosafety training to all personnel. Such training should help personnel understand the need for protection of such materials and the rationale for the specific biosecurity measures, and should include a review of relevant nationa standards and institution specific procedures. Develop procedures describing the security roles and responsibilities of personnel in the event of a security infraction should also be presented during training. Develop code of conduct and professional ethical suitability among workers for working with dangerous pathogens of all personnel who have regular authorized access to sensitive materials is also central to effective laboratory biosecurity activities and should be done through an assessment of the suitability of personnel, security-specific training and rigorous adherence to pathogen protection procedures are reasonable means of enhancing laboratory biosecurity Develop compliance checks with these procedures, with clear instructions on roles, responsibilities and remedial actions. Undertake regular risk and threat assessments, and regular review and updating of procedures.. Impacts associated with inadequate Recruit qualified personell to work in the BSL-3 facility or lack of training of the BSL-3 Conduct safety organisation and training for the BSL-3 workers Facility workers/personell leading Appoint a Biosafety Officer to ensure that biosafety policies and to among others:- programmes are followed consistently throughout the laboratory. The biosafety officer ex ecutes these duties on behalf of the head of the (Human Health Risks, institute or laboratory. Occupational Health and Safety Undertake Supp ort Staff Safety Training for skilled engineers and Risks, Community Health and craftsmen who maintain and repair the structure, facilities and Safety Risks, Environmental Risks) equipment, should have some knowledge of the nature of the work of the laboratory, and of safety regulations and procedures. Testing of equipment after servicing, e.g. testing the efficiency of biological safety cabinets after new filters have been fitted, may be carried out by or under supervision of the biosafety officer. Engineering and maintenance staff should only enter the Biosafety Level 3 facility with clearance and supervision by the biosafety officer and/or the laboratory supervisor. The Biosafety Level 3 facility should only be cleaned by the laboratory staff. Cleaning personnel should only enter Biosafety Level 3 or Biosafety Level 4 laboratories with clearance and supervision by the biosafety officer and/or the laboratory supervisor. Constitute a Biosafety Committee to develop institutional biosafety policies and codes of practice. The biosafety committee should also review research protocols for work involving infectious agents, animal use. Other functions of the committee may include risk assessments, formulation of new safety policies and arbitration in disputes over safety matters. 10 Environmental and Social Management Plan (ESMP) An Environmental and Social Management Plan outlining potential environmental and social riks associated with the proposed BSL3 lab, institutional arrangement for management of risks, parties responsible for implementing and monitoring actions, associated costs, indicators and r capacity building needs and reporting requirements have been prpepared. Responsibilities of ZNPHI, the Project implementation unit, Biosafety Committtee, Biosafety and Biosecurity Officer, Zambia Environment Management Authority and other relevant staff and stakeholders have been described. Monitoring will be undertaken by Zambia Environment Management Authority and ZNPHI.Capacity building measures have been proposed to improve the ZNPHI’s ability to manage the risks associated with the project. To maintain regulatory compliance and to protect personnel, the community and the environment from biohazards, ZNPHI will be responsible for deploying pertinent staff for proper implementation of the ESMP and ICWMP .Capacity building training for ESMP implementation monitoring will be provided to relevant staff of MoH, ZNPHI, and Zambia Environment Management Authority. The proposed budget for the capacity building activities will be USD 68,000. The estimated cost for the implementation of the ESMP and environmental monitoring is U SD 1,460,000.00. 11 1. INTRODU CTION 1.1 Background and Rationale for the Project The Africa Centres for Disease Control and Prevention (Africa CDC) was formally launched in January 2017 to galvanise leadership and ownership in safeguarding Africa’s public health security by support Afrian Union (AU) Member States in improving the health of their people through building the capacity of public health institutes to focus on prevention of infection, surveillance and response to emergencies (including outbreaks, human-made and natural disasters, and public health events of regional and international concern), and building capacity to reduce disease burden on the continent. This is in line with the AU’s Agend 2063 which concr etises the continental vision of “An integrated, prosperous and peaceful Africa, driven by its own citizens, representing a dynamic force in the international arena”. The Resolution AU/Dec.554 (XXIV ) of January 2015 which established Africa CDC also called for each AU Member State to have a National Public Health lnstitute (NPHI) or an equivalent entity. Operationally, Africa CDC is organized at three levels (figure 1): 1) the Secretariat based within the AU Commission in Addis Ababa, Ethiopia; 2) Regional Collaborating Centres (RCCs) to coordinate activities in five sub-regions; 3) NPHIs at individual country level. Figure 1: Africa CDC Operating Framework The Zambian G overnment has fully embraced Africa CDC, committing high-level leadership to serve on both the Africa CDC G overning Board and the Africa CDC Technical Advisory Council. In line with the Africa CDC operational model, Zambia was elected to host the 12 Southern Africa RCC (SA-RCC), which encompasses ten (10) regional AU Member States, namely Angola, Botswana, eSwatini, Lesotho, Malawi, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe. The ten Member States have a combined population of 174 million citizens. In accordance with the hosting agreement, the Zambian G overnment has to date supported the SA-RCC by providing office accommodation, support staff, and interim management and technical staff to operationalize the SA-RCC. Furthermore, an allocation has been included in Zambia’s annual National Budget to meet RCC operational costs. At country level, a bold policy decision was taken in February 2015 to establish the Zambia National Public Health Institute (ZNPHI) as a specialized technical arm of the Ministry of Health mandated to promote and protect the health of Zambia and support health facilities at all levels in improving public health through prevention of infection, disease surveillance, preparedness and response to emergencies including outbreaks, man-made and natural disasters, as well as other events of public health importance. The ZNPHI is tasked to detect and respond quickly and effectively to disease threats and outbreaks based on science, policy and data-driven interventions and programs. Through the ZNPHI, the Ministry of Health endeavours to build resilient capacity through infrastructure, skilled human resources and systems for 1) surveillance and disease intelligence, 2) effective preparedness and efficient management of public health emergencies, 3) efficient Public Health Laboratory networks, and 4) generation, management and dissemination of scientific data to support evidence-based formulation of national policies, strategies and programs for public health actions. Zambia’s public health security faces both in-country and external threats: • Located at the heart of Southern Africa, Zambia is surrounded by eight countries with which she shares land borders. This poses the challenge of increased risk of importation of diseases from neighbouring countries and beyond. • Population movement for trade and socioeconomic activities, refugees and displaced populations, and the unregulated movement of people across the long and porous borders exacerbate the risk of disease spread. • Emerging and re-emerging infections and other public health threats from neighbouring countries including recent disease threats and outbreaks of Ebola virus disease, Listeriosis, yellow fever, influenza, vaccine-derived polio, cholera, typhoid, Rift V alley 13 fever, dengue, plague, anthrax, and Marburg. Most of these pathogens require high bio- containment capabilities which are currently inadequate. • The control of disease outbreaks remains a challenge, particularly in some neighbouring fragile states with weak healthcare systems, thereby increasing the risk of spill over across borders. • Within the country, epidemic-prone areas ex ist due to environmental, climatic, geographic, cultural and social-economic factors. • Zambia lacks a dedicated public health laboratory and relies on clinical laboratories whose primary mandate is to support patient management. Although, Zambia has more than 2,900 healthcare facilities, only 359 have some form of laboratory support. The bulk of ex isting clinical laboratories have limited infrastructure and capacity to adequately perform public health functions. • The reliance on clinical laboratories for public health functions has often led to delays in establishing diagnoses, detecting outbreaks and reporting of results, highlighting a weakness in both the early-warning system and management of outbreaks. A case in point is the cholera outbreak experienced in 2017/18, which amplified these gaps. • Other critical public health laboratory functions related to water and air quality monitoring, animal health, nutrition and food safety, and environmental health protection are limited and largely uncoordinated. Some of these functions are overseen by multiple agencies. These challenges bring to the fore the need for a strong, effective, and efficient national surveillance system, coupled with a state of preparedness and ability to mount timely, appropriate and effective responses when required. These capabilities require to be anchored in a strong National Public Health Laboratory System, which provides timely scientific evidence to back surveillance data and guide decisions pre-, during and after the response stage. Highly dangerous pathogens continue to emerge and re-emerge in new geographic areas in Africa at increasing rates and impact on health, socio-economic and healthcare delivery systems. The following challenges threaten public health security in the region and limit capacity for intervention: • Inadequate public health laboratory capacities, and weak healthcare systems among member states. 14 • Insufficient and uncoordinated surveillance and research programmes on Antimicrobial Resistance (AMR) and pathogens of public health importance including emerging, re- emerging and vector-borne diseases. • Limited regional capacity to develop, validate and implement novel diagnostic assays for rapid and accurate detection and identification of pathogens, including the use of novel molecular and immunological techniques for development, production and deployment of high quality diagnostics, research reagents and therapeutics. • Inadequate bio-containment infrastructure for handling dangerous pathogens and materials thereby limiting research on the continent. • Lack of strategic regional biobanks for long-term secure storage and preservation of reference clinical materials and strains for research and future development of diagnostic assays, vaccines and therapeutics; • Limited regional E xternal Quality Assurance (EQA) programmes for dangerous endemic pathogens (e.g. those causing Ebola virus disease, Anthrax, Cholera, Typhoid, Influenza, Rabies, Rift V alley fever, Marburg, Crimean Congo-haemorrhagic fever, dengue, West Nile virus, yellow fever, Lassa fever, Chikungunya, Monkey pox, bacterial meningitis) limiting the ability to ascertain African capacity to accurately diagnose and characterise these and similar pathogens. • Insufficient number of African scientists trained in working and managing research programmes in high bio-containment facilities; • Limited expertise in bioinformatics hampering rapid characterisation and discovery of new pathogens isolated from humans and animals in Africa; • Inadequate resources for capital investment in public health infrastructure development, compounded by competing social-economic demands and a high regional debt ratio. • V isa-free population movement within the region and high traffic of trade, with insufficient port health management programs pose the challenge of control and prevention of diseases and facilitate easy spread of infections. To address the foregoing national and regional challenges and responsibilities, the Zambian G overnment through the Ministry of Health and ZNPHI aspires to establish resilient public health security systems. Of the priority functional capacities is infrastructure development of 15 Biosafety Level 3 (BSL-3) laboratory to support disease surveillance, enhanced diagnostic capability, containment of pathogens and agents, research, training, and bio-banking of strains and other relevant materials. This will also provide footing for compliance with the International Health Regulations (IHR) 2005 core capacities, the Zambia National Health Strategic Plan 2017-2021, and the Africa CDC vision of strong institutions that support regional and international partnerships. Thus the MoH through ZNPHI intends to set up four-storey purpose-built infrastructure (see conceptual model, figure 6) in Lusaka, comprising a BSL-3 laboratory suite, Public Health Emergency Operations Centre (PHEOC), ICT suite, Proficiency Panel Production Center, Biomedical Equipment Maintenance Center, training facilities, conference facilities and office accommodation. The BSL-3 facility will provide the capability to handle organisms and other materials up to hazard group 3. This will be in a graduated manner as appropriate staff, facilities, and procedural control experience are attained over time. The scale up will also be informed by evolving needs, certification, regulatory compliance and legal requirements. As SA-RCC host, Zambia will provide infrastructure, equipment, facilities and technical competencies required for national needs and for the SA-RCC to provide support to the ten RCC member states. 1.2 Africa Centres for Disease Control and Prev ention Regional Inv estment Financing Program (ACDCP) The ACDCP, encoded by the Bank as P167916, will support vital institutional capacity- building efforts by the Africa CDC headquarters in Addis Ababa, and the health authorities in Ethiopia and Zambia. The ACDCP will thus target three entities: (i) the Africa CDC headquarters; (ii) the Ethiopian Public Health Institute (EPHI); and the ZNPHI. The actions supported by ACDCP are organized under the following components: (i) G overnance and Legal Framework; (ii) Public Health Assets; (iii) Human-Resources Development; (iv) operational . In each area, complementary actions by the three implementing bodies – the Africa CDC Secretariat and the governments of Ethiopia and Zambia- will establish the physical and organizational infrastructure necessary for the Africa CDC to execute its core functions and lay the groundwork for its continued expansion into a continental health institution. The project components described below are designed to leverage network effects and exploit economies of scale to enhance the efficiency of scarce public health resources, overcome national-level capacity constraints, and max imize the positive spillovers produced by 16 integrated transnational disease surveillance and emergency-response systems. Detailed information on each component and sub-component is provided in the Project Description. 1.2.1 Project Dev elop ment Objectiv e The Project Development Objective is to support Africa CDC strengthen and link regional infectious disease detection and response systems. 1.2.2 Project Components The proposed project will support vital institutional capacity-building efforts by the Africa CDC headquarters in Addis Ababa, the SA-RCC in Lusaka, and the Ethiopian and Zambian health authorities. The actions supported by ACDCP are organized under three strategic components: (i) G overnance and the Legal Framework; (ii) Public Health Assets; and (iii) Human Resource Development. In each area, complementary actions by the three implementing bodies—the Africa CDC Secretariat and the Ethiopia and Zambia governments—will establish the physical, organizational infrastructure and technical capabilities necessary for the Africa CDC to execute its core functions and lay the groundwork for its continued expansion into a continental health institution. The Ethiopia and Zambia National Public Health Institutes (NPHIs) and Centers of Excellence. The project components described below are designed to leverage network effects and exploit economies of scale to enhance the efficiency of scarce public health resources, overcome national-level capacity constraints, and max imize the positive spillovers produced by integrated transnational disease surveillance and emergency-response systems. The Zambian component of the programme will involve institutional strengthening of the Zambia National Public Health Institute (ZNPHI) and suppport to operationalise the Africa CDC Southern Africa RCC in Lusaka. 1.2.3 Component 1: Gov ernance, Adv ocacy, and Operational Framew orks This component covers four key areas. To ensure that adequate governance, advocacy, and operational frameworks are in place to support the core functions of the Africa CDC, the ACDCP will support the development of standardized guidelines and standards for coordination between the Africa CDC Secretariat and the NHPIs across the continent, including provisions for sharing public health assets, transferring specimens, and sharing data on disease surveillance and outbreaks. The ACDCP will also ensure that the relevant institutional arrangements facilitate efficient coordination among EPHI, the Africa CDC, the SA-RCC, and the ZNPHI, and it will create a framework for implementing the RCC and RISLNET. 17 1.2.3.1 The Gov ernment of the Republic of Zambia: Subcomponent 1.3 In keeping with the Host Country Agreement between Zambia and the AU, since 2016 the Zambian government has been providing office space, interim management, and technical and support staff to operationalize the SA-RCC. This component will finance technical assistance to support: (i) the adaptation and operationalization of the Africa CDC protocols and guidelines developed under Component 1.1 in Zambia; and (ii) the development of institutional arrangements, operational guidelines, and protocols for operationalizing the SA-RCC Host Country Agreement. 1.2.4 Component 2: Public Health Assets The ACDCP will support the establishment of a small number of sophisticated laboratories, transnational surveillance networks, emergency-response mechanisms, and other health assets designed to manage disease risks on a regional or continental scale. This approach reflects a longstanding international consensus regarding the vital role of shared health assets in Africa, and it is closely aligned with both the World Bank’s Africa Action Plan and Pillar III of the Regional Integration Assistance Strategy, which underscores the need for coordinated interventions to provide regional public goods, including disease monitoring, information sharing, as well as the importance of pooling national-level administrative and institutional capacity to address shared health risks. 1.2.4.1 The Gov ernment of the Republic of Zambia: Subcomponent 2.3 Strengthening Zambia’s national public health laboratory system and associated information networks will improve the ability of the ZNPHI and SA-RCC to effectively detect and rapidly respond to disease outbreaks. Zambia’s current lack of a dedicated national public health laboratory system significantly weakens the country’s disease surveillance, detection, and response capabilities, negatively affecting its ability to host the SA-RCC. Within Zambia, environmental, climatic, geographic, cultural, and socioeconomic factors contribute to the persistence of epidemic-prone areas. Zambia also shares overland borders with eight countries, heightening the risk of imported diseases. The ACDCP will enable the ZNPHI and SA-RCC to serve as a center of excellence for Southern Africa in multiple areas. These include disease-surveillance systems, epidemic preparedness and response, laboratory systems and networks, information-management systems, health and medical research, and health-sector workforce development. The project will finance the procurement of technical services, goods, and civil works for the design, construction, equipping, and maintenance of a laboratory, office complex, and network that 18 will include the PHEOC, ICT Center, training facilities, and other critical infrastructure. This subcomponent will finance: (i) the design, construction, equipping, and maintenance of a BSL- 3 national reference laboratory, including a proficiency testing system and panel production for quality assurance, a biomedical equipment maintenance center, a biobank center for various reference materials, a central warehouse to serve as logistics supply hub for ZNPHI and the SA-RCC countries, and an animal laboratory construction/rehabilitation to be determined in year 2 of project and safeguards instruments will be prepared prior to any physical works . The BSL-3 laboratory will serve as a center of ex cellence for Southern Africa. It will provide: (i) advanced testing facilities for human and animal health; (ii) offices for both the ZNPHI and the SA-RCC; (iii) a PHEOC that will serve both Zambia and the SA-RCC member states; (iv) an ICT suite that will anchor data management, communication and security systems; and (v) training facilities. This subcomponent will also finance technical assistance to support: (i) the strengthening of disease-prevention and control capabilities in Zambia and the SA-RCC member states; (ii) the expansion of sentinel surveillance sites for AMR and major human and animal diseases; (iii) the creation of public health research and information systems; and (iv) the operationalization of the SA-RCC RISLNET. 1.2.5 Component 3: Human-Resources Dev elopment To fulfill its complex mandate and to ensure that the public health assets described above are fully utilized, the Africa CDC will support the development of diverse and skilled cadre of public health workers in line with the One Health Approach. The Africa CDC will build human-resource surge capacity at the national, regional, and continental levels by working with RCCs and NPHI partners to create a pool of trained African professionals able to respond rapidly and effectively to infectious disease outbreaks and other public health emergencies. Training programs will build on ex isting courses in member states to increase the number of highly skilled technical experts operating in key areas. 1.2.5.1 The Gov ernment of the Republic of Zambia: Subcomponent 3.3 To fulfill Zambia’s domestic and regional mandates, and to ensure that the public health assets created under subcomponent 2.3 are functional and fully utilized, the Africa CDC will assist the ZNPHI in developing a diverse and skilled cadre of public health and livestock sector workers in line with the “One Health” approach. This subcomponent will provide financing and technical assistance to assess and build human-resource surge capacity at the national and regional levels. The subcomponent will assist the ZNPHI and SA-RCC in creating a pool of trained African professionals able to respond rapidly to infectious disease outbreaks and other 19 public health emergencies. This component will finance the hiring and training of key personnel in critical skills related to laboratory systems, disease surveillance, outbreak investigations, emergency responses, data management, project management and ex ecution, monitoring and evaluation, and risk communication. Training programs will build on ex isting courses in member states to increase the number of highly skilled technical experts operating in key areas. Seven staff members will be recruited and deployed to ZNPHI during the transition period to facilitate the implementation of the project. The subcomponent will also finance technical assistance to prepare a comprehensive human-resource needs assessment for the Zambian disease surveillance and response activities that are part of the Africa CDC’s continental mission. This assessment will address: (i) current staffing shortages; (ii) retention issues; (iii) incentive structures; (iv) staffing requirements; and (v) initial and ongoing training for both new and ex isting staff. The assessment will form the basis for a comprehensive training program, which will be implemented with funds from the project’s allocated budget following the completion of the assessment. 1.2.6 Cross cutting Component: The Contingent E mergency Response Component The occurrence of a large-scale disease outbreak or other health emergency during the life of the project could entail deeply negative social and economic consequences. This component will improve emergency-response capacity in Ethiopia and Zambia by financing the preparation of two Emergency Response Operational Manuals for Ethiopia and Zambia that reflect the procedures set forth in OP/BP 10.00 paragraph 13 (Rapid Response to Crisis and Emergencies). The component will provide the technical assistance necessary to develop these manuals and cover their production cost. The manuals will define the triggers for an emergency response, the process for reallocating funds from other project components to finance the emergency response, and the approved list of goods, works, and services eligible for emergency-response funding. 1.2.7 Access to the Laboratory / Office Comp lex and Sample Transportation The ACDCP will address this significant shortcoming by providing financial and technical assistance to construct and equipping of dedicated National Public Health Laboratory at Biosafety Level (BSL3) with associated information and communication technology. The new facilities will enable the country to detect, confirm, track and characterize economically important pathogens for human and livestock as well as support a research platform and training facility. The BSL3 will provide support for the integration of surveillance programs and cross-border cooperation in responding to outbreaks in RCC member countries in addition 20 to providing a platform for the development of a regional E xternal Quality Assurance (EQA) program for livestock and human pathogens, and a regional biobank. The laboratory facility and services will be accessible to all ten SA-RCC Member States, based on the hosting agreement, MoUs and other guiding legal frameworks to be developed and signed under the ACDCP. The ACDCP will facilitate support towards the intra-country transportation of samples and specimens. Furthermore, it is expected that the ACDCP grant to the Africa CDC will contribute to the cost of trans-boundary transportation of samples and materials as well as reagent costs. Additionally Member States will provide contributions (financial and in kind) to support and sustain the smooth operations of the facility as spelt out in the MoUs and Agreements. ZNPHI shall adopt standard package, label, and transport procedures in conformance with all applicable local and international transportation / shipping regulations and standards, elaborated in Annex 7. 1.3 Project E nv ironmental and Social Impact Assessment (E SIA) M ethodology In line with Zambia’s Environmental Management Act No.12 of 2011, and in conformity with the Bank’s OP4.01, the project is subject to an environmental and social impact assessment, outlined hereunder. The ZNPHI has therefore engaged the responsible national competent authority, Zambia Environmental Management Agency (ZEMA), which have provided guidance on the required instruments to be used for appraising the project. This is the Environmental Project Brief (EPB), as per Annex 1. Consideration has also been given to satisfy the Bank’s internal requirements as per OP4.01. The study followed the Environmental Impact Assessment regulation (1997) of Zambia Environment Management Authority (ZEMA). It followed a typical process of establishing baseline conditions, identifying specific environmental and social risks that need to be addressed, characterization of the effects the project will have and the impacts (positive or negative) they will result in, determination of significance of the issues identified, establishment of mitigation measures and monitoring measures, and finally proposals for management plans to ensure effective implementation of mitigation and management of the anticipated issues. The approach and methodology chosen ensures that World Bank safeguards policies, the ZEMA Environment and Social Impact Assessment (ESIA) processes have been followed. This involved collecting data on the environmental and social situation, conducting consultations with stakeholders and data analysis. An essential element of the ESIA is the environmental 21 scoping study which was undertaken in accordance with World Bank OP4.01 and the EIA ZEMA regulations. It should be emphasized that much of the work initiated in the environmental scoping process continues as a logical set of steps merging into the ESIA process. The background data collected, reviews conducted, draft reports, plans, assessment of risks looked at during scoping are simply moved to a higher level of environmental assessment with emphasis on risk aversion and adaptation strategies during project implementation. Relevant literature was reviewed while conducting the assessment. This included studying relevant legislation and policies; national and local secondary (collated) data sources; available maps of the Project area; and other related reports and documents related to the proposed construction of the Zambia National Public Health Laboratory and World Bank safeguards policies on ESIA and associated guidelines. Key documents reviewed included: The Constitution of Zambia, Environmental Management Act 2011, Environmental (Impact Assessment and Audit) Regulations, 1997, The Physical Planning Act, 1996, The Public Health Act (Cap 242), Occupational Safety and Health Act, Water Act, Layout Design Report for Project, and World Bank OP. 4.01. The data in the environmental baseline comprised secondary data collected through review of literature and primary data which was collected through field site visit and transect walks on the project area. Site surveys were carried as part of the ESIA study process to understand the baseline biophysical and socio-economic environment which would be affected by the proposed project. Besides, stakeholder consultation was conducted. The specific objectives of public consultations were to: disseminate information on the proposed project; collect views and issues to be considered in the scoping process and ESIA study; evaluate perceptions about positive and negative impacts of the project; and receive concerns about environmental impacts and other implementation problems such as communication strategy and avenues for participation in the project. 1.4 Construction Cost and Proposed Imp lementation Timeframe The overall construction cost for core infrastructure and accessory components of the complex is estimated at US$36.5million. This includes the main office and laboratory blocks, biobank, animal health laboratory, biomedical equipment maintenance center, waste management facilities, sewage/waste water managemnt system, power substation and backup systems, paving/landscaping & external lighting, security infrastructure and perimeter fence. Project 22 implementation is envisaged to start in January 2020, with the construction phase expected to take around 24-36 months.. 23 2. DE SCRIPTION OF THE PROJE CT 2.1 Location The BSL3 lab will be located approx imately 26km from Lusaka central business district along Palabana road in Silver Rest , Chongwe district. It will be built on a 10-hectare piece of land. Figure 2: Map showing the location of Chongwe District in Lusaka province The tarred road leading to the project site branches off from the G reat East road (T2) at Silver Rest primary school, 9km from the airport roundabout. The Project site is located in close prox imity with the following social receptors as shown in the table below. It is imperative to mention that the general surrounding to the site location is farm area. Table 1 Social receptors in prox imity to the site No Social receptor in Proximity Distance from Site Vector 1 Police Post 1 Km North East 2 Silver Rest Primary School 5.17 Km North 3 Silver Rest Gardens Residential Estate 3.4 Km North 24 The police post is located approx imately 1km from the proposed site location, north east of the site, also located 5.17km in the north direction of the site is Silver Rest primary school and Silver Rest gardens residential estate is located 3.4 km, north of the site. Figure 3: Sign post showing the location of Silver Rest at the junction with Great East Road Figure 4: Silver Rest junction with the Great East Road 25 Figure 5: Satellite map showing location of the project site 26 2.2 Nature of the Infrastructure The main infrastructure is envisioned to be a four- storey building of an inverted “T” shape, with accessory two-storey arc-shaped blocks at its rear. The front of the building will connected through a central circular façade that will serve as the primary public entrance into the complex. The two rectangular blocka wil accommodate the offices, training/seminar rooms, ICT suite, conference facilities and library/resource center. The top two floors of the circular area will house the PHEOC (one floor each for national and regional). The stem of the inverted “T” will be the main laboratory block, with the BSL -3 suite occupying the uppermost floor, while other support laboratories will be on the lower three floors. These will support functions including V irology, Bacteriology, Immunology/V accinology, V ector biology & Parasitology, a Molecular biology suite, Chemistry, Haematology, Tox icology and and proficiency testing panel production center to support quality assurance programs. The arch- shaped blocks will house the Biorepository and animal health laboratory facilities. Other accessory features will include a biomedical equipment maintenance center, power substation, onsite industrial autoclave and shredder unit, and waste management system (for both liquid and solid biomedical and domestic waste). The entire building will be surrounded by a road network connecting to a number of parking spaces. As per figure 6: – Blocks A and C will accommodate the offices, training/seminar rooms, ICT suite, conference facilities and library. – Block B which is the main access point into the facility will have a lobby and reception area. The top two floors will accommodate the PHEOC (one floor each for national and regional). – Block D, the stem of the inverted T, will be the main laboratory block. The BSL-3+suite will occupy the uppermost floor, while other laboratories (at BSL-2 level) will be on the lower three floors. These will include V irology, Bacteriology, Immunology/V accinology, V ector biology & Parasitology, Molecular biology suite, Chemistry, Haematology, and Tox icology. – Block E will house the Biorepository. – Block F will house animal health laboratory facilities 27 Figure 6: Conceptual Design of the Proposed Complex The structure spans approx imately 109m from Wing A to C and approx imately 78m from the main entrance of Wing B to the Rear Entrance of Wing D. The surface area breakdown of the building is shown in the table below. Table 2: proposed Floor Area Distribution Area per Floor No. of Cummulative Section Dimensions (m 2) Floors Floor Area A: ZNPHI Office Block 43.1m X 18m 775.8 4 3,103.2 B: Central Lobby (circular) 528.3 3 1,584.9 C: RCC Office Block 43.1m X 18m 775.8 4 3,103.2 D: Laboratory Block (BSL-3) 55.2m X 24.9m 1,374.3 1 1,374.3 Laboratory Block (BSL-1 & 2) 55.2m X 24.9m 1,374.3 3 4,122.9 E: Bio-Bank (curved) 1,352.7 2 2,705.4 F: Animal Laboratory (curved) 1,352.7 2 2,705.4 Walkway 1 31.5 1 31.5 Walkway 2 31.5 1 31.5 Totals 6,222.6 20,847.0 28 Autoclave/shredder & temporary waste holding Figure 7: Laboratory and Public Health Complex Site Plan 29 2.3 The proposed Biosafety Lev el 3 Laboratory Laboratory facilities are designated as basic – Biosafety Level 1, basic – Biosafety Level 2, containment – Biosafety Level 3, and max imum containment – Biosafety Level 4. Biosafety level designations are based on a composite of the design features, construction, containment facilities, equipment, practices and operational procedures required for working with agents from the various risk groups. The BSL-3 laboratory which is going to be constructed at ZNHIP would be designed and operated in accordance with guidance for BSL-3 laboratories established by reputable international organizations (CDC 1999, NIH 2001, WHO 2004). The proposed laboratory will be tested for verification that the design and operational parameters have been met prior to operation. The BSL3 laboratory will consist of an anteroom and laboratory rooms. It will have gas- impermeable walls, ceilings and floors. Air gaps under doors would be acceptable for directional airflow. If door gaps are sealed, the laboratory must not leak gaseous decontamination materials. The BSL3 laboratory will be designed for ease of maintenance, so that access to critical mechanical equipment (ventilation ducts, fans, piping, etc.) is outside containment. The laboratory will consist of high-quality room construction with special consideration given to joints, finishes and penetrations. There will be a room for large equipment decontamination. The room will be capable of being sealed for decontamination with gaseous paraformaldehyde and must have a connection to the HV AC ex haust system. All shutoffs (steam, water, natural gas) will be external to containment. All tall and/or heavy fixtures and equipment (e.g. biological safety cabinets, autoclaves, freezers, incubators, etc.) will be fitted with a seismic anchoring system/device engineered to withstand earthquake stresses equal to 7.0 on the Richter scale. Work surfaces, floors, walls and ceilings will be designed, constructed and finished to facilitate easy cleaning and decontamination. The laboratory will be located away from public areas and corridors used by laboratory personnel who do not work in the BSL-3 laboratory. The BSL3 must pass third-party inspection and tests to verify that design and operational parameters have been met. Also reference should be made Annex 3 for further guidance. 30 2.3.1 Raw M aterials for construction of the lab and construction phase activ ities The main raw materials to be used in the project are both consumptive and non-consumptive materials the majority will be non-consumptive ones. The consumptive raw materials are in the form of construction materials. The table below shows the list of raw materials to be used in the project during the construction phase. Table 3: Raw material to be using during the construction phase M ode of No. Raw M aterial Source Delivery 1 River and building sand for concrete and building mortar Local suppliers Road truck 2 Laterite / gravel for foundations and construction of road ZEMA approved quarry Road truck sub base 3 Cement for concrete, mortar and road works Local approved supplier Road truck 4 Bricks Registered local clay Road truck brick Supplies 5 Concrete blocks Local approved supplier Road truck 6 Diesel for operation of plant and machinery Approved ERB bulk fuel Approved ERB storage facility fuel bowser 7 Water for construction, dust suppression and workers Local streams and on site Pump and domestic use borehole(s) reticulation 8 Electricity Initial supply by on-site 33kV generator, subsequently transmission independent 3 rd party line 9 General building materials ( e.g. timber for shuttering, door Local approved Road truck and window frames, polythene sheeting, brick force and suppliers. Trusses will be mesh reinforcement, timber purlins, sewer pipes, paint etc.) produced locally 10 Finished products and equipment (e.g. IBR roofing sheets Imported ensuring Road truck (chromadeck), PVC and HDPE piping, switches, aluminium compliance with window frames, geysers, sanitary ware, glassware and Zambian standards and finishes, ceramic floor tiles, booster pumps, etc.) regulations Project activites will be intiatied in the following sequence; preparatory, construction and operational phases. 2.3.1.1 Site Preparation Phase Activ ities Site preparation will involve the following activities;  Stripping of topsoil and vegetative material for access roads and building foundations. 31  The foundation which will be constructed with a view to minimise the need for rock breaking. In the event that blasting is carried out this will be controlled to minimise noise and the scattering of debris.  Basic earthworks to establish required finished road and foundation levels and falls. This will entail some filling of areas with laterite and aggregates.  Excavation and foundations:  Excavation of trenches for foundation strips (the concrete footing will not exceed a depth of 1500 mm), drainage, sewage trench, etc. This may require rock breaking and possibly the use of explosives. o Compaction of underside of foundation trenches o Mix ing, pouring and compaction of concrete 2.3.1.2 Construction Phase Activ ities Construction activites will involve the following activities:  Sub-structural works for laying of incineration o Block work o Mix ing, pouring and compaction of concrete o Backfilling and compaction of material according to specifications  Internal access roads and drainage construction: o Stabilization of the base with the piling, spreading and compaction of gravel and aggregate. o Spreading and compaction of aggregates and tar materials on the road for bitumen surface and preparation, pouring and compaction of concrete for concrete surfaced areas. o Excavation and shaping of drains.  Installation of electrical/mechanical equipment/engineering services: o This will involve installation of installation of electric power supply, cables, lighting, medical and specialised equipment etc.  Materials Storage: o Materials such as blocks/bricks, sand, gravel and aggregate, which are not required for immediate use will be stockpiled in a designated area on the site. 32 2.3.2 Resources needed at Operational Phase For operationalization of the the BSL3 lab, the resources needed include among others: a) E quipment 1. Biosafey Cabinets 2. Fume Hood 3. Centrifuge 4. Microscope 5. Spectrophotometer 6. Autoclave 7. Freezers b) Chemicals The number and amounts of chemicals that need to be stored should be reduced to an absolute minimum. Physically segregate your chemicals into their respective hazard categories— corrosive, flammable, reactive, and tox ic. Chemicals should be stored based on their compatibility; compatible chemicals can be stored alphabetically. Acids, flammable liquids, ox idizers and highly reactive chemicals should all be separated and stored properly to avoid an unwanted chemical reaction. Chemicals for U se in Laboratory  Nitric Acid  Sulphuric Acid  Hydrolflouric Acid  Ethidium Bromide  Dimethyl Mercury  Cryogenic liquids, such as liquid nitrogen,  Chemicals causing acute health effects or long-term chronic health effects e.g. hydrogen cyanide, phosgene or arsine.  Hydrogen perox ide  Potassium  Bromine  Ammonium nitrate  Acetylene  Sulfuric acid  Sodium perox ide  Sodium  Ox ygen  Chlorine diox ide 33 c) Comp ressed Gases Compressed gases may present both physical and health hazards. G ases may be flammable, reactive, corrosive, or toxic and these properties must be considered when developing experimental procedures and designing apparatus. In addition, compressed gases, when not handled properly or not contained in properly designed vessels, can be extremely hazardous with a high potential for explosion. d) Facility Cleaning Chemicals Many types of chemicals will be used as disinfectants and/or antiseptics to clean/disinfect the facility. They include among others:- Facility Cleaning Chemicals  Chlorine (sodium hypochlorite)  Sodium dichloroisocyanurate  Chloramines  Chlorine diox ide  Formaldehyde  G lutaraldehyde  Phenolic compounds  Quaternary ammonium compounds  Alcohols  Iodine and iodophors  Hydrogen perox ide and peracids 2.3.3 E xpected Types and Quantities of Wastes The operation of the BSL-3 facility will generate different types of wastes (gaseous, liquid and solid) in nature and general and harzadious in categorization. The wastes will emanate from the different activities in the BSL-3 facility. The wastes will be infectious waste and non infectious in nature and will include, but is not limited to, cultures and stocks of infectious agents, pathological wastes, waste human blood and blood products, sharps used in patient and animal care, biological laboratory wastes among others. . In general, the hazardous waste will be generated primarily from the BSL3 laboratory facility including its onsite support laboratories. The office functions and occupation will generate mainly domestic waste. The different types of waste, both solid and liquid forms, will be handled in specific ways elaborated in the project’s infection Control and Waste Management Plan (IC WMP). A description of the types of waste follows, with methods of treatment summarised in table 6. 34 Laboratory Cultures and Microorganism Stocks This type of waste is expected to be generated predominantly from the BSL3 facility, cell culture labs, Microbiology laboratories, animal health laboratory, biobank, and proficiency testing panel production center. The waste will be include cultures and stocks of infectious agents or microorganisms; cultures of medical and clinical specimens from pathology units; and receptacles and other potentially contaminated materials used in processing of microbial cultures and stocks. Blood, Blood Products and Tissues of Human Origin This includes human tissue, body parts, organs, blood and blood products (plasma, platelets, red cells, leukocytes, and other derivatives) and other body fluids such as cerebrospinal, peritoneal, pleural, pericardial, synovial, genitourinary fluids. Additionally there may be items that incorporate human bodily fluids or receptacles and apparatus used in processing, storing or delivery of tissues human of human origin. Tissues of Non-human Origin Operations of the animal health laboratory will include use of various approved animal tissues and organs. Remnants from animal autopsies, animal droppings, receptacles and apparatus used in processing, storing or delivery of tissues and other residues will constitute the main waste in this category. Sharps This category includes any sharp objects such as used blades, broken glass, syringes, needles (hollow or solid), pipettes, scalpel blades, vials, test tubes, lancets, microscope slides, covers slips, microtome blades and other such objects that would have been in contact with infectious or potentially infectious material. Chemical Waste This includes, but not limited to: most laboratory reagents, drugs, pharmaceutical products, organic and inorganic solvents, disinfectants such as hypochlorite, phenol, chloroform, formaldehyde, alcohols (ethyl alcohol, isopropyl alcohol, amyl alcohol, etc) and others. 35 Included are chemicals that are no longer required or that have expired or become unsuitable for use. Liquid Waste from the Laboratories Several laboratory procedures and functions require the use of water which is eventually discharged as potentially infectious / hazardous waste. This includes discharges from the sluice rooms and re-usable equipment wash units. Domestic Liquid Waste This will include waste water and sewerage from the kitchens, rest rooms / lavatories, showers and other areas outside the laboratories. The volume of waste is based on max imum occupancy of the facility, expected to be at 200 when fully operational. Non-Hazardous Waste Common waste in this category includes paper, newsprint, cardboard, plastic wrapping, and other non-infectious / non-contaminated materials. These materials will predominantly be generated from office functions and packaging materials for supplies. Table 4 Expected Quantities of Waste and Methods of Treatment E xpected Type of Waste M ain Sources M ethod of Treatment Quantity Laboratory BSL-3 facility, cell culture labs, 40 kg/day Sterilization within the laboratory/point of Cultures and Microbiology laboratories, generation, followed by high temperature Microorganism vector biology labs, animal incineration (at ZAMRA) Stocks health labs Blood, Blood BSL-3 facility, Microbiology 6 kg/day Chemical disinfection, autoclaving (within the Products and laboratories, biobank, lab) and incineration. Tissues of proficiency testing panel Human Origin production center Tissues of BSL-3 facility, vector biology 2kg/day Chemical disinfection, autoclaving (within the Non-human labs, insectaries, animal health lab) and incineration. Origin lab Sharps BSL-3 facility, cell culture labs, 3.5 kg/day Sharps to be collected in puncture-proof Microbiology laboratories, sharps containers. When three-quarters full, vector biology labs, animal the sharps containers and contents will be health labs shredded by the sharps shredding module within the onsite industrial shredder. Chemical BSL-3 facility, cell culture labs, 5 Dilution with distilled water; neutralization waste Microbiology laboratories, litres/day (using an acid or alkali as appropriate). vector biology labs, insectaries, Ex pired pharmaceutical products to be animal health labs, biobank, returned to supplier or disposed of at proficiency testing panel ZAMRA. production center 36 Laboratory BSL-3 facility, cell culture labs, 400 Disinfection with hypochlorite, where Liquid Waste Microbiology laboratories, litres/day appropriate, followed by treatment through vector biology labs, insectaries, the liquid waste channel). animal health labs, biobank, proficiency testing panel production center Domestic Rest rooms, lavatories, showers, 4,320 Domestic liquid waste will be treated through Liquid Waste kitchens the onsite sewerage network. litres/day* Non-hazardous Office areas, BSL3 facility, 23 kg/day Non-hazardous wastes would be incinerated waste support labs after sorting. Fly ash Incinerator The fly ash will be disposed of at Chunga landfill. This ESIA will be updated during implementation to assess the capability of Chunga landfill 1 to serve the purpose. Sludge Onsite wastewater treatment The sludge will be disposed of Manchinchi system WWTP2 . This ESIA will be updated during implementation to assess the capability of the WWTP to serve the purpose. *Based on Zambian standard of 80% of 27 litres water use per capita per day for office occupancy. The table 5 below highlights the wastes that will be generated from the facility during its operation phase. Table 1. Waste Types and Disposal Method Waste Type Treatment M ethod Aerosols (gasesous) Emissions Biosafety Cabinet: HV AC system G eneral Wastes (Broken glasses, paper, used gloves, Shredding and/or Incineration laboratory equipment) etc Bilogoical wastes (urine, blood, silava, sharps) Autoclaving and/or Incineration Effluent Waste Sterlisation, filtration and disposal in Manchinchi WWTP The proposed BSL-3 laboratory will have procedures for compliance with all applicable regulations for collecting, storing, processing, and disposing of sanitary liquid wastes, solid wastes and hazardous wastes. 2.3.3.1 Waste M inimization Appropriate plans, strategies and actions would be established to ensure minimization of healthcare wastes. The proposed BSL3 laboratory will implement the following waste minimization strategies :  Purchasing restrictions to ensure the selection of less wasteful materials;  Recycle materials and products when applicable 1 Has an approved ESIA 2 Environmental and social brief is being prepared for the WWTP 37  Ensure good management and control practices especially in the purchase and use of pharmaceuticals; and  Enforcing a rigorous and careful segregation of the healthcare wastses at source. 2.3.3.2 Waste Segregation Proper segregation of waste at source generation is essential, efficient and effective in managing healthcare wastes. It helps in reducing the quantity of waste requiring treatment prior to final disposal and ultimately reduces the cost of waste treatment/management. Segregation involves putting different classes of wastes into separate and appropriate temporary storage color-coded containers/bags. The waste generated from the proposed BSL 3 laboratory, will be segregated and color-coded as outlined below in Table 6 as recommended by WHO. Table 2: Laboratory waste collection and segregation methods Waste categories Colour of container and Type of container Collection freq uency markings Y ellow with biohazard Leak-proof strong plastic When three-quarters Infectious w aste symbol (highly infectious bag placed in a container filled or at least once a waste would be additionally (bags for highly infectious day. marked waste would be capable of HIG HLY INFECTIOUS). being autoclaved). Sharps w aste Y ellow, marked SHARPS Puncture-proof container. When filled to the line with biohazard symbol. or three-quarters filled. Pathological w aste Y ellow with biohazard Leak-proof strong plastic When three-quarters symbol. bag placed in a container. filled or at least once a day. Chemical w aste Brown, labelled with Plastic bag or rigid On demand. appropriate hazard symbol. container. Non- hazardous Black Plastic bag inside a When three-quarters Waste container or container filled or at least once a which is disinfected after day. use. 2.3.3.3 Colour Coding Color coding is done by using colors to differentiate waste classes from one other. It is efficient and helps in the process of waste segregation at source. It is also simple, easy to use and thus can be understood even by illiterate patients particularly at health posts where illiteracy level is high. Color coding is one of the efficient ways of achieving segregation of waste and for sorting out items such as paper, plastic, glass and metal for recycling. 38 2.3.3.4 Packaging Infectious waste would be contained from its point of origin to the point at which it is treated and no longer infectious. The packaging would be appropriate for the type of waste involved. The following guidelines would be included for packaging sharps and other health care wastes:  Sharps (sharp items or items with sharp corners) would be placed in rigid, puncture- resistant containers made of glass, metal, rigid plastic, or cardboard.  Liquid infectious wastes would be placed in capped or tightly stopped bottles or flasks; large quantities may be placed in containment tanks.  Solid or semisolid wastes would be placed in tear-resistant plastic bags judged by their thickness or durability.  There would be special packaging characteristics for some treatment techniques: incineration requires combustible containers, and steam sterilization requires packaging materials that allow steam penetration and evacuation of air. 2.3.3.5 Labelling An important aspect of colour coding is labelling. All waste bags or containers would be labelled with basic information in English. Basic label information would include type of waste in the container; name of the laboratory section, date of collection and, warning of hazardous nature.  Identify the source of HCW or date of generation in case of an accident or improper segregation of the waste, ensure that the workers responsible for HCW management handle the different types of wastes safely, ensure that each staff member feels more responsible for what they put into the bag/receptacle 2.3.3.6 Waste Collection approach at the proposed BSL 3 laboratory Collection of waste is extremely important particularly to avoid over spilling of waste out of collection containers. Collection would be done promptly and routinely or as often as required. This will reduce the probability of contaminated wastes coming into contact with the public. Collection of waste would be done by approved and trained personnel fully equipped with appropriate PPEs and conveying machinery such as laboratory trolley and carts. The 39 laboratory staff will be actively involved in collection of waste as would the waste handlers. They would ensure that their containers/bags (Bins/box es and collection receptacles) are never more than three-quarter full before sealing them at their points of generation. The following would also be adhered to when collecting waste  All HCW would be sorted on site before collection and transportation. This will bring about easy identification of content of containers thus preventing careless handling and the risk of secondary infection.  There would be a fix ed schedule for the collection of waste bags and containers from each medical department. This is to ensure the regular removal of waste from each location and to ensure coordination between medical staff and cleaning or housekeeping staff. The minimum frequency of waste removal would be once per working shift.  No bags would be removed without labelling indicating the point of generation (department, office and laboratory section) and content;  Laboratory workers would immediately replace the bags or containers with new ones of the same type.  There would be separate schedules and separate collection times for different colour coded containers. Separate trolleys would be used for different types of waste.  V ehicles will be disinfected and cleaned daily or at the end of haulage with an appropriate disinfectant at an appropriate site where wastewater will be properly disposed of.  Waste ducts that convey sacks of waste by gravity will not be used, as they tend to scatter wastes at the ex its of the chutes, and are subject to fouling by the wastes, leading to nuisances such as smell and insects.  Carts and vehicles used to transport the waste will be carefully designed so that they are stable, quiet in operation, and so that transportation can be achieved with the minimum of effort and inconvenience.  Trolleys or carts would be large enough so that waste is not piled up on them in an unsafe way and the trolleys and carts would be designed to prevent and accommodate any form of spillages.  Sealed sharps containers would be placed in a labelled, yellow infectious health-care waste bag before removal from the healthcare or laboratories. 40  Water and hand-wash materials would be readily available for healthcare waste handlers to wash their hands after handling HCW. 2.3.3.7 Handling Waste at the BSL 3 lab When handling waste, handlers will wear protective clothing at all times including face masks, aprons, boots, and heavy-duty gloves, as required. Proposed Waste Handling Safety Measures at the BSL 3 Lab 1. All personnel handling infectious medical waste will wear gloves and additional protective medical clothing and personal protective equipment (PPE) appropriate to the level of risk they encounter and will remove any protective medical clothing used prior to leaving the work area and to place it in a designated area or container. When performing procedures where splashing is not expected, gloves are the minimum PPE that would be worn; 2. Protective medical clothing and PPE would not be submitted for laundering unless sterilized; 3. When performing procedures where splashing may occur or when infectious medical waste bags or containers may contact more than the worker’s hands and wrists, the following medical protective clothing and PPE is provided in addition to gloves;  Appropriate protective medical clothing would be of material that does not permit infectious medical waste from penetrating and reaching workers clothes or skin;  E ye protection, surgical face masks, and face shields when personnel may reasonably anticipate facial exposure to infectious medical waste. Additionally, immunization will be undertaken for staff members, as necessary (e.g. vaccination for hepatitis B virus, tetanus immunization).  Sharps:  When handling sharps, needles will not be recapped or bent.  Syringe will be placed in a safety box immediately. When there is a need to use needle removers, it will take place immediately after the injection. Safety boxes will be fully and properly assembled before use. • Safety boxes will also be sealed and collected when they are ¾ full and will never be emptied or opened. 41 • Sharps containers (i.e., safety boxes) will be placed as close to the point of use as possible and practical, ideally within arm’s reach. • Safety box es will be labeled so that people will not unknowingly use them as a garbage container for discarding other items. • Safety box will not be shaken to settle their contents. • Safety box es will not be placed in high traffic areas (corridors outside laboratory rooms or sample preparation rooms) where people could bump into them or be stuck by someone carrying sharps to be disposed of. • Containers will not be placed on the floor or anywhere they could be knocked over.  Infectious w aste bins: Infectious waste bins would be covered before collection. It would be cleaned and disinfected with 0.5% chlorine solution after emptying and before reuse. 2.3.3.8 Waste Storage at the BSL-3 Laboratory Facility Storage is classified into internal and external. Consideration for storage will be based on the classification or type of waste being dealt with and the potential risk of infection to health-care workers and waste disposal staff. The following rules would be observed for proper storage of healthcare wastes from the BSL3 lab:  Initial packaging and storage would take place where healthcare waste is generated.  Storage of waste will then be moved to a temporary on-site storage location (onsite storage refers temporary storing of disinfected solid wastes on the premises of the lab)  Non-risk healthcare wastes would always be stored in a separate location from the infectious/ hazardous healthcare wastes to avoid cross-contamination. Internal storage is the temporary placement of waste at the point of generation before transfer to external storage points. A storage location for the healthcare wastes would be designated inside the BSL-3 laboratory. The waste in the bin-liners or containers would be stored in a separate area, room or building appropriate to the quantity of waste produced bearing in mind the frequency of collection. Segregation of hazardous waste from general waste would be maintained in storage. There would be planned periodic cleaning and disinfection of temporary storage areas and the 42 containers. The storage time for healthcare wastes before it is transferred to external storage facilities would on daily basis. External storage refers to the transit point where waste is stored after removal from primary storage to the time it is collected and transported for treatment and final disposal. The external waste storage will be located in a secure area within the vicinity of the autoclave/shredder (figure 6). To ensure that waste is kept separated, the central storage receptacles (include bags, bins, sharps box es should be available to staff in each medical and other waste-producing area) for each colour coded bags will be placed in similarly colour coded receptacles.  There will be one or more external storage points for hazardous and non-hazardous waste depending on the layout of BSL 3 laboratory.  The external storage point(s) for the hazardous and non-hazardous waste will be geographically separate at BSL 3 laboratory section.  The walls and floors would be smooth, without cracks, impervious, easy to clean and disinfect  The site will be spacious, well ventilated and lit;  All loading and unloading of waste would take place within the designated collection area around the storage point;  Larger volume waste bins would be available at the external storage facility to receive waste containers from the internal storage points. The BSL 3 laboratory facility will designate an area within its premises where waste may be temporarily stored until final collection for disposal and onward treatment. Such a general storage location would be located away from the view of the public and it would be included in design of the proposed BSL 3 building. In addition, the waste storage area will be large enough to contain all the hazardous waste produced by the lab with capacity to cope with any maintenance or breakdown of the autoclave/shredder unit. The storage area will be totally enclosed and secured from unauthorized access, be inaccessible to animals, insects, and birds, and easy to clean and disinfect with an impermeable hard-standing base, good water supply, drainage, and ventilation. 43 Infectious waste should be kept cool or refrigerated at a temperature preferably no higher than 3 °C to 8 °C if stored for more than a week. Unless a refrigerated storage room is available, storage times for infectious waste (e.g. the time gap between generation and treatment) should not exceed the following periods: Temperate climate Warm climate 72 hours in winter 48 hours during the cool season 48 hours in summer 24 hours during the hot season 2.3.3.9 Waste Transportation Consideration for transportation must be based on the classification or type of waste being dealt with and the potential risk of infection to health-care workers and waste disposal staff. Transportation is classified into on-site transport and off-site transport (e.g., off-site transport will be done for, autoclave disinfected solid waste, sludge from the onsite wastewater treatment and wastewater) . 2.3.3.9.1 On site transportation The on-site transport involves conveying of wastes from the various points of generation within a laboratory to a temporary storage location also within the same area. The following would be adhered to when carrying out On Site transportation and every effort would be made to avoid unnecessary handling of healthcare wastes;  All waste bags would in-place and intact at the end of transportation;  Carts, trolley, or containers used for the transportation of health-care waste would not be used for the transportation of any other material; and would be used for transporting safety boxes and bins  Waste that has the potential to leak will be double bagged;  Waste bags would be placed in containers (e.g. cardboard boxes or wheeled, rigid, lidded plastic or galvanized bins), before being placed directly into the transportation vehicle  A trolley, bin, or wheelbarrow will be used for transporting safety boxes and bins.  The collected waste will not be left even temporarily anywhere other than at the designated storage room (external waste storage facility; see Figure 8). 44  Containers would be covered with lids during storage and transport. 2.3.3.9.2 Off-site Transportation During the transportation of waste outside the BSL3 lab compound the following safety precautions would be needed:  Single-bagged waste and containers of sharps and liquids would be placed within a rigid or semi-rigid container such as a bucket, box, or carton lined with a plastic bag.  Containers would be covered with lids during transportation.  When transporting plastic bags of infectious waste, care would be taken to prevent tearing of the bags.  Infectious waste would not be compacted before treatment.  Outside the BSL3 lab, infectious waste would be transported in closed, leak-proof, rigid containers using trucks  The transportation would be properly documented, and all vehicles will carry a consignment note from the point-of collection to the treatment facility.  V ehicles used for the carriage of waste would be disinfected prior to use for any other purpose.  The vehicles would be free of sharp edges, easy to load and unload by hand, easy to clean and disinfect, and fully enclosed to prevent any spillage in the facility premises or on the road during transportation.  The vehicles would carry adequate supplies of plastic bags, protective clothing, cleaning tools, and disinfectants to clean and disinfect in case of any spillage.  Staff would be properly trained in the handling, loading and unloading, transportation, and disposal of waste  Staff would be fully aware of emergency procedures for dealing with accidents and spillage. 2.3.4 Approaches for M anagement of General and Health Care Solid Waste from the proposed BSL3 lab Health care solid waste from the BSL -3 laboratory will be initially autoclaved within the laboratories as per BSL -3 biosafety requirements. From the central autoclaving system, sterilised solid waste will be shredded to reduce on the volume. The autoclaved and shredded 45 waste will be taken to the waste collection chambers/ temporary solid waste storage facility and ultimately be transported to ZAMRA for incineration following the procedures specified in 2.3.3.9. Figure 7: Managment of General and Healthcare Waste 46 2.3.4.1Autoclav ing In line with the Stockholm convention on persistent organic pollutants (POPs) to which Zambia is a signatory, ZNPHI shall promote current best practices of using non- incineration methods including the use of autoclaves for health care waste management to minimize emission of POPs in order to meet the Stockholm convention requirements. Therefore, the ZNPHI shall have a central autoclaving system for sterilisation of health care solid waste. Waste from the BSL-3 laboratory will be initially autoclaved within the facility as per BSL -3 biosafety requirements provided for by WHO Laboratory Biosafety Manual. The sterilised solid waste will then be conveyed to the central solid waste autoclaving system for secondary autoclaving. The disinfected solid waste will then be transported to ZAMRA for incineration. 2.3.4.2 Incineration at ZAM RA During the operational phase, ZNPHI will outsource ZAMRA incinerators that were commissioned on Friday 9th of February 2018 and capable of handling medical and pharmaceutical waste. The incinerator compound is located off airport Road next to NISIR in Lusaka. Most of the incinerator materials at the site include pharmaceuticals, medicines and other materials brought for incineration. These are stored in secure storage facilities, with the highest level of hygiene. The incinerator is a an electric fired type that taps power from the ZESCO grid system.  Monolithic construction.  Built-in emission control.  Heated refractory screen.  G rit settling chamber.  Stainless steel arrestor.  Door operated draught breaker.  Heated primary and secondary air. 47 Figure 9: ZAM RA E lectric Incinerator Figure 8: ZAMRA – Building Housing the two Incinerators 48 Figure 9: An Inciner8 Incinerator at ZAMRA. Inciner8 Incinerator Specifcation and E mission lev els. 49 Figure 10: Incinerator flue-gas stack Figure 11: Inciner8 Capacity The incinerator has the follow ing specifications: 50 o Capacity – 600 kg/hour each o Stack height 15m o Powered by electricity (7.5Kw/hour) o Dimensions (3x2.7x3.2), chimney diameter 800mm. The incinerator has the following specifications: o Capacity – 250-300 KG /V o Burn rate upto 120kg/per hour o Operational temperature >850 degrees celcius o Average ash yield = 3%. Table 7. Average E missions Parameter Limits ½ hr (av ) Total Dust 30mg/m3 Sulphur Diox ide 200mg/m3 Nitrogen Ox ide 400mg/m3 Carbon Momox ide 100mg/m3 2.3.4.3 M anagement of of incinerator fly ash Fly ash refers to dust and other finely divided particles produced during incineration. The incinerator at ZAMRA generates up to 5kg of fly ash for every 100kg of waste incinerated. For the ZAMRA incinerator waste and effluent and by-products generated during operations are managed in the following manner:-  Particulate emissions are trapped within the stack  Ash (which is 5kg for every 100kg incinerated) will be transported to an approved landfill. The physical properties of fly ash are listed in table 8 below. Table 8 Physical properties of fly ash Property Parameters Density 2.17 g/cm 3 Bulk density 1.26 g/cm 3 Moisture content 2% Particle shape Spherical/irregular Color Gray pH 6.0 - 10.0 51 Specific gravity 1.66 – 2.55 Grain size distribution Sandy silt to silty loam Porosity 45% – 55% Water holding capacity 45% – 60% Electrical conductivity (dS/m) 0.15 – 0.45 Disposal of fly ash from incineration, if not well managed, poses a risk for environmental (air, soil, surface water and ground water) pollution as well as health problems. This raises concerns for efficient ash disposal mechanisms. Figure 15 below highlights the pathways of ash pollutant dispersal into the environment. Figure14: Schematic pathways of ash pollutant movement in the environment The fly ash from the incinerator is presently collected using a dry disposal system. The incinerator is equipped with an electrostatic precipitator which removes the ash from the flue gas and maintains the flue gas emissions below 30mg/m 3 . The ash is collected into ash collection hoppers and removed periodically by a pneumatic ash handling system into storage silos. During retrieval of dry fly ash from the silos, adequate water injection will be made to prevent spreading of dust. 52 As per the provisions of the the Environmental Protection and Pollution Control Act, Ninth Schedule (Regulation 11) of the Laws of Zambia, incinerator ash can be disposed of at approved landfill sites. After collection from the storage silos, the ash will be transported by trucks and disposed of at the Chunga landfill site, which is located next to the Lusaka North Forest Reserve. Chunga landfill has an approved ESIA. Chunga is the proposed landfill which is an engineered landfill that meets the prescribed standard. It is a licensed and accredited by Zambia Environmental Management Agency (ZEMA) which monitors operations at the site. It occupies a land area of 26 hectares and the engineered cell sits on an land area of about 5 hectares. The site was opened in 2001 followed by the engineered part which was opened in 2007.Waste received come from Municipal Solid Waste (MSW) generated in the city of Lusaka and operated by the Lusaka City Council. This means that industrial waste,waste from the trade and commerce, from institutions, markets, hospitals and clinics is collected, transported and disposed at the landfill. The landfill has a workforce of 30 workers who include the Superintendent, Foreman, Supervisors, Cashiers, Pointers and machine operators. There are different machines which include; landfill compactor, excavator, loaders, and tipper trucks(Strategic Municipal Solid Waste Management Plan for Lusaka City, 2003). Transportation and delivery of waste is carried out by licensed transporters of waste such as Franchise contractors, Community based Enterprises and individual companies who have been given the right to collect their own waste (see table list of licensed garbage collection / solid waste management companies). Chunga landfill receives an average per day of 550 tonnes of waste per day. Zambia E nvironmental Management Agency (ZEMA) regulates and monitors the operations of the landfill. Paramount to the selection of a credible and operational landfill that meets the required standards is the assurance that what is planned to be dumped at these sites is safe and does not filter into and contaminate the environment. The landfill operates under the legal provisions provided in the Environmental Management Act. 2.3.5 M edical Wastew ater M anagement Approach for the proposed BSL3 lab The complex will have two separate wastewater networks for management of healthcare waste effluent and domestic waste effluent as descriebd below. The medical wastewater will be collected into a leak proof storage tank whose filling capacity will be auto monitored so as not to exceed ¾ full. The wastewater will then be steam sterilised using the liquid cycle of the 53 Sewerage Inspection Office BSL-3 chambers Complex Network Labs Medical Retention Inspection Solid particle filtration Sedimentation Tanks wastewater storage tank Tank A chambers system Liquid waste Retention Autoclaving Tank B system Retention Tank C Vacuum tanked to the offsite municipal wastewater treatment plant autoclave connected to the storage tank. The autoclaved wastewater will then be discharged into the solid particle filtration system to allow solid particles to be filtered out of the waste water as it flows through the system. The filtered waste water will be collected in the retention tanks which will be vacuum tanked by licenced waste collectors for further treatment at the offsite municipal sewage treatment site (Manchinchi Wastewater Treatment Plant) at regular intervals. The domestic waste water network will have several inspection chambers as it leads to the sedimentation tanks. A layer of accumulated solids or sludge, will form at the bottom of the sedimentation tank as the waste water slowly flows through it thereby providing a level of purification prior to discharge. The sludge at the bottom of the sedimentation tanks will be periodically removed during routine maintenance as illustrated in the figure below. Figure 15: Management of Domestic and Laboratory Waste Water Wastew ater Treatment in Lusaka Manchinchi Wastewater Treatment Plant Management of wastewater in Lusaka province falls under the responsibility of the Lusaka Water and Sewerage Company (LWSC). Most wastewater in Lusaka is predominantly treated 54 at Manchinchi Wastewater Treatment Plant (See also Annex 8), which has a treatment capacity of up to 36,000m 3 per day, and is earmarked for upgrade to over 60,000m 3 per day. Effluent is treated in accordance with Zambia E nvironmental Management Agency (ZEMA) stipulated standards before discharge into Ngwerere stream. The legal framework for waste water management for Zambia is contained in the Environmental Management Act (EMA), No. 12 of 2011. Disposal of liquid waste at the plant is currently charged at the rate of K36 ($2.7) per 1,000 litres (1m 3 ) as at 6 June 2019. The average cost of vacuum tanker services per trip is K800 ($60) and tankers available on the market have capacity ranging from 7,000 to 15,000 litres. There are around 61 private companies licensed to handle transport wastewater to Manchinchi wastewater treatment plant. The LWSC also regulates the discharge of trade effluent into its sewer networks for both onsite and offsite sanitation using the local administration (Trade Effluent Regulations) Act of 1994. The effluent and pollution control section at LWSC monitors and regulates discharge of trade effluent and enforces the “Polluter Pays Principle” in accordance with the trade effluent regulations. The section conducts fortnight inspections on clients or operators who discharge in its sewer networks. They also collect trade effluent samples which are analyzed for key parameters. The plant also has a section for sludge which is digested anaerobically for four months and sold as fertiliser for enriching grass, horticulture, and agriculture use. Sludge from the ZNPHI project site wastewater treatment will be transported to Manchinchi Wastewater Treatment Plant for final disposal.. Other Wastew ater Treatment Plants Other sewage treatment plants and ponds in the city of Lusaka include Chunga sewage treatment plant, Chelstone stabilization ponds, G arden stabilization ponds, Kaunda Square stabilization ponds, and Ngwerere stabilization ponds. Chunga treatment plant receives industrial wastewater for treatment through a sewer network serving the western side of Lusaka. 55 2.3.6 Surv eillance and M aintenance of the Wastew ater Treatment System ZNPHI shall have trained Environmental Health personnel to conduct routine monitoring and surveillance of the waste management system at the complex. ZNPHI shall have trained Environmental Health personnel to conduct routine monitoring and surveillance of the waste management system at the complex. For wastewater, the officers will be responsible for collecting waste water samples, for isolation of indicator orgasms which ideally are not naturally found in the environment, at several sampling points including medical wastewater storage tank, after the wastewater autoclaving and solid particle filtration systems. In addition, ZNPHI shall have a dedicated maintenance unit that will be responsible for routine maintenance of the wastewater management system. 56 3. LE GAL AND POLICY FRAM E WORK 3.1 Institutional Framew ork The legislative responsibility for environmental impact assessment is vested in the Zambia Environmental Management Agency (ZEMA) which administers the Environmental Management Act (EMA) of 2011. It is responsible for enforcing environmental regulations and coordinating sectoral government agencies involved in environmental management in their sectors. This ESIA has been developed in accordance with the EIA Regulations of 1997. 3.2 Rev iew of Relev ant National Regulatory Framew ork The proposed project activities touch on many regulatory instruments which need compliance with. Presented below is a listing of key legislation relevant to the project and requiring legal compliance were applicable. 57 Relevant Legislation LE GISLATION INTE RPRE TATION RE LE VANCE Environmental The Act provides for continued ex istence of the Zambia Environmental The proposed construction of an office complex housing a BSL3 Management Act, 2011 Management Agency (ZEMA) and mandates it to do all such things as laboratory falls within the first schedule of the EIA Regulations of necessary to protect the environment and control pollution to provide for 1997. the health and welfare of persons, animals, plants and the environment in general. Noting that program activities involving crop production closely The ZHPHI have submitted an ESIA to comply with the regulation interacts with the environment the provisions of this Act and its and will only initiate construction activities once an approval and subsidiary pieces of legislation will require compliance with. This will accompanying decision letter has been issued by ZEMA. be done through implementation of the appropriate ESIA and obtaining the relevant licenses. Environmental Impact The Regulations state that “a developer shall not implement a project for Assessment Regulations, which a project brief or an environmental impact statement is required 1997 under the Regulations, unless a Project Brief or an Environmental Impact Assessment has been concluded in accordance with the Regulations and the Council has issued a decision letter”. Gender Equity and An Act to establish the Gender Equity and Equality Commission and The project will undertake surveillance and disease intelligence and Equality Act, 2015 provide for its functions and powers; provide for the taking of measures this will help identify potential threats to public health security. and making of strategic decisions in all spheres of life in order to ensure Women and children still remain the most vulnerable to public health gender equity, equality and integration of both sex es in society; promote risks as they are often maginalised in society. Availability of data gender equity and equality as a cross cutting issue in all spheres of life from surveillance and disease intelligence will insure measures are and stimulate productive resources and development opportunities for put in place to protect the public health of the most vulnerable and both sex es; prohibit harassment, victimization and harmful social, maginalised in society. cultural and religious practices; provide for public awareness and training on issues of gender equity and equality; provide for the elimination of all forms of discrimination against women, empower women and achieve gender equity and equality by giving effect to the Convention on the Elimination of all Forms of Discrimination against Women, the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa and the SADC Protocol on Gender and Development; and provide for matters connected with, or incidental to, the foregoing. Human Rights An Act to provide for the functions and powers of the Human Rights Access to information and guaranteed public health security remain Commission Act, 1996 Commission; to provide for its composition and to provide for matters one of the fundamental human rights. The operation of the facility 58 LE GISLATION INTE RPRE TATION RE LE VANCE connected with or incidental to the foregoing. will ensure they is an established early warning system for diseases in the region and protect the health of members of the beneficiary countries. National Health An Act to establish the National Health Research Authority and provide The proposed facility will undertake field survey and research This Research Act, 2013 for its functions and powers; establish the National Health Research will require that all research is undertaken in like with the Ethics Board and provide for its functions and powers; provide a requirements of the National Health Research Ethics Board. regulatory framework for the development, regulation, financing and coordination of health research and ensure the development of consistent health research standards and guidelines for ethically sound health research; provide for the establishment of health research ethics committees and the regulation and management of research institutions, health researchers and health establishments involved in or undertaking research; provide for the regulation of biological material for health research; provide for ethical approval for the conduct of clinical trials; provide for the use of traditional, complementary and alternative medicines in health research; provide for data management and intellectual property rights in health research; provide for the designation of bio banks; and provide for matters connected with, or incidental to, the foregoing. Non-Governmental An Act to provide for the co-ordination and registration of non- Non-Governmental Organizations (NGO’s) are some of the major Organizations Act, 2009 governmental organizations; establish the Non-Governmental stakeholders on the project, their involvement on the project will Organizations’ Registration Board and the Zambia Congress of Non- range from; information dissemination, educational activities and Governmental Organizations; constitute the Council of Non- livelihood initiatives. This will require that NGO’s are registered, Governmental Organizations; enhance the transparency, accountability regulated and adhere to ethical practices set by the Non-Government and performance of non- governmental organizations; and provide for Organizations Registration Board and The Zambia Congress of Non- matters connected with or incidental to the foregoing. Governmental Organizations. Public Health Act, 1995 The Act provides for the prevention and suppression of diseases and The establishment of the CDC Regional Center in Zambia that will general regulation of all matters connected with public health in the house a BSL3 Laboratory that will conduct research and tests for various communicable diseases. This will be done within a bio- safety country. The Act also stipulates conditions for production, distribution and vending of food products. environment that is regulated and will not pose a risk to members of the public. The center will further enhance public health by establishing early warning systems. Public Procurement An Act to continue the ex istence of the Zambia National Tender Board The project will involve the procurement of studies, works, goods and Act, 2008 and re-name it as the Zambia Public Procurement Authority; revise the services and this will require that the process to follow the Zambia law relating to procurement So as to ensure transparency and Public Procurement Authority (ZPPA) guidelines to ensure fairness, accountability in public procurement; regulate and control practices transparency, integrity, accountability and promote public and relating to public procurement in order to promote the integrity of, stakeholder confidence. The process will be further complimented by 59 LE GISLATION INTE RPRE TATION RE LE VANCE fairness and public confidence in, the procurement process; repeal and World Bank procurement polices replace the Zambia National Tender Board Act, 1982; and provide for matters connected with or incidental to the foregoing The Local Government The Act provides for the establishment of Councils or Districts, the The proposed project will fall within the jurisdiction of Chongwe Act (1991 functions of local authorities and the local government system. Some of District Council. The developer, ZNPHI will be required to obtain all these functions relate to pollution control and the protection of the the required permits from the local authority. environment in general. The Medicines and An Act to continue the ex istence of the Pharmaceutical Regulatory During the operation of the center, the use of any medication or allied Allied Substances, 2013 Authority and re-name it as the Zambia Medicines Regulatory Authority; substance and control of clinical trials will be done in line with the provide for the functions and powers of the Authority; provide for the requirement of the Zambia Medicines Regulatory Authority. The registration and regulation of pharmacies, health shops and agro- center will obtain all the requiremed licences and permits before veterinary shops; provide for the registration and regulation of medicines resuming operations. and allied substances; provide for the regulation of the manufacture, importation, ex portation, possession, storage, distribution, supply, promotion, advertising, sale and use of medicines and allied substances; provide for the regulation and control of clinical trials; repeal and replace the Pharmaceutical Act, 2004; and provide for matters connected with, or incidental to, the foregoing. Urban and Regional The Act provides for the development, planning and administration The Act is relevant to this project because all project activities such as Planning Act, 2015 principles, standards and requirements for urban and regional planning infrastructure development will require planning permission from the processes and systems; provide for a framework for administering and planning authorities in each respective area. The project will ensure managing urban and regional planning for the Republic; provide for a that all relevant permissions are obtained before embarking on any planning framework, guidelines, systems and processes for urban and project that requires development planning authorization. regional planning for the Republic; establish a democratic, accountable, transparent, participatory and inclusive process for urban and regional planning that allows for involvement of communities, private sector, interest groups and other stakeholders in the planning process. National Council for This Act provides for the establishment of the National Council for The construction of the proposed Regional Laboratory will involve Construction Act, 2003 Construction (NCC) and to define its function; to provide for the engaging a contractor and/or subcontractors. During the promotion and development of the construction industrial in Zambia; to implementation of the Regional Laboratory, ZNPHI will only engage provide for the registration of the contractors to provide for the registered contractors/subcontractors who adhere to the regulation affiliation to the council of professional bodies or organisation whose Act. members are engaged in activities related to the construction industry; to provide for the regulation of the construction industry; to provide for the establishement for the construction school; to provide for the training of persons engaged in construction or in activities related to the 60 LE GISLATION INTE RPRE TATION RE LE VANCE construction; and provide for matters connected with or incidental to the fore-going. . Road and Traffic The Road Traffic Act No. 11 of 2002 establishes and defines the Relevance: The proposed ZABs Regional Laboratory is located off Control, 2002 functions of the Road Transport and Safety Agency(RTSA) which Great East Road and will involve traffic movement to and from the replaced the National Roads Safety Council. The new act repealed the National Roads Safety Council Act and parts V to XIV, First Schedule, site during operations. ZNPHI will engnage RTSA to ensure the Second Schedule and Third Schedule of the Roads and Road Traffic smooth flow of traffic. Act. Water Resources The Act provides for the control, ownership and use of water ex cluding The project will be implemented in the Silverest area on land whose Management Act (Act that of the Zambezi, Luapula and parts of the Luangwa Rivers which boundary is transverse by the Chalimbana stream. Any plans by the no. 21 of 2011) form borders with other countries. The Act establishes the Water developer to abstract or alter the flow of the stream will be in line Resources Management Authority and regulates the use of public water with the provision of the Water Resources Act of 2011. including protection against pollution. 61 3.3 Rev iew of Relev ant Policy Framew ork Two main sector policies are identified as relevant to the proposed program and need to be complied with, namely the National Health Policy and the National Policy on Environment. 3.3.1 National Health Policy The National Health Policy for Zambia seeks to respond to these challenges. It has been developed within the context of the V ision 2030 and has taken into consideration other relevant national, regional and global health related policies, protocols and strategic frameworks, including the Millennium Development Goals (MDG s). 3.3.2 National Policy on E nv ironment The overall vision of the National Policy on Environment is to provide a framework management guide for the management of Zambia’s environment and natural resources so as to ensure that they are managed on a sustainable basis and retain their integrity to support the needs of the current and future generation without compromising either of the two. The guiding principle on heatlh are;-  Urban, district and rural planning and development activities should incorporate human settlement and health concerns;  Human settlements should incorporate environmental concerns as well as disaster preparedness;  Temporary settlements for refugees and other displaced people are managed using the same guidelines for environmental, pollution and health concerns as for all other human settlements including environmental impact assessment and monitoring;  Development and improvement of human settlements should incorporate the concept of community development with focus upon social services, particularly water supply, schools, health facilities, recreation facilities, communications, transport and security, in order to discourage random roadside ribbon development which is difficult to maintain and tend to be environmentally unfriendly. 3.4 World Bank Operational Policies In addition to the national environmental legal framework, this ESIA takes into consideration the ten of the World Bank Safeguards Policies. Two out of the ten safeguards polices have been triggered by the project. Table 2 lists the safeguards policies that have been triggered and reasons for the same. 62 Table 9: Explanation of Policies Triggered World Bank Safeguard s E xp lanation for Triggering Policies Environmental Assessment The project funded activities have the potential of high risk due (OP/BP 4.01) to the highly infectious nature of the agents and samples which are to be collected, transported and tested and the environmental and social risks on human health and general environment. Construction of BSL3 facility will not only lead to geenration of harzadious solid and liquid waste management and disposal related issues but also occupational health and safety, labor influx etc. This Policy is triggered to ensure that all potential adverse environmental and social impacts are managed and mitigated. Physical Cultural Resources The policy is triggered for precautionary purposes as chance OP/BP 4.11 finds may happen during the construction of laboratory. Chance Find Procedures will be included in the ESIA/ESIA and in the civil works contract. 3.5 International and Regional Conv entions Zambia is a party to many international and regional conventions aimed at addressing environmental concerns. Those relevant to the proposed construction of a CDC Regional Center and its environmental setting will require compliance with and include but not limited to:-:  United Nations Framework Convention on Climate Change  United Nations Convention on Biological Diversity  International Plant Protection Convention for the prevention and control of the introduction and spread of pests of plants and plant products  Stockholm Convention on Persistent Organic Pollutantspollutants  Convention on Wetlands of International Important especially as Waterfowl Habitat (RAMSAR Conventions) This entails that national developments should be done with due consideration to these conventions and protocols and as such ZNPHI under the Ministry of health is obliged to abide by these national commitments. Epidemics Control and Public Health Surveillance: Zambia is still prone to outbreaks of epidemics including cholera, measles and polio, leading to significant public health concerns. In order to improve the detection and management of epidemics, in 2000, the country adopted the Integrated Disease Surveillance and Response Strategy (IDSR). The policy direction will focus on improving capacity to conduct surveillance, preparedness and control of epidemics at all levels. 63 3.6 The World Bank Group E HS and WHO Biosafety manuals The World Bank G roup EHS guidelines and WHO guidelines related to healthcare facilities are usually considered as bench mark International G ood Practice Standards. For the proposed BSL3 Laboratory, the WHO Laboratory Biosafety Manual and the World Bank G roup guideline for healthcare facilities appears to be directly relevant. Besides, the World Bank G roup G eneral EHS G uideline has important provisions which are applicable to various components of the proposed project namely Hazardous waste management,Occupational health and safety (against biological and chemical hazards), Community health and safety including traffic safety such as during project construction or disease prevention (where incinerators emission waft into and affect the local communities) and Construction and decommissioning. The incinerator (s) to be used by the proposed BSL3 lab need to fulfil the air emission standard proposed in the WBG EHS guidelines (2007). Table 10: Air E mission Levels for Hospital Waste Incineration Facilities Pollutants U nits Guidance v alue Total Particulate Matter (PM) mg/Nm 3 10 Total organic carbon (TOC) mg/Nm 3 10 Hydrogen chloride (HCl) mg/Nm 3 10 Hydrogen fluoride (HF) mg/Nm 3 1 Sulfur diox ide (SO2 ) mg/Nm 3 50 Carbon monox ide (CO) mg/Nm 3 50 NOx mg/Nm 3 200-400 (a) Mercury (Hg) mg/Nm 3 0.05 Cadmium + Thallium (Cd + Tl) mg/Nm 3 0.05 Sb, As, Pb, Cr, Co, Cu, Mn, Ni and V mg/Nm 3 0.5 Polychlorinated dibenzodiox in and dibenzofuran Ng/Nm 3 TEQ 0.1 (PCDD/F) Notes: a. 200 mg/m3 for new plants or for ex isting incinerators with a normal capacity ex ceeding 6 tones per hour, 400 mg/m3 for ex isting incinerators with a nominal capacity of 6 tones per hour or less b. Ox ygen level for incinerators is 7 percent Source: the WBG EHS guideline , Health Care Facilities, 2007 These emission levels should be achieved without dilution, at least 95 percent of the time that the plant or unit is operating, to make calculation as a proportion of annual operating hours. 64 This ESIA will be updated at the implementation stage to assess the due diligence of ZAMRA’s incinerator emission levels. The World Bank G roup EHS guideline for effluent levels for Health Care Facilities are shown in the Table below. As the wastewater to be generated from the BSL-3 lab complex will be discharged into a local wastewater treatment plant (rather than being discharged into the environment) after onsite treatment, the effluent requirements of the WBG EHS guideline does not seem to apply for this laboratory complex. This is because the guidelines are applicable for direct discharges of treated effluents to surface waters for general use. Table 11: Effluent Levels for Health Care Facilities Pollutants U nits Guid eline v alues pH S.U 6 –9 Biochemical Ox ygen Demand (BOD5) mg/L 50 Chemical Ox ygen Demand (COD) mg/L 250 Oil and grease mg/L 10 Total Suspended Solid (TSS) mg/L 50 Cadmium (Cd) mg/L 0.05 Chromium (Cr) mg/L 0.5 Lead (Pb) mg/L 0.1 Mercury (Hg) mg/L 0.01 Chlorine, total residue mg/L 0.2 Phenol mg/L 0.5 Total Coliform bacteria MPNa 400 Polychlorinated dibenzodiox in and dibenzofuran (PCDD/F) Ng/L 0.1 o Temperature increase C <3 b Notes: a MPN = Most Probable Number b At the edge of a scientifically established mix ing zone which takes into account ambient water quality, receiving water use, potential receptors and assimilative capacity These levels should be achieved, without dilution, at least 95 percent of the time that the treatment unit is operating, to make calculations as a proportion of annual operating hours. 65 4. DE SCRIPTION OF THE BASE LINE E NVIRONM E NT 4.1 Location The project site is approx imately 4.8km at the terminal end of the newly tarred Silverest road from Silverest primary school on G reat East Road. The tarred road leading to the project site branches off from the G reat East road (T2) at Silverest primary school, 9km from the airport roundabout. The central G PS coordinates for the 10-hectare project site are; Latitude 15°23’ 38 South and Longitude 2 8°28 41’ East. Figure 16: Sign post showing the location of Silverest at the junction with G reat East Road Figure 17: Google map showing location of the project site 66 4.2 Physical E nv ironment 4.2.1 Climate Zambia is divided into three major agro-ecological regions ( Regions I, II and III), based primarily on rainfall amount and other climatic and soil characteristics. Region I is semi-arid, while Region II has the most fertile soils and annual rainfall averages 800-1000mm, and Region III is the high rainfall area, receiving over 1000mm of precipitation each year. The area around Silver Rest lies in Region II of the agro-ecological regions. The climate essentially comprises a long dry season (May to September) and a wet season (November to March), April and October are mainly transitional months. The annual rainfall is 800 mm of which nearly 75% falls from December to February. The reliability of rainfall over the last decade has generally been very low. June and July are the coldest months, with an average minimum temperature range of 9 0 C to 14 0 C. October has the highest max imum temperatures, averaging 18 0 C to 32 0 C. Daily max imum temperature of 37 0 C may be reached during the period from September to January. From December to April, the monthly average temperatures are 16.7 0 C minimum and 26.1 0 C max imum. The annual mean temperature is 20.6 0 C. The mean relative humidity ranges from 42% in October to 89% in February. Figures 16-19 below show a 16-year summary of average climatic data for Lusaka, including humidity, rainfall, and sunshine hours. The area around Silverest lies in region two of the agro ecological regions; the climate essentially comprises a long dry season (May to September) and a wet season (November to March), April and October are mainly transitional months. The annual rainfall is 800 mm of which nearly 75% falls from December to February; the reliability of rainfall over the last decade has generally been very low. June and July are the coldest months, with an average minimum temperature of about 9 0 C and an annual average of about 140 C. October has the highest max imum and minimum temperatures, averaging 32 0 C and 18 0 C respectively. The period from December to April has monthly averages close to 26.1 0 C for the max imum and 16.7 0 C for the minimum temperature. The annual mean temperature is 20.6 0 C the mean relative humidity ranges from 42% in October to 89% in February. The figure below shows a 16-year summary of some average climatic data for Silverest. 67 Figure 18: Average Relative Humidity for Lusaka (sourced from www.weather-and- cimate.com) Figure 12: Average Sunshine Hours for Lusaka Rainfall mainly occurs in heavy thunderstorms producing typical precipitation events of between 10 and 40mm. Rainfall is unpredictable, and the mean annual rainfall is 804mm per annum . Figure 130: Average Precipitation for Lusaka 68 The area experiences annual temperature averaging 20°C. Lower temperatures occur during the dry season months with the lowest temperatures occurring in June and July. The highest temperatures occur in October. Figure 21: Average Temperature for Lusaka 4.2.2 Air Quality Air quality in the project area is generally good although pollutants generated by vehicle ex haust emissions and dust raised by traffic passing through the area contributes to deterioration of the ambient air quality, especially when local inversions are experienced. Apart from vehicular traffic, other sources of air pollution include the burning of fuel (wood and charcoal) in townships and informal settlements and the burning of bush and scrub as well as charcoal burning in surrounding areas around Silver Rest, especially during the dry season. Increases in fugitive dust levels, particularly under hot and dry conditions, also periodically results in the deterioration of air quality. 4.2.3 Soils and Land use The in-situ materials range from silty sands, clayey/silty sands, silts to coarse gravels while several areas have rocky outcrops. There are alluvial soils along the rivers, streams, and valley floors. The soil types have positive implications for agriculture. The soils in the project area are particularly susceptible to erosion, more so where the ground cover has been cleared, where gradients are steeper, or where soil and vegetation cover has been disturbed by both human and animal activity, for example cultivation, tree felling, overgrazing and trampling. The soils are permeable, well drained and reflect possibly the gemstone geology beneath. The soils fall under the Ibex Soil series, which represent agriculturally productive soils with high inherent fertility. This arises from a relatively high organic matter content which forms a pool of nutrients. The mineralogy of the soils, which have developed over the basic rocks such as gemstone and dolomite, also supports the high inherent fertility. 69 Figure 14 Typical Soils at the Project Site 4.2.4 Landscape and Topography The Chongwe catchment can be divided into the mountainous lower part dominated by the Zambezi escarpment and the relatively flat upper part comprising all sub catchments but the Lower Chongwe. The upper part ranges between an elevation of 1000m and 1300m above sea level while the Lower Chongwe reaches from approx imately 1300m (with peaks up to 1500 m) to the Zambezi River at 330m above sea level. 70 Figure 15 Topography of Lusaka and Chongwe 71 4.2.5 Ground and Surface Water In terms of ground water resources, while rainfall is the primary contributor, it is the lithology (or rock type) and the structural character (porosity, clay content, folding, faulting, jointing and foliation) that are relevant to water availability. The rainfall regime has remained reasonably uniform over a long period in the project area and provides sufficient recharge facility for the aquifer although seasonal ground water level fluctuations occur depending on rainfall and pumping. G enerally, ground water levels go down between May and November and rise between December and April during the rainy season. While the Lusaka Dolomite Formation normally provides the best aquifer in the region, the schists associated with the beds below, especially within the Cheta formation give relatively poor yields. This is indicative of the structural character of the geological environment which, as reflected by the geophysical investigations of the area, should be relatively conducive to water production. Figure 16 Chalimbana Stream on the Eastern Boundary of the Project Site The quality of the ground water associated with the three significant lithologies present in the area may be characterized as good based on similar geological formation elsewhere, even though no specific chemical analysis or bacterial tests were carried out in this specif location. 72 The following general hydro chemical parameters for water may be ascribed to the rock formations encountered in the area: Dolomite and dolomitic gemstone: G round water in these rock types are characterized by pH values from 7.0 to 7.5 and total dissolved solids (TDS) in the range of 250 to 600 ppm (parts per million). The TDS are generally of the calcium salt type with low chlorine and sulphate content. Schists, Sandstones and Phyllites (psammites and pelites): In these rock formations the groundwater is characterized by pH values in the range of 6.5 to 7.0 with TDS values around 300 to 1000 ppm. The relatively high TDS values are usually associated with the schists. Alluvial cover (weathered profile): The superficial cover in this area is relatively thin but thickens to the west and southwest. The pH in these is generally neutral (7.0) and TDS often less than 500 ppm. 4.2.6 Geology The project area is dominated by the geology of the Basement Complex which is extensively exposed. The Basement Complex is extensively interrupted by granite inselbergs, a product of granite intrusions. As a result, paragneiss and granite are the dominant rock forms within the vicinity of the project. Close to the valley floor are red sandstone, basalt and sandstone all belonging to the Karroo System. A variety of rocks, such as biotite schists, quartzite, meta- quartzite, granite gneisses calci-silicate and carbon rocks, distributed widely in the region, were produced by ancient volcanic activities and metamorphism in the region. 4.2.7 Noise Lev els There is very limited noise pollution as the area is away from densely populated areas and has been reserved for the development of G overnment institutions and research centers. Field observations showed very low noise levels emanating from within the ex isting road traffic and infrastructural developments. Although no documented noise studies have been done in the Silver Rest area, since the population density is low, it can be assumed that the area experiences low noise levels. 73 4.3 E cological Resources 4.3.1 Fauna The presence of anthills formed a unique vegetation thicket, with the presence of Euphorbia ingens, due to the rich nutrients attributed by insect/termite activity, hence forming a moderate habitat for smaller terrestrial fauna and common bird species. Jatropha inflorescence attracted bees on the project site and other insects. The rocky nature of the proposed project site is believed to be characterised by snakes which are regarded as venomous and non-venomous. Among the snakes reported by the local people to occur on the project site yet not encountered at the time of the survey, included the cobra, blind snake, puff adder, and the house snake. Associated with the project area were smaller terrestrial animals such as hares and mice as evidenced from excrete matter and their activity in the study area. These are considered as food as well as pests in the agriculture fields (non- significant impact) by the indigenous people. The land subdivision project area and the immediate surrounding areas presented a variety of common bird species among which include:  Mammals: Wildlife in the project site is limited to smaller species such as hare and grant rat, since the natural habitat for wildlife has greatly lost its value due to agricultural purposes. Only small mammals were observed during the field survey. The following mammals were sighted within the proposed area: Rattus rattus (Black Rat), Thryonomys swinderianus, (Cane Rat) and, Paraxereus cepapi (Bush Squirrel).  Reptiles: It is believed that Snakes such as cobra ( Naja mosambica), puff adder ( Bitis arietans), blind snake, and house snake are present in the project area. Representative of the tortoises, Terrapins and Turtles are also believed to be found in the project area. Other reptiles include representatives of lizards such as monitor lizard ( Varantus niloticus), geckos, chameleons and skinks.  Insects: Insect survey at the project site was done and several insects were observed in the area. Insect life included a variety of species of dragonfly, wasps, bees, crickets, grasshoppers, termites, mosquitoes, ants, red ants, lady bugs, butterflies and moths 4.3.2 Flora The diverse vegetation types of the area are closely associated with the physiographic, geology, soils, and moisture regimes. These are zoned along topographic gradients. The vegetation around the project area is dominated by Miombo species, which contains a wide variety of species of the genera Brachystegia, Julbernardia and Isoberlina. The majority of the species 74 are deciduous, dropping their leaves in the early dry season and flushing in August as temperatures rise. In addition to the above genera, local patches of Combretum-Terminalia may be present. Gorges cutting down from the mountain ranges to the valley floor support richer vegetation due to seepage, and include species of Ficus, Commiphora marlothii, Afzelia quanzensis, Kirkia acimunata, Terminalia sambesiaca and Albizia zimmermannii. Figure 17 V egetation around the Chalimbana Stream Figure 18 Distribution of grass vegetation around the project site 75 4.4 Social, E conomic and Cultural Issues 4.4.1 Administration The project site is located within Chongwe District in Lusaka Province. In terms of traditional administration, the project site falls under Chieftainess Nkhomeshya of the Soli speaking people. 4.4.2 Land Tenure Land tenure at the site is similar to the rest of the country and is vested in the Republican President who holds it on behalf of the Zambian people. The parent land title at the proposed site is held by NISIR. NISIR has allocated approx imately 10 hectares of the land in Silver Rest to ZNPHI for the construction of the proposed project. Figure 19 UNZA farm South West of the Project site 4.4.3 Culture and Traditional E stab lishments in the Project Area In Chongwe district, there are three major ethnic groupings- the Soli people, who dominate much of the district, the Chikunda and Nsenga Luzi people. The people close to the project site 76 (i.e. Soli people) celebrate the Chibwela Kumushi traditional ceremony annually, which is an appeal to the ancestral spirits for good rains and good yield. The ceremony takes place when the rainy season is commencing, normally around late October. The Soli tribe a matrilineal tribe, meaning that an individual takes his or her mother’s clan. A village, in the sense of the people in the project area of influence, is usually a grouping of matrilineally related men and women with their wives, husbands and unmarried siblings and children, under the authority of a headman– which literally means ‘owner of the village’. A headman is the intermediary between the village community and the chief and has authority to allow distant relatives and strangers or newcomers to take residence in the village. The primary group in each village is the matrilineal extended family. Figure 20 Rural household structures for the Caretaker within the Project Site The household structure shown above was put up by NISIR to accommodate a local employee to guard the area from unathorised squatters in the area. Since ownership of the land has now been transferred to ZNPHI, NISIR will transfer their employee to the other NISIR sites and ZNPHI shall find alternative means of securing the land from encroachment and unathorised squartters. 4.4.4 E conomic Activ ity The project site is found in an upcoming mix ed-use area with infrastructural developments such as Silver Rest G ardens, subsistence and commercial farms and government institutions. In the eastern part of the proposed site, the main sources of livelihood include subsistence agriculture (crops, livestock), charcoal burning and selling, trading, beer brewing, and “wild” 77 natural resources, including trees, grasses, nuts, fruits, and medicinal plants. The most ubiquitous activity is agriculture -- virtually all households in the village grow crops. However, it is noticeable both from literature review and field interviews that although almost all residents of the project areas identify agriculture as their main activity, it is only some who rely on it as their main source of income. 4.4.5 Built E nv ironment Apart from the newly constructed Silver Rest G ardens residential area, the area remains undeveloped with a lot of natural vegetation cover and seasonal gardens and it is generally virgin land with farming activities around the project site. 78 5. PROJE CT ALTE RNATIVE S 5.1 No Project Alternativ e Zambia currently lacks a dedicated public health laboratory system, and relies on the already overloaded clinical laboratories whose core mandate is to provide diagnostic services to support the clinical management of patients in hospitals. These laboratories are located mainly at health centers, hospitals, research centers, private health institutions, defense, mines, NG Os and the animal health sector. The reliance on clinical laboratories for public health functions has led to delays in establishing diagnoses and reporting of results, highlighting a weakness in the early-warning system. The ever-present risk of epidemics and public health threats from within the country, the region and elsewhere underscores the pressing need for a dedicated Public Health Laboratory. 5.2 Site Alternativ es Site alternatives considered for location of the BSL-3 Laboratory and Office Complex project were based on the availability of government-owned land (Annex 2) in a less densely populated area so as to avoid impacts associated with community exposure by the facility and possible need for resettlement of residents. NISIR has allocated a 10-hectare piece of land to ZNPHI for the proposed project in the Silver Rest area which is sparsely populated. 5.3 Design Alternativ e The World Health Organisation (WHO) Laboratory Biosafety Manual contains a design requirement for BSL-3 facilities. In view of this requirement, which is aimed at ensuring that risks associated with BSL-3 facilities are minimized at the design stage, the general design of the facility was fashioned along the WHO requirement and therefore other possible designs were not considered.Because of the nature of the laboratories, the design of the Laboratory and Office complex was dictated by the need to isolate the block for laboratory facilities as far away as possible from the offices and workers. Therefore, only one design option was considered and preferred in order to collocate the laboratory and the offices and grantee biosafety and biosecurity so as to minimise exposure of workers to diseases pathogens. 5.4 Construction Materials Alternativ e The laboratory and office complex and other site structures can be made from concrete blocks, clay bricks, hydra form bricks or a combination of them. Conventional building methods (i.e. 79 using block-work, mortar and roofing sheet) are more time consuming but offer several advantages, which has led to the adoption of this approach for the proposed project. These advantages include:  Under the present economic climate, this building method is the most econzomically viable  A large proportion of construction materials are locally produced which would benefit the local and regional economy due to multiplier effects  This method is more labour intensive and will offer more employment opportunities  G enerally, the skills and technology for this construction method are already available in the country 5.5 Water source alternativ es Water sources for use in the BSL-3 facility include among others:-  Borehole water  Roof catchment water  Water from ex isting water utility The preferred source of water for this project is borehole water with plans by the project to drill a borehole to provide water for the BSL-3 facility. The use of roof catchment and supply from water utility was rejected even though they were considered. Pipe water from the water utility was rejected due to the lack of a water supply system while roof catchment was not considered as an adequate option for supply the quantity of water required by the BSL-3 facility. 5.6 Alternativ e E nergy Source The preferred source of energy use in the BSL-3 facility is from the national grid. Other sources that were considered and rejected include:  Solar Pow er: -This was considered to be too costly for the project even though it is environmentally friendly. In future, the project may consider use of solar energy for the facility.  Generator:- Even though the project will install a stand by generator for the facility, this will be for emergency purposes only and this was not considered as the main source of energy. 80 5.7 Solid waste treatment options In line with the Stockholm convention on persistent organic pollutants (POPs) to which Zambia is a signatory, ZNPHI shall promote current best practices of using non- incineration methods including the use of autoclaves for health care waste management to minimize emission of POPs in order to meet the Stockholm convention requirements. Therefore, the ZNPHI shall have a central autoclaving system for sterilisation of health care solid waste. Health care solid waste from the BSL -3 laboratory will be initially autoclaved within the laboratories as per BSL -3 biosafety requirements. The sterilised solid waste will then be conveyed to the central solid waste autoclaving system for secondary autoclaving. From the central autoclaving system, sterilised solid waste will be shredded to reduce on the volume. During the operational phase, ZNPHI will outsource ZAMRA incinerators that were commissioned on the 9th of February 2018 and capable of handling medical and pharmaceutical waste. The Incinerator compound is located off airport Road next to NISIR in Lusaka. Most of the incinerator materials at the site include pharmaceuticals, medicines and other materials brought for incineration. These are stored in secure storage facilities, with the highest level of hygiene. The incinerator is an electic fired type that taps power from the ZESCO grid system. The ash from the incinerators will be disposed of in an approved landfill. 5.8 Wastewater management alternativ es 5.8.1 Wastew ater M anagement 1st Alternativ e M edical Waste Water : The Medical Waste Water will be collected into a leak proof storage tank whose filling capacity will be auto monitored so as not to exceed ¾ full. The medical waste water will then be steam sterilised using the liquid cycle of the autoclave connected to the storage tank. The autoclaved waste water will then be discharged into the solid particle filtration system to allow solid particles to be filtered out of the wastewater as it flows through the system. The filtered waste water will be collected in the retention tanks which will be vacuum tanked by licenced waste collectors for further treatment at the offsite municipal sewage treatment site at regular intervals. Domestic Waste Water Netw ork: The domestic waste water network will have several inspection chambers as it leads to the sedimentation tanks. A layer of accumulated solids or sludge, will form at the bottom of the sedimentation tank as the waste water slowly flows through it thereby providing a level of purification prior to discharge. The sludge at the bottom 81 of the sedimentation tanks will be periodically removed during routine maintenance as illustrated in the figure below. Proposed Water Treatment Plant: The proposed sewerage treatment plant to be utilised for processing sewer waste from the facility is the Manchichi Sewerage Treatment plant, it is located approx imately 26Km west of the location site. The Manchinchi sewerage treatment plant in Lusaka is a fully functional conventional trickling filter type. Within the stages of sewage treatment, there are different steps and methods that can be employed to treat the water. These include: Preliminary treatment, Primary sedimentation, Biological treatment and Secondary sedimentation and Sludge treatment. Additionally, also available in prox imity are alternative sewerage treatment plants that can provide substitute options for sewerage treatment should the ideal treatment plant develop faults. These include the recently refurbished Munali Sewage Treatment Plant (Figure 17). Proposed Water Treatment Plant : The proposed sewerage treatment plant to be utilised for processing sewer waste from the facility is the Manchichi Sewerage Treatment plant, it is located approx imately 26Km west of the location site. The Manchinchi sewerage treatment plant in Lusaka is a fully functional conventional trickling filter type. Within the stages of sewage treatment, there are different steps and methods that can be employed to treat the water. These include: Preliminary treatment, Primary sedimentation, Biological treatment and Secondary sedimentation and Sludge treatment. A Sludge from the onsite wastewater treatment system will be also be disposed of in Manchichi Sewerage Treatment plant. dditionally, also available in prox imity are alternative sewerage treatment plants that can provide substitute options for sewerage treatment should the ideal treatment plant develop faults which include Chunga Sewerage Treatment Plant and Mutumbi Sewerage Treatment Plant to mention a few. 5.8.2 Waste Water M anagement 2nd Alternativ e The second option considered was linking the domestic and medical waste systems. This was ruled out as the area is not connected to a sewerage network and this may result in ground water contamination and public health risks. 82 Figure 29 Locations of waste treatment systems relative to the ZNPHI Project site 83 6. STAKE HOLDE R CONSU LTATIONS ANDINFORM ATION DISCLOSU RE In order to get input, promote wide ownership and incorporate the views of stakeholders, the general public, interest groups and institutions, the ZNPHI held several interactive consultative meetings at various stages starting from the development of the project concept. These include meetings held at Waterfalls lodge in June 2019, Anina’s lodge in November and December 2018 (Annex 5), and Ministry of Health in July 2019 (Annex 6). The meetings were attended by relevant stakeholders that included: government agencies, regulator bodies, the local community representatives, civic and traditional leaders. Among others, the consultations incorporated representatives from the Department of V eterinary Services, Ministry of Fisheries and Livestock; University of Zambia; Food and Drugs Control Laboratory; Environmental Health Department, Ministry of Health; Infrastructure and Medical Technologies Unit, Ministry of Health; National Institute for Scientific and Industrial Research; Department of Public Infrastructure, Ministry of Housing and Infrastructure Development; Ministry of Defence; Ministry of Justice; Lusaka City Council; Chongwe Municipal Council; Ministry of Higher Education; Ministry of Lands and Natural Resources; Ministry of Finance; Ministry of National Development Planning; Center for Infectious Disease Research in Zambia (CIDRZ); Lusaka apex Medical University (LAMU); ZAMRA; ZEMA; Zambia Bureau of Standards; School of Public Health, University of Zambia; University Teaching Hospital; Africa CDC; World Health Organisation (WHO); US Centers for Disease Control and Prevention (CDC); Japan International Cooperation Agency (JICA); and others. As need arises, bilateral and cross- sector consultations continue to be made with relevant G overnment departments and agencies, as well as Cooperating Partners, individuals and interest groups. On 16th July 2019, a public disclosure and consultative meeting on the project was held at the Ministry of Health Headquarters and attended by a wide representation of stakeholders including community members, local leaders, cooperating partners, MOH senior leadership, NG O, and government agencies (Annex 6). The meeting was chaired by the Honourable Minister of Health Dr Chitalu Chilufya and the area Chiefdom, the Busoli royal establishment (BRE), was represented by Princess Cholwe Nkomeshya. Following detailed description of the the project by the ZNPHI Director Dr V ictor Mukonka, an open question and answer session was held, durimg which the stakeholders were encouraged to seek clarity on anything related to the project and air any concerns. The following were the issues raised and responses given: 84 1. How the multiple functions at the proposed laboratory complex will link with the functions already being played by specific entities, such as the Food and Drugs Control Laboratory (FDCL) which among other areas looks at food safety and toxicology. Response: The National Public Health Laboratory (NPHL) is not meant to replace ex isting capacities, but rather enhance them. The NPHL would be at the apex of a network of laboratories that will also incorporate some ex isting capacities based on competence and competitive advantage. Furthermore the project would provide additional capacity beyond what is currently available in ex isting institutions. 2. What considerations would be taken into account in dividing the country into the proposed three sub-regions for the planned National Public Health Laboratory system. Response: Risk mapping willguide the division of the country into the respective regions. This will be to ensure that each part of the country is assigned due attention, as informed by both identified and potential public health threats in each region. The availability of laboratory capacity would be another factor, although the vision of ZNPHI was to ensure that where capacity didn’t yet ex ist, this would eventually be established as the NPHL system is expanded. 3. What capacity the biobank was planned to have and whether there were plans to generate sequence data, and if so what mechanisms were being considered to safeguard such information and materials. Response: The project will provide adequate capacity for storage of a range of samples, isolates and other reference materials to support research and understanding of diseases in the local context. This will also provide a resource for developing appropriate diagnostic tests, therapeutic agents and vaccines. The biobank will be certified and operate in accordance with the regulations set by the National Health Research Authority (NHRA) and in conformity with international best practice. As for sequencing, provision has been made for molecular biology a core laboratory as well as a bioinformatics suite to support the modern diagnostic capabilities. This will be augmented by the ICT capabilities which the project is also funding. Biosecurity and biosafety issues will also be addressed through the engineering designs, policies, procedures, training, medical surveillance for staff, administrative controls and infection control and waste management protocols. Biosecurity has been recognised as a gap through the JEE and the Africa CDC has launched a continental initiative to improve the capacities in this area. To this end the SA-RCC convened a regional meeting in June 2019 to devise strategies 85 of improving biosafety and biosecurity in Member States, as per JEE requirements. A key aspect addressed was the need to develop lists of High Consequence Agents and Toxins (HCATs) as well as to develop relevant legislation on regulating use/stocking of these HCATs. Zambia is fully participating in these initiatives and when developed and consensus reached at national, regional and continental level, these shall also guide practices in the laboratory facility. Furthermore, relevant security and access control systems have been factored into the project to ensure that only those with the required level of clearance can access certain areas of the laboratory, or access certain information. 4. A resident from Silver rest area requested for a detailed description of the proposed location of the project site within Silver rest area. Response: A satellite image of the area was reviewed and key landmarks outlined. The proposed project site is adjacent to the UNZA farm on Palabana road (D153), and the surrounding area is generally farmland. He indicated that the site lies at the junction of the recently tarred road which branches off southwards from the G reat east road at Silver Rest Primary School and Palabana road (D153). Key social receptors in the area are located north east of the site and are: (i) a Police Post (approx imately 1 Km away); (ii) Silver Rest G ardens Residential Estate (about 3.4 Km away); and (iii) Silver Rest Primary School (approx imately 5.17 Km away). 5. The representative of Her Royal Highness Chieftainess Mukamambo II, Princess Cholwe Nkomeshya, expressed her elation at that the G overnment had considered setting up the project in the Busoli Chiefdom. She pledged full support for the project by the Busoli Royal Establishment and indicated that the BRE was full of expectation that once complete the laboratory would greatly help to answer health challenges faced by the people in the Chiefdom and across the entire country and Southern Africa region. She indicated that the BRE was in support of the efforts by the Ministry of Health to safeguard the health and security of the country’s residents. Princess Cholwe also indicated interest in showing the detailed powerpoint presentation directly to Her Royal Highness Senior Chieftainess Nkomesha Mukamambo II to enable her fully appreciate the scale and importance of the modern infrastructure being proposed to be established in the chiefdom. She requested the ZNPHI team to contact the Busoli palace when they are ready for a special session with Her Royal Highness the Chieftainess. Overall there was acceptance and support for the project. 86 7. E NVIRONM E NTAL AND SOCIAL IM PACTS AND M ITIGATION M E ASU RE S The proposed construction of the ZNPHI BSL 3 Laboratory/SA-RCC office complex is likely to have both negative and positive impacts on the environment and community around the project site. Therefore it important that ZNPHI puts in place measures to mitigate the anticipated negative impacts and to enhance the anticipated positive impacts of the proposed project on the community and environment. An assessment of the overall significance of these impacts based on consequence and likelihood is made on the basis of information gathered during the environmental baseline study of the project area which has included field visits, as well as a desk study of relevant ex isting documents and information pertaining to the study and information describing the nature and design of the proposed project. Major impacts that are likely to arise during the construction and operational phases of the project are highlighted below. 7.1 Positiv e Impacts The new infrastructure will aid the institute to be more efficient in implementing its mandate of monitoring new diseases that threaten global health security (like the Ebola virus, SARS etc.) and the changes in distribution and virulence of well-known diseases. Having different sectors housed in the same building will reduce response time, enhanced multi-sectoral collaboration, improve communication with public health workers, health care professionals, and the public about emerging health threats. The institute will also act as a command centre to identify, prepare, manage and promptly respond to public health events. Therefore, the institute will help the country to establish an early warning system for highly infectious diseases. The institute will also contribute to preventing or reducing the impacts of disasters on our communities which will help reduce the financial costs of these hazards on the economy. The new infrastructure will increase technical sustainability by fostering leaders capable of designing, monitoring, supervising, and evaluating programs to reduce health threats based on cutting-edge information and tools. The new laboratories will improve biosecurity in the region, as the country will be able to handle highly infectious pathogens both in animal and human sectors with a one health approach. The laboratory infrastructure will build capacity in surveillance and monitoring of antimicrobial resistance (AMR) in the country and region. This will involve training and 87 mentoring in public health. Provision of state of the art facilities for Public Health and Bio- medical Research will add to the country and regional evidence based knowledge that may inform implementation of interventions and policy. Food security- through food and water monitoring will also be improved. Other socioeconomic positive impacts include: I.Prov ision of E mployment : - The project will be a source of employment as it will require skilled technicians and crafts people as well as un-skilled labour for the construction of the four-storey ZNPHI/RCC laboratory & office complex of the project. It is expected that a temporal workforce of up to 50 to 100 (at peak period) persons will be required on the construction site at a time. This will provide employment opportunities not only to the people of the immediate vicinity (Lusaka District) but other districts/regions in the country. Many employment opportunities, especially for semi and unskilled labour, will benefit local communities within the project area. It is anticipated that employment opportunities will also be available for women from the local communities; women are often regarded as reliable workers and contractors generally hire women as casual workers for various jobs, including domestic ones for construction workers living on site who come from elsewhere. The project will also avail opportunities for technical experts like engineers, architects etc. to collaborate with other experts in the sub region or continents. II.Boost to construction sector (regional/national multiplier effect):- Implementation of the project will provide a positive boost to various sectors related to the construction industry as the developer is committed to ensuring that local raw materials, finished products and services will be utilized as much as possible for its successful completion. This in turn will promote employment opportunities in related sectors in the region. Manufacturers and suppliers of local (i.e. regional) materials will include manufacturers of protective ware, cement manufacturers, local manufacturers of blocks, sub-contractors for the supply of sand and gravel as well as manufacturers of other local building materials such as timber and door / window frames. III.Increased Rev enue: - Multiplier effects resulting from increased employment and operation will include increased public revenues such as taxes (PAY E to ZRA) and contributions to NAPSA from formally employed persons and other indirect taxes resulting from the construction project such as V AT on materials and services. 88 IV.Boost to the local economy: - The workforce will get most of their food and other necessities from the surrounding area and this will provide a market for the local agricultural producers and other small businesses (local shops). This will in turn increase the incomes of the local people which can be invested in other (productive) activities and be used for paying school fees, medical expenses and other domestic needs. V.Imp rov ed Access Road: - The access road to the area of the planned area for the construction of the four-storey ZNPHI/RCC laboratory & office complex of the project will allow an increase of other users to reach other communities, including traders, NG O and government support programmes and even some forms of public transport. VI.General security in the area: The site and its immediate surrounds are isolated and it is likely for incidences of mugging and rape to occur in the area, especially at night. It is expected that the development of the project which will operate day and night will have a significant positive impact on general security in the area. There is also a police post located 1km from the project site and this will add to the improved security in the area. The project will be manned by a hired security firm that will manage the premises and surrounding areas. This will add to the general security and reassure the community of a safe environment. 7.2 Construction Phase Negativ e Impacts 7.2.1 Negativ e Physical E nv ironment I. Deterioration of pub lic access road s due to heav y traffic: The project will at times experience a high volume of heavy construction traffic delivering materials and/or equipment to the site. This has the potential to cause damage to access roads approaching the site which is beyond normal wear and tear, especially at point of ingress and egress to the site. II. Dust E missions: Dust will be generated by the operation of the front end loader and other heavy duty machinery.Dust is a major environmental problem on gravel roads.When vehicles pass,road dust in settlements is an extreme inconvenience and health hazard,Dust also pollutes surface water for drinking for human beings and animals. Fume emissions will come from the fossil fuel consuming vehicles that will be used during the construction phase leading to an increase in the 89 emission of carbon monox ide and other fumes that have negative impacts on the environment. These emissions will have direct effects on the quality of air which may result in increased respiratory diseases among the nearby community. III. Soil E rosion: Soil mov ement is common during construction projects. Machinery will be used during the site preparation and construction phases for earth movement and excavation. would lead to instability of the soil at the project site and may lead to top soil erosion while movement of equipment would lead to compaction of top soil. As a consequence of poorly designed erosion control and drainage measures may result,this will lead to further pollution of waste water. As much excavated soil as possible will be re-used on the site as backfill and will be compacted to make it stable. All cut slopes, embankments, and other erosion- prone working areas will be stabilized while work is going on to the extent that is feasible. All earth disturbed areas will be stabilized after earth movement has ceased at the site. IV. Occupational Health And Safety: Health problems likely to be encountered range from skin diseases, heat stroke, lung irritation and eye strains asimpacts from dust, hazardous waste and explosives: V arious operating procedures have been proposed and these include provision of personal protective equipment, monitoring and medical check-ups for all the employees. A detailed Infection Prevention, Control and Waste Management Plan (IPCWMP) has been developed and it provide procedures for ensuring Occupational Health and Safety. V. Solid Waste Pollution: Huge quantities of solid w astes are normally generated from construction projects. Solid waste will mainly be construction debris,rods of metal,wood,stones, packaging materials, kitchen waste etc. During the operation phase domestic and operational waste from offices and laboratories (both human and animal) that will require proper management. Therefore, all solid waste generated during operations should be taken for proper disposal to approved landfills by licenced handlers. V I. Noise and v ibration due to blasting and mov ement of machinery: Noise and vibration pollution is another health and safety harzard which may lead to annoyance and disruption of concentration.Physical effects include loss of hearing, pain, nausea and interference with communication when exposure is severe.- Noise monitoring shall be done every three months, noise protective clothes shall 90 be provided to workers and warning signs to show places where protective clothes are required shall be installed. VII. Impacts on Aesthetics: The proposed construction of the office complex and the BSL3 Laboratory will be undertaken in an area that is predominately virgin land. Apart from the newly constructed Silverest G ardens residential area, the area remains undeveloped with a lot of vegetation cover and seasonal gardens. The construction of the facility is likely to alter the aesthetics of the area due to visual intrusion. The design of the complex will factor in the receiving environment to ensure the structure blends into the surroundings. 7.2.2 Negativ e impacts on Biological E nv ironment I. Loss of flora and fauna due to site clearing activ ities: This shall be managed by restricting site clearing to specific areas, obtaining a site clearing permit from management before site clearing and conducting conservation awareness activities. This implies that the significance in terms of loss shall be minimal. II. Contamination of surface and ground w ater: - There is a potential for surface and groundwater pollution occurring due to contaminants emanating from various waste products generated by construction activities entering the surface drainage regime and / or polluting the soil and infiltrating the underlying aquifer. III. Contamination surface and ground w ater by w aste w ater from the Labs: - There is a potential for surface and groundwater pollution occurring due to contaminants emanating from waste products generated by the laboratory activities entering the surface drainage regime and infiltrating the underlying aquifer. Waste water from the laboratories will be collected and channeled to a collection tank linked to decontamination and disinfection equipment for primary treatment. The decontaminated and disinfected waste water will then be channeled into the Interceptor Tanks for secondary treatment before being transported to a waste water treatment plant. IV. Laboratory E missions: - There is a potential for air pollution occurring due to contaminates emanating from airborne pathogens processed in the laboratory into the natural air. The Laboratories will be designed to be air tight and negatively pressured. All compartments of the Laboratories will be fitted with the Highly Effective Particulate Air Filtration (HEPA) systems. The fumes from the Laboratories will collected and channeled through the HEPA systems for treatment before emission into the air. 91 7.2.3 Negativ e impacts on socio-economic E nv ironment I. Conflicts w ith the community and nearby facilities: ZNPHI shall developed a grievance and redress management plan (G RMP) to manage any conflict that may arise during the project life cycle. This G RMP shall be publicized to the community once developed will provide a platform for presenting and addressing grievances. II. Community health and safety: Construction projects are commonly associated site excavation which would create water collecting bodies which if left uncovered will lead to breeding gound for diseases such as Malaria and other tropical diseases such as bilhazia among children .Also excavation.Furthermore the construct projects are associated with social interactions amongst the construction workers and local communities which can lead to casual or commercial sexual relationships producing an inherent increased risk of the incidence of the transmission of sexually transmitted diseases (STDs) and HIV . To mitigate this risk, the project will as much as is possible employ personnel (especially general and semi-skilled workers) from within nearby local communities. Other workers such as the contractor’s core personnel who may come from other areas will be accommodated appropriately in Lusaka and all staff will commute daily to site. The potential for epidemiological impacts associated with the presence of construction workers is considered moderate. III. Impacts Associated with Air Quality E missions: Construction activities of materials delivery, excavation, concrete works and construction traffic will generate dust. V ehicular traffic to the proposed site is expected to increase especially during delivery of raw materials and construction. V ehicular traffic emissions will bring about air pollution by increasing the fossil fuel emissions into the atmosphere. However, the construction activities are mainly going to be through manual labour and use of hand held equipment with limited use of mechanized machines whenever necessary. IV . Impacts Associated w ith Noise and Vibration. Noise and vibration generated during construction by construction machinery, such as excavators, and transportation vehicles. There will be limited use of construction machinery which will not be heavy in nature. In order to create employment, the project will use manual forms of labour and equipment. G enerally, construction noise exceeding a 92 noise level of 70 decibels (dB) has significant impacts on surrounding sensitive receptors within 50m of the construction site. The noise impact will be short term in nature and not continuous to significantly affect sensitive receptors. There are no sensitive receptors e.g. health and educational facilities within 300m of the project site. 93 Summary of Potential Impacts associated with the Construction Phases Table 12 List of Potential Impacts during the Constrction of the Phase Nature of Impact M agnitude of Potential Impacts during Construction E xtent Significance: impact Temporary job creation during construction phase Positive Local 3 / Regional4 Moderate Skills Transfer in the construction of an office complex es housing a BSL3 Laboratory Positive Local Moderate Increased local revenue for the local communities from wages and trading with the workers Positive Local Moderate Increased noise levels during the construction phase from heavy machinery Negative Local Moderate Soil erosion and impacts on soils due to spillage of hydrocarbon fuels and lubricants Negative Local Low Effect on ambient air quality from increased levels of dust Negative Local Low Visual intrusion (aesthetics) during the construction of the multi-storey building Negative Local Low Increased incidences of sex ually transmitted diseases (STD’s) and HIV between contractors and local communities Negative Local Low Risks related to Community safety and security impacts on the site and surrounding areas Negative Local Moderate Increase influx of workers seeking employment on the construction site Negative Local Moderate Ecological impacts on Flora, avifauna and Fauna, from the clearing of vegetation Negative Local moderate Gender bias in construction jobs Negative Local Moderate Trafic congestion Negative Local low Child labor Negative Local high 3 Local refers to surrounding Communities 4 Regional refers to Nationwide and the Southern African Region 94 Table 13: Mitigation measures for anticipated construction phase impacts Potential Negative Performance M onitoring Impacts Frequency M itigation measures Time Frame Cost Indicator and Reporting Construction Phase Ecological impacts Construction Restricting clearance of vegetation to only specific 12 Months Reduced impacts The Contractor, From the 580,0000 on Flora, avifauna Phase areas of the project footprint on the ecology of Supervising allocated to ESIA and Fauna, from the the area Engineer and clearing of ZNPHI vegetation Increased noise Construction Construction activities will be restricted to normal 12 Months Zero complaints The Contractor, From the 580,0000 levels during the Phase working hours, 06:00hours to 18:00hours or reports of Supervising allocated to ESIA construction phase increased noise Engineer and from heavy levels ZNPHI machinery Soil erosion and Construction The contractorEarth movement will provide a waste 12 Months Rehabilitation of Contractor From the 580,0000 impacts on soils due Phase management planbe restricted to areas earmarked affected areas allocated to ESIA to spillage of for management of solid and liquid waste before the onset hydrocarbon fuels The contractor to engage a ZEMA licensed waste of the operational and lubricants operator to dispose wastes phase Contractor to provide litter bins for waste disposal to recycle or re-use certain types of wastes (scrap metal) etc, to provide mobile toilets for workers at the construction site works Reagents and hazardous chemicals should be stored in a bunded area All construction equipment will be serviced regularly. Effect on ambient air Construction During the dry season with no rainfall, the site will 12 Months Zero reports of The Contractor From the 580,0000 quality from Phase be watered down as required to reduce dust levels. increased dust and allocated to ESIA increased levels of levels from Supervising dust construction Engineer activities and associated health 95 risks. Visual intrusion Construction Equipment during construction will be 12 Months Disturbance to the Contractor From the 580,0000 (aesthetics) during Phase stored/parked in a designated area to avoid visual natural scenery in allocated to ESIA the construction of intrusion. the area should be the the lab complex negligible Increase influx of Construction The orientation programme will include sensitizing 12 Months Zero incidences ZNPHI and the Costs to be included in workers seeking Phase workers on the social and cultural values of the of conflicts with Contractor contractual agreements employment on the local communities. the local of contractors construction site community Increased incidences Project Life Sensitizing the workers on the danger of STDs and Duration of Workers made ZNPHI and the Costs to be included in of sex ually Cycle HIV including preventative measures. the Project aware on the Contractor contractual agreements transmitted diseases dangers of STDs of contractors (STD’s) and HIV and HIV Risks related to Construction All the construction sites will be barricaded, and Duration of No of theft or Contractor From the 580,0000 Community safety Phase signage will be placed at strategic points. the Project Accidents allocated to ESIA and security impacts on the site and surrounding areas Traffic Congestion Construction Provide and implement a traffic management plan Duration of Contractor 5,000.00 Phase Provision temporary road signs or notices to the Project indicate ongoing works. Effecting traffic controls to avoid congestion and accidents on construction site and associated roads. Choosing suitable traffic routes to reduce the impact in the neighbourhood. Ensuring no interference with traffic through traffic control, designated parking, speed limits and hiring a banksman. Gender Construction Ensuring equitable distribution of employment Construction Equal opportunty Contractor empowerment Phase opportunities between men and women phase provided Child Labour and Construction Prepare and implement a child protection strategy Construction Child labor and Contractor protection Phase Ensuring no children are employed on site in phase offenses are accordance with national labour laws avoided Ensuring that any child sex ual relations offenses among contractors' workers are promptly reported to the police 96 7.3 Operations and maintenance phase imp acts and mitigation measures There are risks associated with operations of BSL3 labs, due to the highly infectious nature of pathogens and samples which are tested and disposed. The mitigation measures associated with operational phase is detailed in a separate document, Infection Control and Waste Maagement Plan, associated with this project. The following are the anticipated risks at this phase: 7.3.1 Imp acts Associated w ith Inad eq uate Proposed Facility Design According to the World Health Organsiation (WHO) Laboratory Biosafety Manual, there is a requirement to adopt a particular BSL-3 design in order to ensure containment of infectious and harzadous materials and minimize the risks associated with activities in such a facility. The poor design of this BSL-3 facility which fails to comply with the WHO Laboratory Biosafety Manual will lead to human health, environmental and social impacts due to exposure associated with poor containment and will have adverse impacts on occupational health and safety as well as community health and safety including the environment in general. Impact Significance: Contrywide; Moderate and Long Term M itigation: The laboratory design and facilities for the facility must comply with WHO BSL-3 design requirements including but not limited to: 1. The laboratory must be separated from the areas that are open to unrestricted traffic flow within the building. Additional separation may be achieved by placing the laboratory at the blind end of a corridor, or constructing a partition and door or access through an anteroom (e.g. a double-door entry or basic laboratory – Biosafety Level 2), describing a specific area designed to maintain the pressure differential between the laboratory and its adjacent space. The anteroom should have facilities for separating clean and dirty clothing and a shower may also be necessary. 2. Anteroom doors may be self-closing and interlocking so that only one door is open at a time. A break-through panel may be provided for emergency ex it use. 3. Surfaces of walls, floors and ceilings should be water-resistant and easy to clean. Openings through these surfaces (e.g. for service pipes) should be sealed to facilitate decontamination of the room(s). 4. The laboratory room must be sealable for decontamination. Air-ducting systems must be constructed to permit gaseous decontamination. 5. Windows must be closed, sealed and break-resistant. 6. A hand-washing station with hands-free controls should be provided near each ex it door. 7. There must be a controlled ventilation system that maintains a directional airflow into the 97 laboratory room. A visual monitoring device with or without alarm(s) should be installed so that staff can at all times ensure that proper directional airflow into the laboratory room is maintained. 8. The building ventilation system must be so constructed that air from the containment laboratory – Biosafety Level 3 is not recirculated to other areas within the building. Air may be high-efficiency particulate air (HEPA) filtered, reconditioned and recirculated within that laboratory. When ex haust air from the laboratory (other than from biological safety cabinets) is discharged to the outside of the building, it must be dispersed away from occupied buildings and air intakes. Depending on the agents in use, this air may be discharged through HEPA filters. A heating, ventilation and air-conditioning (HV AC) control system may be installed to prevent sustained positive pressurization of the laboratory. Consideration should be given to the installation of audible or clearly visible alarms to notify personnel of HV AC system failure. 9. All HEPA filters must be installed in a manner that permits gaseous decontamination and testing. 10. Biological safety cabinets should be sited away from walking areas and out of crosscurrents from doors and ventilation systems. 11. The ex haust air from Class I or Class II biological safety cabinets (see Chapter 10), which will have been passed through HEPA filters, must be discharged in such a way as to avoid interference with the air balance of the cabinet or the building ex haust system. 12. An autoclave for the decontamination of contaminated waste material should be available in the containment laboratory. If infectious waste has to be removed from the containment laboratory for decontamination and disposal, it must be transported in sealed, unbreakable and leakproof containers according to national or international regulations, as appropriate. 13. Backflow-precaution devices must be fitted to the water supply. V acuum lines should be protected with liquid disinfectant traps and HEPA filters, or their equivalent. Alternative vacuum pumps should also be properly protected with traps and filters. 14. The containment laboratory – Biosafety Level 3 facility design and operational procedures should be documented. 7.3.2 Imp acts Associated w ith Non-Commissioning of Proposed BSL-3 Facility Laboratory/facility commissioning may be defined as the systematic review and documentation process signifying that specified laboratory structural components, systems and/or system components have been installed, inspected, functionally tested and verified to meet national or international standards, as appropriate. The lack of non-commissioning of the BSL-3 facility as required by the WHO Laboratory Biosafety Manual will lead to human health and environmental and social impacts due to exposure associated with poor containment and will have adverse impacts on occupational health and safety as well as community health and safety including the environment in general. 98 Impact Significance: Regional; Moderate and Long Term M itigation: Ensure that the BSL-3 facility is commissioned as per WHO Laboratory Biosafety Manual. Ensure that the commissioning is undertaken by an outside commissioning agent who has demonstrated experience and success in the commissioning of complex biosafety laboratory and animal facilities. Ensure that, in addition to the commissioning agent, the institution’s Safety Officer, Project Officer, Programme Manager and a representative of the Operations and Maintenance staff are also part of the team. The following is a list of laboratory systems and components that may be included in a commissioning plan for functional testing, depending on the containment level of the facility being renovated or constructed. The list is not exhaustive and the actual commissioning plan will reflect the complex ity of the laboratory being planned. 1. Building automation systems including links to remote monitoring and control sites 2. Electronic surveillance and detection systems 3. Electronic security locks and prox imity device readers 4. Heating, ventilation (supply and ex haust) and air-conditioning (HV AC) systems 5. High-efficiency particulate air (HEPA) filtration systems 6. HEPA decontamination systems 7. HV AC and ex haust air system controls and control interlocks 8. Airtight isolation dampers 9. Laboratory refrigeration systems 10. Boilers and steam systems 11. Fire detection, suppression and alarm systems 12. Domestic water backflow prevention devices 13. Processed water systems (i.e. reverse osmosis, distilled water) 14. Liquid effluent treatment and neutralization systems 15. Plumbing drain primer systems 16. Chemical decontaminant systems 17.Medical laboratory gas systems 18. Breathing air systems 19. Service and instrument air systems 20. Cascading pressure differential verification of laboratories and support areas 21. Local area network (LAN) and computer data systems 22. Normal power systems 23. Emergency power systems 24. Uninterruptible power systems 25. Emergency lighting systems 26. Lighting fixture penetration seals 27. Electrical and mechanical penetration seals 28. Telephone systems 29. Airlock door control interlocks 30. Airtight door seals 99 31.Window and vision-panel penetration seals 32. Barrier pass-through penetration 33. Structural integrity verification: concrete floors, walls and ceilings 34. Barrier coating verification: floors, walls and ceilings 36. Biological safety cabinets 37. Autoclaves 38. Liquid nitrogen system and alarms 39.Water detection systems (e.g. in case of flooding inside containment zone) 40. Decontamination shower and chemical additive systems 41. Cage-wash and neutralization systems 42.Waste management. 7.3.3 Imp acts Associated w ith Non-Certification of Proposed BSL-3 Facility In order to avoid impacts associtaited with BSL-3 facilities, there is need to undertake laboratory certification of such a facility. The proposed BSL-3 facility is likely to lead to adverse occupational health and safety risks as well as community health and safety risks and environmental risks if not certififed prior to operationalization. Laboratory certification is the systematic review of all safety features and processes associated with the laboratory (engineering controls, personal protective equipment, building and system integrity, standard operating procedures (SOPs) and administrative controls such as documentation and record retention systems). This validation assures that all reasonable facility controls and prudent practices are in place to minimize, to the greatest extent possible, the risks associated with laboratory operations and the use of biohazardous materials. Standardization of an initial and annual certification process for BSL-3 facilities will provide accountability that ensures proper and regular maintenance and demonstrates the use of Stanadrd Operating Procedures (SOPs) that protect human and animal occupants, the environment and the research integrity. Biosafety Level 3 (BSL-3/ABSL-3) containment laboratories for animals and research are the most difficult containment level facilities to design and operate. They should be certified for use before initial operation and subsequently on an annual schedule or after a program change, renovation or replacement of critical HV AC/ex haust system components (specifically fans, air valves, or fan motors) that may affect the operating environment of the laboratory. 100 Impact Significance: Regional/Countrywide; Moderate and Long Term M itigation: Ensure that the BSL-3 is performed by a team of professionals with experience and credentials in engineering and biosafety/occupational safety and health. As a part of the laboratory certification process, a sample attached checklist which must be completed as a retained record document Undertake Re-certification of the facility will be performed on an annual basis, as a minimum. A comparison should be made to the baseline established during initial certification. Detailed records of the certification process and test results must be maintained to provide an accurate operations history of the laboratory. 7.3.4 Impacts Associated w ith Workers’s Chemical E xposure Some chemicals used in the BSL-3 facility are likely to adversely affect the health of workers who handle them or inhale their vapours during laboratorya activities. Apart from overt poisons, a number of chemicals are known to have various tox ic effects. The respiratory system, blood, lungs, liver, kidneys and the gastrointestinal system, as well as other organs and tissues may be adversely affected or seriously damaged. Some chemicals are known to be carcinogenic or teratogenic. Workers in microbiological laboratory are not only likely to be exposed to pathogenic microorganisms, but also to chemical hazards. Aerosol particles of less than 5 µ m in diameter and small droplets of 5 –100 µ m in diameter are not visible to the naked eye. The laboratory worker is generally not aware that such particles are being generated and may be inhaled or may cross contaminate work surface materials. Other laboratory activities, such as streaking agar plates, inoculating cell culture flasks with a pipette, using a multichannel pipette to dispense liquid suspensions of infectious agents into microculture plates, homogenizing and vortex ing infectious materials, and centrifugation. Exposure to hazardous chemicals may occur by:- 1. Inhalation 2. Contact 3. Ingestion 4. Needle-sticks 5. Through broken skin. 101 Impact Significance: Localised; Moderate and Long Term M itigation: Provide training to workers in the BSL-3 and ensure they have proper knowledge of the tox ic effects of these chemicals, the routes of exposure and the hazards that may be associated with handling and storage. Material safety data sheets or other chemical hazard information should be available from chemical manufacturers and/or suppliers. These should be accessible in laboratories where these chemicals are used, e.g. as part of a safety or operations manual. Ensure that there are Biological Safety Cabinets (BSCs) (Class III) in the BSL-3 designed to protect the operator, the laboratory environment and work materials from exposure to infectious aerosols and splashes that may be generated when manipulating materials containing infectious agents, such as primary cultures, stocks and diagnostic specimens. BSCs, when properly used, have been shown to be highly effective in reducing laboratory-acquired infections and cross-contaminations of cultures due to aerosol exposures. BSCs also protect the environment. 7.3.5 Impacts Associated w ith Inadequate Disinfection of BSL-3 Workers in the BSL-3 are likely to get exposed to occupational health and safety risks as a result of inadequate disnfection of the BSL-3 facility. Working areas within the BSL3-facility contain infectious materials which need to be disinfected. Impact Significance: Localised; Moderate and Long Term M itigation: All items within BSCs, including equipment, should be surface-decontaminated and removed from the cabinet when work is completed, since residual culture media may provide an opportunity for microbial growth. The interior surfaces of BSCs should be decontaminated before and after each use. The work surfaces and interior walls should be wiped with a disinfectant that will kill any microorganisms that might be found inside the cabinet. At the end of the work day, the final surface decontamination should include a wipe- down of the work surface, the sides, back and interior of the glass. A solution of bleach or 70% alcohol should be used where effective for target organisms. A second wiping with sterile water is needed when a corrosive disinfectant, such as bleach, is used. BSCs must be decontaminated before filter changes and before being moved. The most common decontamination method is by fumigation with formaldehyde gas. BSC decontamination should be performed by a qualified professional. 102 7.3.6 Impacts Associated w ith E xposure through Pipetting The most common hazards associated with pipetting procedures are the result of mouth suction. Oral aspiration and ingestion of hazardous materials have been responsible for many laboratory- associated infections. Pathogens can also be transferred to the mouth if a contaminated finger is placed on the suction end of a pipette. A lesser known hazard of mouth pipetting is the inhalation of aerosols caused by suction. Impact Significance: Localised; Moderate and Long Term M itigation: Provide training to workers in the BSL-3 and ensure they have proper knowledge of the tox ic effects of these chemicals, the routes of exposure and the hazards that may be associated with handling and storage. Material safety data sheets or other chemical hazard information should be available from chemical manufacturers and/or suppliers. These should be accessible in laboratories where these chemicals are used, e.g. as part of a safety or operations manual. Provide piping aids to prevent the ingestion of pathogens by workers. Pipettes with cracked or chipped suction ends should not be used as they damage the seating seals of pipetting aids and so create a hazard. 7.3.7 Impacts Associated w ith Liquid Waste E xposure Effluent wastes from the BSL-3 facility will be hazadious (infectious and domestic) in nature and will emanate from among other the suit area, decontamination chamber, decontamination shower, or Class III biological safety cabinet which must be must be decontaminated before final discharge. The effluent wastes if not properly disposed, will adversely affect the environment and could lead to impacts and harm human health and biolociagal environment. This project has designed an effluent wates disposal/handling method which is in accordance with the WHO Laboratory Biosafety Manual for handling of effluent wastes. The medical wastewater will be collected into a leak proof storage tank whose filling capacity will be auto monitored so as not to exceed ¾ full. The wastewater will then be steam sterilised using the liquid cycle of the autoclave connected to the storage tank. The autoclaved wastewater will then be discharged into the solid particle filtration system to allow solid particles to be filtered out of the waste water as it flows through the system. The filtered waste water will be 103 collected in the retention tanks which will be vacuum tanked by licenced waste collectors for further treatment at the offsite municipal sewage treatment site (Manchinchi Wastewater Treatment Plant) at regular interval Impact Significance: Local; High and Long Term M itigation: Onsite wastewater treatment offsite sewage treatment (Manchinchi Wastewater Treatment Plant) Sludge disposal at Manchinchi Wastewater Treatment Plant 7.3.8 Impacts Associated w ith Transport of infectious Substances Transport of infectious and potentially infectious materials to the BSL-3 facility for analysis as well as transport of the same for disposal may lead to contamination of the environment through accidental spills or impact on the human health due to the accidental exposures. Mitigation measures will include: training of personnel on specimen and waste handling, transport and storage; Use triple package during transportation of infectious materials; Use of rigid and leak- proof specimen containers. Furthermore, transportation of infectious and potentially infectious materials to the BSL-3 facility is subject to strict national and international regulations. The project will comply with these regulations specifically (United Nations Model Regulations on the Transport of Dangerous G oods (40) regulations describe the proper use of packaging materials, as well as other shipping requirements. Impact Significance: Contrywide; High and Long Term M itigation: Provide training to workers in the BSL-3 and ensure they have proper knowledge of the tox ic effects of these chemicals, the routes of exposure and the hazards that may be associated with handling and storage. Material safety data sheets or other chemical hazard information should be available from chemical manufacturers and/or suppliers. These should be accessible in laboratories where these chemicals are used, e.g. as part of a safety or operations manual. Laboratory personnel must ship infectious substances according to applicable transport regulations. Compliance with the rules will: 1. Reduce the likelihood that packages will be damaged and leak, and thereby 2. Reduce the exposures resulting in possible infections 3. Improve the efficiency of package delivery. The regulations for the transport of infectious materials (by any mode of transport) based 104 upon the United Nations Model Regulations on the Transport of Dangerous Goods (40 ) should be followed including:- The basic triple packaging system Spill clean-up procedure Materials for incineration, even with prior decontamination, should be transported to the incinerator in bags, preferably plastic. Incinerator attendants should receive proper instructions about loading and temperature control. It should also be noted that the efficient operation of an incinerator depends heavily on the right mix of materials in the waste being treated. In the event of a spill of infectious or potentially infectious material, the following spill clean-up procedure should be used. Wear gloves and protective clothing, including face and eye protection if indicated. Cover the spill with cloth or paper towels to contain it. Pour an appropriate disinfectant over the paper towels and the immediately surrounding area (generally, 5% bleach solutions are appropriate; but for spills on aircraft, quaternary ammonium disinfectants should be used). Apply disinfectant concentrically beginning at the outer margin of the spill area, working toward the centre. After the appropriate amount of time (e.g. 30 min), clear away the materials. If there is broken glass or other sharps involved, use a dustpan or a piece of stiff cardboard to collect the material and deposit it into a puncture-resistant container for disposal. Clean and disinfect the area of the spillage (if necessary, repeat steps 2 –5). Dispose of contaminated materials into a leakproof, puncture-resistant waste disposal container. After successful disinfection, inform the competent authority that the site has now been decontaminated 7.3.9 Impacts Associated w ith Specimen E xposure Receipt and opening of samples/specimen during the operation of the BSL-3 facility could result to human health impacts due to exposure to the infectious samples. Impact Significance: Local; High and Long Term M itigation: To avoid accidental leakage or spillage, secondary containers, such as boxes, should be used, fitted with racks so that the specimen containers remain upright. The secondary containers may be of metal or plastic, should be autoclavable or resistant to the action of chemical disinfectants, and the seal should preferably have a gasket. They should be regularly decontaminated. The facility should designate a Receipt of specimen room or area designated for this purpose. Personnel who receive and unpack specimens should be aware of the potential health hazards involved, and should be trained to adopt standard precautions (2), particularly 105 when dealing with broken or leaking containers. Primary specimen containers should be opened in a biological safety cabinet. Disinfectants should be available. Every laboratory that works with infective microorganisms should institute safety precautions appropriate to the hazard of the organisms and the animals being handled. 7.3.10 Imp acts Associated w ith E mergency Hazard s During the operation of the BSL-3 facility, there are emergency situations and hazards that may be encountered and caused as a result of the BSL-3 activities. Such hazards, if not contained rapidly and effectively could lead to adverse occupational health and safety impacts, community health and safety impacts as well as environmental impacts. The leakages/exposure of some of the tox ic and infectious materials from the BSL could harm human health and the environment. Typical emergency incidences that may be encountered during the operation of the BSL-3 facility include:-  Puncture wounds, cuts and abrasions  Ingestion of potentially infectious material  Potentially infectious aerosol release (outside a biological safety cabinet)  Broken containers and spilled infectious substances  Breakage of tubes containing potentially infectious material in centrifuges  not having sealable buckets  Breakage of tubes inside sealable buckets (safety cups)  Fire and natural disasters  Emergency services: whom to contact The contingency plan should provide operational procedures for: The BSL-3 management will be expected to develop a written contingency plan procedure for dealing with laboratory and animal facility accidents for a BSL-3 and the national and/or local health authorities should be involved in the development of the emergency preparedness plan. Key plans and procedures to be developed should include among others:- 1. Precautions against natural disasters, e.g. fire, flood, earthquake and explosion 2. Biohazard risk assessment 3. Incident-exposure management and decontamination 4. Emergency evacuation of people and animals from the premises 5. Emergency medical treatment of exposed and injured persons 106 6. Medical surveillance of exposed persons 7. Clinical management of exposed persons 8. Epidemiological investigation 9. Post-incident continuation of operations. In the development of this plan the following items should be considered for inclusion: 1. Identification of high-risk organisms 2. Location of high-risk areas, e.g. laboratories, storage areas, animal facilities 3. Identification of at-risk personnel and populations 4. Identification of responsible personnel and their duties, e.g. biosafety officer, safety personnel, local health authority, clinicians, microbiologists, veterinarians, epidemiologists, and fire and police services 5. Lists of treatment and isolation facilities that can receive exposed or infected persons 6. Transport of exposed or infected persons 7. Lists of sources of immune serum, vaccines, drugs, special equipment and supplies 8. Provision of emergency equipment, e.g. protective clothing, disinfectants, chemical and biological spill kits, decontamination equipment and supplies. The following emergency equipment must be available: 1. First-aid kit, including universal and special antidotes 2. Appropriate fire extinguishers, fire blankets E mergency E quipment The following are also required. 1. Full protective clothing (one-piece coveralls, gloves and head covering – for incidents involving microorganisms in Risk G roups 3) 2. Full-face respirators with appropriate chemical and particulate filter canisters 3. Room disinfection apparatus, e.g. sprays and formaldehyde vaporizers 4. Stretcher 5. Tools, e.g. hammers, axes, spanners, screwdrivers, ladders, ropes 6. Hazard area demarcation equipment and notices. 7.3.11 Imp acts Associated w ith Fire Hazard s Laboratory personnel may confront hazards posed by forms of energy including fire, electricity, radiation and noise. The proposed BSL-3 facility is likely to experience fire related hazards that could lead to occupational health and safety harm (including death), community health and safety injury (including death), accidental releases of infectious and tox ic substances as a result of the fire and destruction or property. Common causes of fires in laboratories are: 1. Electrical circuit overloading 2. Poor electrical maintenance, e.g. poor and perished insulation on cables 3. Excessively long gas tubing or long electrical leads 4. Equipment unnecessarily left switched on 5. Equipment that was not designed for a laboratory environment 107 6. Open flames 7. Deteriorated gas tubing 8. Improper handling and storage of flammable or explosive materials 9. Improper segregation of incompatible chemicals 10. Sparking equipment near flammable substances and vapours 11. Improper or inadequate ventilation. Impact Significance: Local; High and Long Term M itigation: Fire-fighting equipment should be placed near room doors and at strategic points in corridors and hallways. This equipment may include hoses, buckets (of water or sand) and a fire extinguisher. Fire extinguishers should be regularly inspected and maintained, and their shelf-life kept up to date. Close cooperation between safety officers and local fire prevention officers is essential. Apart from chemical hazards, the effects of fire on the possible dissemination of infectious material must be considered. This may determine whether it is best to extinguish or contain the fire. The assistance of local fire prevention officers in the training of laboratory staff in fire prevention, immediate action in case of fire and the use of fire-fighting equipment is desirable. Fire warnings, instructions and escape routes should be displayed prominently in each room and in corridors and hallways. 7.3.12 Imp acts Associated w ith E lectrical Hazard s The proposed BSL-3 facility is likely to experience electrical related hazards that could lead to occupational health and safety harm (including death), community health and safety injury (including death), accidental releases of infectious and toxic substances as a result of the fire and destruction or property. Common causes of fires in laboratories are: Impact Significance: Local; High and Long Term M itigation: It is essential that all electrical installations and equipment are inspected and tested regularly, including earthing/grounding systems. Circuit-breakers and earth-fault-interrupters should be installed in appropriate laboratory electrical circuits. All laboratory electrical equipment should be earthed/grounded, preferably through three- prong plugs. All laboratory electrical equipment and wiring should conform to national electrical safety standards and codes. 108 7.3.13 Imp acts Associated w ith Noise Hazards The equipment in use in the BSL-3 facility is likely to lead to excessive noise even if insidious over time which would have an impact on the workers. Some types of laboratory equipment, such as certain laser systems, fans etc. will likely produce significant noise exposure to workers. Impact Significance: Local; Low and Long Term M itigation: Where noise levels cannot be abated and where laboratory personnel routinely experience excessive exposures, a hearing conservation programme that includes the use of hearing protection while working in hazardous noise and a medical monitoring programme to determine the effect of noise on the workers should be instituted. Noise measurement surveys be conducted to determine the noise hazard. Where warranted by data, engineering controls such as enclosures or barriers around noisy equipment or between noisy areas and other work areas, can be considered. 7.3.14 Imp acts Associated w ith Ionizing Rad iation Hazards The use of radiological emitting equipment in the BSL-3 facility is likely to lead to harmful effects of radiation to the workers which may include somatic effects, e.g. clinical symptoms observable in exposed individuals. Somatic effects include radiation-induced cancers, e.g. leukaemia and bone, lung and skin cancers, the onset of which may occur many years after irradiation. Less severe somatic effects include minor skin damage, hair loss, blood deficiencies, gastrointestinal damage and cataract formation. Exposure of the developing fetus, particularly in weeks 8 –15 of pregnancy, may increase the risk of congenital malformations, mental impairment or radiation-induced cancers in later life. Impact Significance: Local; High and Long Term M itigation: To limit the harmful effects of ionizing radiation, the use of radioisotopes should be controlled and should comply with relevant national standards. Protection from radiation is managed on the basis of four principles: Minimizing the time of radiation exposure Max imizing the distance from the radiation source Shielding the radiation source Substituting the use of radionuclides with non-radiometric techniques. Mark radiation containers with the radiation symbol, including radionuclide identity, activity and assay date Use radiation meters to monitor working areas, protective clothing and hands after completion of work. 109 Use appropriately shielded transport containers Remove radioactive waste frequently from the working area. Maintain accurate records of use and disposal of radioactive materials. Screen dosimetry records for materials exceeding the dose limits. Establish and regularly exercise emergency response plans. In emergencies, assist injured persons first. Clean contaminated areas thoroughly. Request assistance from the safety office, if available. Write and keep incident reports. 7.3.15 Imp acts Associated w ith Inad eq uate Biosecurity System and Programme G lobal events in the recent past have highlighted the need to protect laboratories and the materials they contain from being intentionally compromised in ways that may harm people, livestock, agriculture or the environment. “Laboratory biosecurity” refers to institutional and personal security measures designed to prevent the loss, theft, misuse, diversion or intentional release of pathogens and tox ins. The absence of a robust biosecurity programme for the proposed BSL-3 facility may lead to intentional exposure of the infectious materials and could harm people, livestock, agriculture or the environment as indicated above. Impact Significance: Countrywide; High and Long Term M itigation: Develop laboratory biosecurity measures based on a comprehensive programme of accountability for pathogens and tox ins that includes an updated inventory with storage location, identification of personnel with access, description of use, documentation of internal and external transfers within and between facilities, and any inactivation and/or disposal of the materials. Develop institutional laboratory biosecurity protocol should be established for identifying, reporting, investigating and remediating breaches in laboratory biosecurity, including discrepancies in inventory results The involvement and roles and responsibilities of public health and security authorities in the event of a security infraction must be clearly defined. Undertake laboratory biosecurity training, distinct from laboratory biosafety training to all personnel. Such training should help personnel understand the need for protection of such materials and the rationale for the specific biosecurity measures, and should include a review of relevant national standards and institution specific procedures. Develop Procedures describing the security roles and responsibilities of personnel in the event of a security infraction should also be presented during training. 110 Develop code of conduct and professional ethical suitability among workers for working with dangerous pathogens of all personnel who have regular authorized access to sensitive materials is also central to effective laboratory biosecurity activities and should be done through an assessment of the suitability of personnel, security-specific training and rigorous adherence to pathogen protection procedures are reasonable means of enhancing laboratory biosecurity Develop compliance checks with these procedures, with clear instructions on roles, responsibilities and remedial actions. Undertake regular risk and threat assessments, and regular review and updating of procedures. 7.3.16 Imp acts Associated w ith Inad eq uate/Lack of Training For Laboratory Personnel Inadequate or lack of recruitment and training of qualified personnel to work in the BSL-3 facility could lead to adverse impacts on the workers within the facility caused by exposure to infectious substances and even to the external environment (community health) in the event of external leakages. Laboratory safety is also the responsibility of all supervisors and laboratory employees, and individual workers are responsible for their own safety and that of their colleagues. Impact Significance: Local; High and Long Term M itigation: Conduct safety organisation and training Employees are expected to perform their work safely and should report any unsafe acts, conditions or incidents to their supervisor. Periodic safety audits by internal or external personnel are desirable. Wherever possible a biosafety officer should be appointed to ensure that biosafety policies and programmes are followed consistently throughout the laboratory. The biosafety officer executes these duties on behalf of the head of the institute or laboratory. Undertake Support Staff Safety Training for skilled engineers and craftsmen who maintain and repair the structure, facilities and equipment, should have some knowledge of the nature of the work of the laboratory, and of safety regulations and procedures. Testing of equipment after servicing, e.g. testing the efficiency of biological safety cabinets after new filters have been fitted, may be carried out by or under supervision of the biosafety officer. Engineering and maintenance staff should only enter the Biosafety Level 3 facility with clearance and supervision by the biosafety officer and/or the laboratory supervisor. The Biosafety Level 3 facility should only be cleaned by the laboratory staff. Cleaning personnel should only enter Biosafety Level 3 or Biosafety Level 4 laboratories with clearance and supervision by the biosafety officer and/or the laboratory supervisor. Constitute a Biosafety Committee to develop institutional biosafety policies and codes of practice. The biosafety committee should also review research protocols for work 111 involving infectious agents, animal use. Other functions of the committee may include risk assessments, formulation of new safety policies and arbitration in disputes over safety matters. The membership of the biosafety committee should reflect the diverse occupational areas of the organization as well as its scientific expertise. The composition of a basic biosafety committee may include: 1. Biosafety officer(s) 2. Scientists 3. Medical personnel 4. V eterinarian (s) (if work with animals is conducted) 5. Representatives of technical staff 6. Representatives of laboratory management. The estinmated costs for implementation of mitigation measures are summarized in table 14. 112 8. E NVIRONM E NTAL AND SOCIAL M ANAGE M E NT PLAN (E SM P) In this chapter, institutional responsibilities for management of environmental and social risks, environmental monitoring, capacity development and training, and Chance Finds and G RM Procedure are presented. In addition of this ESMP, an Infection Control and Waste Management Plan (ICWMP) has been prepared to address environmental and social risks associated with the proposed BSL3 lab. 8.1 Institutional Arrangements for Management of E nv ironmental and Social Risks Assocated with the BSL3 Laboratory For successful implementation of environmental and social risks mitigation measures, the following institutions, organizational units, committee(s) and specilalists will play key roles. 8.1.1 ZNPH I ZNPHI will be responsible for overall management of the proposed BSL3 lab. It will be responsible for appointing for technical and support staff required for the BSL-3 lab; capacity building; ensuring that research at the proposed BSL3 lab conforms to the best international practices (such as the NIH G uidelines, BMBL and WHO Biosafety Manual) ; establishing and maintaining a Biosafety Committee ;establishing and maintaining a health surveillance program for personnel; reporting, when required, any significant problems, violations or significant research-related accidents or illnesses to relevant Zambian regulatory agencies ; and facilitating the preparation of guidelines, policies and plan relevant for smooth functioning of the lab. 8.1.2 Project Imp lementation U nit (PIU ) A Project Implementation Unit (PIU) for this project will be established by Zambia National Public Health Institute (ZNPHI) which is the implementing agency. The ZNPHI Project Implemetation Unit (PIU) will be responsible for ensuring compliance with the necessary, health, safety and environmental standards as specified in the ESMP and specifically during the operation phase. The ZNPHI will bear overall responsibility for environmental and social management at all the project phases. However, during the construction phase, the contractor will bear responsibility for compliance with the relevant health, safety and environmental aspects of the project. 113 The PIU will be required to among others undertake and assure the following during the operation phase:- 1. Review and approve the design of the BSL-3 facility and ensure that it is in line with the WHO Laboratory Biosafety Manual as appertains to design and layout. 2. Identify an independent entity to commission the facility before operations begin 3. Identify an independent entity to certify the facility before operations begin 4. Oversee the recruitment of a qualified biosafety and biosecurity officer for the BSL-3 facility 5. Oversee the establishment of a Biosafety Committee for the BSL-3 facility 6. Ensure that all the other staff recruited in the BSL-3 are competent 7. Develop or engage experts to develop Standard Operating Procedures for the BSL-3 in accordance with WHO Laboratory Biosafety Manual. 8.1.3 The Biosafety Committee The Biosafety Committee will oversee the review, approval and oversight of biohazards in research activities at the EPHI campus. The committee will be responsible for assessment of facilities in collaboration with the Biosafety Officer, and developing procedures, practices, and training of research personnel, or taking other steps necessary to assure compliance with WHO standard, CDC G uidelines, the BMBL, and other standards and regulations. The Committee has the authority to approve, require modifications to secure approval, disapprove, suspend or terminate research activities as required to assure compliance with applicable regulations and guidelines. Besides, Biosafety Committee will monitor ICWMP implementation, supervise the Infection control and waste management system of ZNPHI and the committee will be responsible to action for any deviation from the waste management procedure practices or malpractice during waste handling transportation, storage, treatment and disposal. 8.1.4 Biosafety and biosecurity Officer Biosafety and biosecurity officer is responsible for advising about, developing, implementing and supervising the safe and efficient collection, transportation, storage treatment, disposal and recycling of waste  Advise on risk assessment for all proposed work with biological agents and the development of codes of practice 114  Advise on waste disposal policy and arrangements  Advise on disinfection policy  Prepare contingency plans for action following accidents and incidents involving biological agents  Advise and assist management in investigations following accidents and incidents involving biological agents  Carry out periodic inspections of containment facilities  Develop, implement, and maintain the lab’s biosafety program to address issues of biosafety and biosecurity.  Perform and review the required risk assessment to determine appropriate biosafety level and personal protective equipment (PPE) for biohazards.  Advise scientists/researchers on proper waste disposal methods.  Assist scientists/researchers in the development of plans for preventing and handling accidental spills and personnel contamination.  Investigate laboratory accidents involving biohazards and recombinant and synthetic nucleic acid molecules.  Develop, implement, and maintain the lab’s program for select agents and tox ins.  Perform periodic inspections to ensure that laboratory standards are rigorously followed.  Promote regulatory compliance and a safe laboratory environment.  Provide advice on laboratory security.  Provide technical advice to the Biosafety Committee on research safety procedures.  Provide technical advice to ensure that individuals working in the wastewater treatment Plant  Supervise the infection control and waste management system of the BSL3 lab and  Ensure the implementation the Infection control and waste management procedure during waste handling transportation, storage, treatment and disposal  Provide training and resources for the safe use and practices for those working with potential biohazards, and laboratory equipment. 8.1.5 Project Superv ision E ngineer The Project Supervision Engineer with a qualified Environmental Health and Safety Officer will be charged with the responsibilities of supervision, review of site reports, preparation of 115 monthly progress reports, prepare and issue appropriate instructions to the Contractor and monitor ESMP implementation. 8.1.6 Contractor For an effective integration of environmental and social safeguards into the project implementation the Contractor will need to adopt this ESMP and prepare a comprehensive Construction Environment and Social Management Plan (C-ESMP) that will provide the key reference point for compliance. The Contractor will ensure that the established safeguards are integrated and implemented throughout the project works as per the C-ESMP. The Contractor will internalize the ESMP/C-ESMP, prepare monthly progress reports and implement instructions issued by the Supervision Consultant. The Contractor will also undertake ESIA Studies for sites outside the project zone and seek appropriate ZEMA licenses. The Contractor, therefore, will engage qualified Environmental Health and Safety Officer to interpret the C-ESMP and advice on the implementation of the same, as well to the Counterpart Personnel for the Supervision Expert. The full Contractor’s Team will comprise of the following key staff cadres as specified in the Bidding Document. 8.1.7 Zambia E nv ironment M anagement Authority The Zambua Environment Management Authority (ZEMA) is responsible for ensuring environmental compliance in Zambia and its staff will further ensure that the ESMP is implemented as part of their mandate, functions and responsibilities. ZEMA will undertake surveillance on the project implementation and review compliance performance based on the supervision monitoring reports. Agreed corrective action will be undertaken by the project or its contractor within the agreed timeframe. The date of the completed action will be recorded in the log against the complainant’s grievance. 8.2 Mitigation Measures Plan The mitigation measures for antipated environmental risks associated with the proposed BSL-3 laboratory and estimated costs for mitigation activities are presented in Table 14 below. 116 Table 14 : Environmental and Social risks mitigation measures plan Construction phase Cost USD *Contractor E nvironmental / Social to revise ESMP and M itigation M easures Responsibility Impact reflect actual costs based on update. Traffic Congestion Provide and implement a traffic management plan Contractor 5,000.00 Provision temporary road signs or notices to indicate ongoing works. Effecting traffic controls to avoid congestion and accidents on construction site and associated roads. Choosing suitable traffic routes to reduce the impact in the neighbourhood. Ensuring no interference with traffic through traffic control, designated parking, speed limits and hiring a banksman. Site Related Oil Spills Employee awareness on company procedures for dealing with spills and leaks from oil Contractor 10,000.00 storage tanks. Containment of leaks. Provision of absorbent material Maintenance of contractor’s plant Provision of relevant emergency numbers Soil Related Impacts Stock piling of soil for reuse Contractor 7,000.00 Provision temporary drainage channels or holding ponds as a precautionary measure Restoration of the ground by planting adequate grass cover and trees. Planning emergency response measures in case of accidental oil spills. Impact on Water Provide a waste management plan Contractor 5,000.00 Resources Proper solid and liquid wastes disposal mainly from the construction camps, sites and offices. Ensuring proper measures are in place for collection and disposal of spilled oils and lubricants. Influx/Inmigration Hiring unskilled construction and skilled (if available) labour from the local population Contractor 8,000.00 as far as possible. Use of manual labour during ex cavation and construction works where possible. Prepare a labour influx plan to manage labour influx Sensitizing workers and the surrounding community on awareness, prevention and management of HIV/AIDS. Enforcing and maintaining a code of conduct for employees 117 Construction phase Cost USD *Contractor E nvironmental / Social to revise ESMP and M itigation M easures Responsibility Impact reflect actual costs based on update. Air Quality Use of persomal protective clothing (PPE) like dust masks on construction crew. Contractor 20,000.00 Regular water spraying of murram and earth roads and construction site Operated and maintenance of contractor’s plant in compliance with relevant vehicle emission standards and manufacturer’s specification to minimize air pollution. Noise Pollution Use of persomal protective clothing (PPE) like dust masks on construction crew. Contractor 15,000.00 Avoiding night time construction when noise is loudest near residential areas. No discretionary use of noisy machinery within 50 m of residential areas and near institutions or use of manual labour in these sections. Good maintenance and proper operation of construction machinery. Where possible, ensure non mechanized construction to reduce the use of machinery Impact on flora and fauna Re-planting the indigenous vegetation as much as possible once work is completed. Contractor 4,000.00 Sparing the vegetation that must not necessarily be removed. Provide a waste management plan Promoting non-mechanized methods of construction. Ensure that the employees on site are aware of the company procedures for dealing with spills and leaks from oil storage tanks Provision of dustbin and sanitation facilities. Public Health & Safety Ensuring proper maintenance and operation of Contractors’ machinery to mitigate noise Contractor 10,000.00 and dust impacts. Providing crossing areas for access to pedestrians to minimise accidents. Provide workers with adequate drinking water and breaks. Drain all pools of standing water to minimize or altogether eliminate mosquito breeding sites. Provide a waste management plan. Cordon off trenches and working areas with a reflective tape to ensure safety of pedestrians and provide crossing areas HIV & AIDS Impacts Sensitizing workers and the surrounding communities on awareness, prevention and Contractor 35,000.00 management of HIV/AIDS. Provide an on-site clinic to provide VCT services to construction crew. Gender empowerment Ensuring equitable distribution of employment opportunities between men and women Contractor 3,000.00 Providing toilets and bathrooms for both male and female workers on site 118 Construction phase Cost USD *Contractor E nvironmental / Social to revise ESMP and M itigation M easures Responsibility Impact reflect actual costs based on update. Child Labour and Provide and implement a child protection strategy Contractor 3,000.00 Protection Ensuring no children are employed on site in accordance with national labour laws Ensuring that any child sex ual relations offenses among contractors' workers are promptly reported to the police Gender Equity, Sex ual Provide and implement a gender based violence strategy, which will include: Contractor 3,000.00 Harassment Gender mainstreaming in employment at the worksite with opportunities provided for females to work, in consonance with local laws and customs Grievance redress mechanisms including non-retaliation. Provide and implement an employee code of conduct The works contractor should be required, under its contract, to prepare and enforce a No Sex ual Harassment and Non-Discrimination Policy, in accordance with national law where applicable. Liability for loss of life, Provision of PPE. Contractor 3,000.00 injury or damage to Training workers on the operation of the machinery and equipment private property Ensuring there are adequate warning and directional signs. Ensuring that the prepared code of conduct for staff is followed to prevent accidents. Developing a site safety action plan. Cordoning off unsafe areas Provision of first Aid kit within the construction site. Recording of all injuries that occur on site in the incident register, corrective actions for their prevention are instigated as appropriate. Compliance with the Workmen's Compensation Act, ordinance regulations and union agreements. Soil erosion and impacts The contractor will provide a waste management planbe restricted to areas earmarked for Contractor on soils due to spillage of management of solid and liquid waste hydrocarbon fuels and The contractor to engage a ZEMA licensed waste operator to dispose wastes lubricants Contractor to provide litter bins for waste disposal to recycle or re-use certain types of wastes (scrap metal) etc, to provide mobile toilets for workers at the construction site works Reagents and hazardous chemicals should be stored in a bunded area 119 Construction phase Cost USD *Contractor E nvironmental / Social to revise ESMP and M itigation M easures Responsibility Impact reflect actual costs based on update. All construction equipment will be serviced regularly. Visual intrusion Equipment during construction will be stored/parked in a designated area to avoid visual Contractor (aesthetics) during the intrusion. construction of the multi- storey building Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD Impacts associated with inadequate Ensure the BSL-3 Facility is designed in accordance with the ZNHIP TBD through detailed design BSL-3 Facility Design leading to design requirements provided by WHO Laboratory Biosafety and Bill of Quantities. among others: Manual) (Human Health Risks, Occupational Health and Safety Risks, Community Health and Safety Risks, Environmental Risks) Impacts associated with NON- Ensure that the BSL-3 Facility is commissioned as per the ZNHIP 15,000.00 Commissioning of the BSL-3 Facility requirements and in accordance with the design requirements design leading to among others:- provided by WHO Laboratory Biosafety Manual). (Human Health Risks, Occupational Health and Safety Risks, Community Health and Safety Risks, Environmental Risks) Impacts associated with NON- Ensure that the BSL-3 Facility is commissioned as per the ZNHIP 15,000.00 CE RTIFICATION of the BSL-3 requirements and in accordance with the design requirements Facility design leading to among provided by WHO Laboratory Biosafety Manual). others:- Ensure that on an annual basis, RE -CE RTIFICATION of the 120 Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD BSL-3 Facility is undertaken by an independent ex pert. (Human Health Risks, Occupational Health and Safety Risks, Community Health and Safety Risks, Environmental Risks) Impact associated with Workers’ Provide training to workers in the BSL-3 and ensure they have ZNHIP TBD through detailed design Chemical Ex posure leading to proper knowledge of the tox ic effects of these chemicals, the and Bill of Quantities. Occupational Health and Safety Risks routes of ex posure and the hazards that may be associated with handling and storage. Material safety data sheets or other chemical hazard information should be available from chemical manufacturers and/or suppliers. These should be accessible in laboratories where these chemicals are used, e.g. as part of a safety or operations manual. Ensure that there are Biological Safety Cabinets (BSCs) (Class III) in the BSL-3 designed to protect the operator, the laboratory environment and work materials from ex posure to infectious aerosols and splashes that may be generated when manipulating materials containing infectious agents, such as primary cultures, stocks and diagnostic specimens. Impacts associated with inadequate Develop a solid waste management plan for infectious and ZNHIP 3,000.00 (ex cludes cost of management of infectious solid waste harzadious solid wastes with WHO Laboratory Biosafety autoclave which is part of from the the BSL-3 Facility to among Manual project overall cost to be others:- Autoclave all infectious and harzadious solid wastes determined via the detailed Incinerate infectious and harzadious solid wastes in an design and Bill of Quantities. (Human Health Risks, Occupational incinerator that meets the specifications for incinerating wastes Health and Safety Risks, Community from BSL-3 facility Health and Safety Risks, Provide training for workers handling for infectious and Environmental Risks) harzadious solid wastes Provide PPE for workers handling for infectious and harzadious solid wastes Impacts associated with inadequate Develop a liquid waste management plan for infectious and 10,000.00 (ex cludes cost of management of infectious harzadious solid wastes in accordance with WHO Laboratory ZNHIP autoclave which is part of effluent/liquid waste from the the Biosafety Manual project overall cost to be BSL-3 Facility leading to among Autoclave all infectious and harzadious liquid wastes determined via the detailed 121 Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD others:- Provide training for workers handling for infectious and design and Bill of Quantities. harzadious liquid wastes (Human Health Risks, Occupational Provide PPE for workers handling for infectious and harzadious Health and Safety Risks, Community liquid wastes Health and Safety Risks, Environmental Risks) Impacts associated with inadequate All items within BSCs, including equipment, should be surface- ZNHIP No costs associated with daily disinfection of BSL-3 Facility leading decontaminated and removed from the cabinet when work is operations of workers in the lab to among others:- completed, since residual culture media may provide an as appertains to disinfecting the opportunity for microbial growth. The interior surfaces of BSCs work areas Occupational Health and Safety Risks should be decontaminated before and after each use. The work surfaces and interior walls should be wiped with a disinfectant that will kill any microorganisms that might be found inside the cabinet. At the end of the work day, the final surface decontamination should include a wipe-down of the work surface, the sides, back and interior of the glass. A solution of bleach or 70% alcohol should be used where effective for target organisms. A second wiping with sterile water is needed when a corrosive disinfectant, such as bleach, is used. BSCs must be decontaminated before filter changes and before being moved. The most common decontamination method is by fumigation with formaldehyde gas. BSC decontamination should be performed by a qualified professional. Impacts associated with specimen To avoid accidental leakage or spillage, secondary containers, ZNHIP Cost of items/infrastructure ex posure of BSL-3 Facility leading to such as box es, should be used, fitted with racks so that the related to minimising OHS risks among others:- specimen containers remain upright. The secondary containers to be outlined in detailed design may be of metal or plastic, should be autoclavable or resistant to and Bills of Quantities. Occupational Health and Safety Risks the action of chemical disinfectants, and the seal should preferably have a gasket. They should be regularly decontaminated. The facility should designate a Receipt of specimens room or area designated for this purpose. Personnel who receive and unpack specimens should be aware of the potential health hazards involved, and should be trained to 122 Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD adopt standard precautions (2), particularly when dealing with broken or leaking containers. Primary specimen containers should be opened in a biological safety cabinet. Disinfectants should be available. Every laboratory that works with infective microorganisms should institute safety precautions appropriate to the hazard of the organisms and the animals being handled. Impacts associated with E mergency Develop a Contigency Plan Procedure for the BSL-Facility ZNHIP 10,000.00 Hazards from the BSL-3 Facility (refer to Annex 4) design leading to among others: - Provide First-aid kit, including universal and special antidotes (Human Health Risks, Occupational Provide Appropriate fire ex tinguishers, fire blankets Health and Safety Risks, Community Full protective clothing (one-piece coveralls, gloves and head Health and Safety Risks, covering – for incidents involving microorganisms in Risk Environmental Risks) Groups 3) Full-face respirators with appropriate chemical and particulate filter canisters Room disinfection apparatus, e.g. sprays and formaldehyde vaporizers Hazard area demarcation equipment and notices Impacts associated with Fire Hazards Fire-fighting equipment should be placed near room doors and ZNHIP 15,000.00 from the BSL-3 Facility design at strategic points in corridors and hallways. This equipment leading to among others: - may include hoses, buckets (of water or sand) and a fire ex tinguisher. Fire ex tinguishers should be regularly inspected (Human Health Risks, Occupational and maintained, and their shelf-life kept up to date. Health and Safety Risks, Community Close cooperation between safety officers and local fire Health and Safety Risks, prevention officers is essential. Environmental Risks) The assistance of local fire prevention officers in the training of laboratory staff in fire prevention, immediate action in case of fire and the use of fire-fighting equipment is desirable. Fire warnings, instructions and escape routes should be displayed prominently in each room and in corridors and hallways. Impacts associated with Electrical It is essential that all electrical installations and equipment are ZNHIP Costs are related to construction Hazards from the BSL-3 Facility inspected and tested regularly, including earthing/grounding infrastructures and to be 123 Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD design leading to among others: - systems. included in overall detailed Circuit-breakers and earth-fault-interrupters should be installed design and construction costs. (Human Health Risks, Occupational in appropriate laboratory electrical circuits. Health and Safety Risks, Community All laboratory electrical equipment should be earthed/grounded, Health and Safety Risks, preferably through three-prong plugs. Environmental Risks) All laboratory electrical equipment and wiring should conform to national electrical safety standards and codes. Impacts associated with Noise Where noise levels cannot be abated and where laboratory ZNHIP 5,000.00 Hazards from the BSL-3 Facility personnel routinely ex perience ex cessive ex posures, a hearing design leading to among others: - conservation programme that includes the use of hearing Occupational Health and Safety Risks. protection while working in hazardous noise and a medical monitoring programme to determine the effect of noise on the workers should be instituted. Noise measurement surveys be conducted to determine the noise hazard. Where warranted by data, engineering controls such as enclosures or barriers around noisy equipment or between noisy areas and other work areas, can be considered Impacts associated with Ionizing To limit the harmful effects of ionizing radiation, the use of ZNHIP 20,000.00 Radiation Hazards from the BSL-3 radioisotopes should be controlled and should comply with relevant Facility leading to among others: - national standards. Protection from radiation is managed on the basis of four principles: Occupational Health and Safety Risks. Minimizing the time of radiation ex posure Max imizing the distance from the radiation source Shielding the radiation source Substituting the use of radionuclides with non-radiometric techniques. Mark radiation containers with the radiation sym bol, including radionuclide identity, activity and assay date Use radiation meters to monitor working areas, protective clothing and hands after completion of work. Use appropriately shielded transport containers Rem ove radioactive waste frequently from the working area. Maintain accurate records of use and disposal of radioactive 124 Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD materials. Screen dosimetry records for materials ex ceeding the dose limits. Establish and regularly ex ercise emergency response plans. In emergencies, assist injured persons first. Clean contaminated areas thoroughly. Request assistance from the safety office, if available. Write and keep incident reports. Impacts associated with transport of Use the protocol (Annex 7) for transporation and shipment of ZNHIP 3,000.00 infectious samples and specimens specimen and wastes. (including wastes) to and from the the Provide training to workers in the BSL-3 and ensure they have BSL-3 Facility leading to among proper knowledge of the tox ic effects of these chemicals, the others:- routes of ex posure and the hazards that may be associated with handling and storage. (Human Health Risks, Occupational Material safety data sheets or other chemical hazard information Health and Safety Risks, Community should be available from chemical manufacturers and/or Health and Safety Risks, suppliers. These should be accessible in laboratories where Environmental Risks) these chemicals are used, e.g. as part of a safety or operations manual. Laboratory personnel must ship infectious substances according to applicable transport regulations. Develop a Spill Clean Up Procedure Impacts associated with inadequate or Develop laboratory biosecurity measures based on a ZNHIP 20,000.00 lack of bio-security system program comprehensive programme of accountability for pathogens and for the BSL-3 Facility leading to tox ins that includes an updated inventory with storage location, among others:- identification of personnel with access, description of use, documentation of internal and ex ternal transfers within and (Human Health Risks, Occupational between facilities, and any inactivation and/or disposal of the Health and Safety Risks, Community materials. Health and Safety Risks, Develop institutional laboratory biosecurity protocol for Environmental Risks) identifying, reporting, investigating and remediating breaches in laboratory biosecurity, including discrepancies in inventory results Define the involvement and roles and responsibilities of public 125 Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD health and security authorities in the event of a security infraction. Undertake laboratory biosecurity training, distinct from laboratory biosafety training to all personnel. Such training should help personnel understand the need for protection of such materials and the rationale for the specific biosecurity measures, and should include a review of relevant nationa standards and institution specific procedures. Develop procedures describing the security roles and responsibilities of personnel in the event of a security infraction should also be presented during training. Develop code of conduct and professional ethical suitability among workers for working with dangerous pathogens of all personnel who have regular authorized access to sensitive materials is also central to effective laboratory biosecurity activities and should be done through an assessment of the suitability of personnel, security-specific training and rigorous adherence to pathogen protection procedures are reasonable means of enhancing laboratory biosecurity Develop compliance checks with these procedures, with clear instructions on roles, responsibilities and remedial actions. Undertake regular risk and threat assessments, and regular review and updating of procedures.. Impacts associated with inadequate or Recruit qualified personell to work in the BSL-3 facility ZNHIP 30,000.00 lack of training of the BSL-3 Facility Conduct safety organisation and training for the BSL-3 workers workers/personell leading to among Appoint a Biosafety Officer to ensure that biosafety policies others:- and programmes are followed consistently throughout the laboratory. The biosafety officer ex ecutes these duties on behalf (Human Health Risks, Occupational of the head of the institute or laboratory. Health and Safety Risks, Community Undertake Supp ort Staff Safety Training for skilled engineers Health and Safety Risks, and craftsmen who maintain and repair the structure, facilities Environmental Risks) and equipment, should have some knowledge of the nature of the work of the laboratory, and of safety regulations and procedures. Testing of equipment after servicing, e.g. testing the efficiency 126 Operation phase E nvironmental / Social Impact M itigation M easure Responsibility Cost USD of biological safety cabinets after new filters have been fitted, may be carried out by or under supervision of the biosafety officer. Engineering and maintenance staff should only enter the Biosafety Level 3 facility with clearance and supervision by the biosafety officer and/or the laboratory supervisor. The Biosafety Level 3 facility should only be cleaned by the laboratory staff. Cleaning personnel should only enter Biosafety Level 3 or Biosafety Level 4 laboratories with clearance and supervision by the biosafety officer and/or the laboratory supervisor. Constitute a Biosafety Committee to develop institutional biosafety policies and codes of practice. The biosafety committee should also review research protocols for work involving infectious agents, animal use. Other functions of the committee may include risk assessments, formulation of new safety policies and arbitration in disputes over safety matters. 127 Allocate Percentage Impact Significance: Project Phase Budget (U S$) (%) Localised; Low and Long Term Construction 580,000 40 M itigation: Operations 880,000 60 Total The design of the complex will factor in the receiving environment to ensure the structure blends into the 1,460,000 100 surroundings. 8.3 E nv ironmental and Social M onitoring The ZNPHI Project Implemetation Unit (PIU) will be responsible for ensuring compliance with the necessary, health, safety and environmental Standards. It will develop a monitoring plan in and around the project site to monitor environmental performance and compliance with the ex isting statutory environmental regulations. The ZNPHI will bear overall responsibility for environmental management at all the project phases. However, during the construction phase, the contractor will bear responsibility for compliance with the relevant health, safety and environmental aspects of the project. In this project, key stakeholders in the environmental management activities include the ZNPHI, the contractor, the ZEMA, Ministry of Health, NHCC, Zambia Bureau of Standards, and members of the public. The provisions of the monitoring plan outlined here below will apply from the onset of the construction works right through to the operation phase. Monitoring will provide information for periodic review and alteration of the ESMP as may be necessary to ensure optimization of environmental protection throughout the lifespan of the project. This will ensure early detection and remediation of undesirable impacts. With respect to the envisaged activities, the environs of interest are air, land, flora, surface and ground water resources, traffic, health and safety. Each of these environs will be impacted upon as already explained in the impacts section. The monitoring plan highlights measures put in place to ensure adherence to the proposed management plan. The main objectives of the enviormental monitoring are: 1. To provide a database from which the enviormental impacts of the project can be assessed 128 2. To provide an early indication should any of the enviormental control measures or practices fail to achieve the accepatable standards 3. To monitor the performance of the project and effectiveness of the mitigation measures 4. To determibne project compliance with regualatory reuquirements,standards and government polices. 5. To take remedial actions if unexpected problems or unacceptable impacts arise. The implemention of mitigation measures will be monitored based on the E nv ironmental and Social M onitoring Plan presented in Table 15. 129 Table 15: Environmental and Social Monitoring Plan E nvironmental and Frequency Responsibility Performance Indicators M onitoring Requirements Social Comp onent Scattered litter Physical inspection Monthly Contractor Signs of obstruction of water ways. Number of complaints Solid and liquid Waste Flow of wastewater on the ground surface. Provision of sanitary facilities to the construction crews. Level of noise generated. Liaise with other stakeholders. Monthly Contractor Provision of PPE. Documentation on complaints about noise Noise Pollution Compliance with ex isting noise standard issued by ZEMA. Level of dust generated. Physical inspection Monthly Contractor Air Pollution Provision of PPE. Interview residents including workers Liaise with other stakeholders Amount of vegetation removed Documentation of uprooted trees Quarterly Contractor Flora and Fauna Change in animal behavioural patterns Observation Gender E mpowerment Number of female employees Review of company staff records. Quarterly Contractor Number of male and female toilets Physical Inspection Child Labour Record of employees including IDs Review of records Monthly Contractor Interviews with staff and local community Gender E quity and Number of complaints Review of grievance redress forms. Monthly Contractor Sexual Harassment Interviews with local community Loss of Life, Injury and Record of accidents and damages done Review of records Monthly Contractor Damage to Private Interviews with staff and local community. property HIV&AIDS Number campaign meetings on Inspection of HIV/AIDS prevention services Quarterly Contractor transmission of diseases like HIV/AIDS within the site. and other STDs. Number of condoms, A provided. Number of condom dispensers within the site. 130 E nvironmental and Frequency of monitoring Responsibility Performance Indicators M onitoring Requirements Social Comp onent Availability of detailed design for BSL-3 Once during design ZNHIP Availability of approved Detailed Design of BSL-3 Facility Facility in accordance with WHO stage Design for BSL-3 Facility Laboratory Biosafety Manual. Recruitment of consultant to undertake Once during ZNHIP Availability of Contract Commissioning of BSL- commissioning of BSL-3 Facility in commissioning Documents showing recruitment 3 Facility accordance with WHO Laboratory of commissioning consultant. Biosafety Manual. Recruitment of consultant to undertake Annual or whenever ZNHIP Availability of Contract Certification of BSL-3 certification of BSL-3 Facility in changes are made in the Documents showing recruitment Facility accordance with WHO Laboratory facility e.g. fitting of of certification consultant. Biosafety Manual. new HVACs, BSC etc. Availability and proposer use of PPE for all Physical and routine inspections to Daily inspection ZNHIP workers determine use of PPEs and other Training frequency Availability of specimen reception area equipment. conducted annually or Workers E xposure to Availability of Biosafety Cabinet Documentation of training given as needed Chemicals Record of trainings given to workers on to workers ex posure minimisation Documentation of ex posure Number of worker ex posures recorded incidences Physical routne inspections to Daily inspection ZNHIP ascertain use of waste disposal Training frequency Availability of a functional autoclave equipment conducted annually or Solid Waste (Infectious Availability of a functional incinerator Documentation of training given as needed and non-infectious) Record of trainings given to waste to workers equipment operators Documentation of ex posure incidences Daily inspection ZNHIP Physical routne inspections to Training frequency ascertain use of waste disposal conducted annually or E ffluent Waste Availability of a functional autoclave equipment as needed (Infectious and non- Record of trainings given to waste Documentation of training given infectious) equipment operators to workers Documentation of ex posure incidences 131 Daily inspection on PPE ZNHIP Evidence of written Contigency Plan Documentation of training given use Number of emergency hazards recorded to workers on emergency response Training frequency Record of trainings given to workers on procedures conducted annually or emergency response Documentation of ex posure as needed Presence of First-aid kit, including incidences due to emergency Emergency drills to be universal and special antidotes hazards conducted annually Presence of fire ex tinguishers, fire blankets Physical and routine inspections to Regualr (semi-annual) Availability of Full protective clothing ascertain use of PPEs imspection of (one-piece coveralls, gloves and head Physical and routine inspections to equipment (electrical E mergency Hazards covering, Full-face respirators with ascertain presence of emergency and fire) including appropriate chemical and particulate filter (Fire, E lectric, Noise, response equipmemt testing tested Radiation) etc canisters Documentation of emergency Noise measurement Availability of room disinfection apparatus, drills conducted surveys conducted e.g. sprays and formaldehyde vaporizers Medical reports of noise ex posure annually Hazard area demarcation equipment and impacts on workers Medical monitoring of notices Medical reports of radiation worker ex posure to Evidence of fire warnings, instructions and ex posure impacts on workers noise undertaken escape routes should be displayed annually Accurate records of use and prominently in each room and in corridors disposal of radioactive materials. Medical monitoring of and hallways worker ex posure to Number of emergency response drills radiation undertaken undertaken annually Biosecurity protocol ZNHIP Documentation of training given review to be undertaken Availability of Bio-Security Protocol to workers on biosecurity annually Number of Bio-security related breaches Documentation of ex posure Quarterly inspections on Bio-Security Hazards Record of trainings given to workers on incidences due to biosecurity all the aspects in the biosecurity breaches facility aimed at ensuring security enhancement 132 Documentation of training given Training frequency ZNHIP Availability of organisational training to workers on safety conducted annually or program on safety Documentation of number of as needed Personnel Training and Record of trainings given to workers on meetings held by Biosafety Biosafety Committee Capacity E nhancement BSL-3 safety measures Committee (minutes of meeting) meetings to be held on a Availability of Biosafety Officer Availability of contract for monthly basis Availability of Biosafety Committee Biosafety Officer 133 8.4 Capacity Dev elopment and Training G iven that the operation and maintenance of BSL3 labs will be a new practice in the implementing entity, there is a need for capacity development so that the potential environmental and social risks associated with the lab will be addressed effectively. To this end, the recommended training topics and estimated costs for training activities are summarized in the table below. Table 16: Capacity building plan technical and support staff Traiining topic Target Participant E stimated Cost (USD) Infection control and waste All technical and support staff who will be working in 10,000 management the proposed BSL3 lab Occuapation health and safety, All technical and support staff who will be working in 10,000 safe work practices, and the proposed BSL3 lab appropriate PPE Training on biosafety and All technical and support staff who will be working in 6,000.00 biosecurity the proposed BSL3 lab Quality management system All technical staff 5000.00 Specimens management All technical staff 6,000.00 Training on emergency All technical and support staff who will be working in 6,000.00 preparedness and response the proposed BSL3 lab other staff of the BSL 3 laboratory Specific Laboratory technique Technical staff 15, 000.00 (microbiology, molecular methods and other related training) Training on BSL 3 lab The staff who will be in charge of maintenance 10, 000.00 maintenance activities 8.6 Griev ance redress and Chance Find Procedures 8.6.1 Grev ance red ress mechanism G rievance redress mechanisms provide a way to provide an effective avenue for expressing concerns and achieving remedies for communities, promote a mutually constructive relationship and enhance the achievement of project development objectives. G RMs are increasingly important for development projects where ongoing risks or adverse impacts are anticipated. They serve as a way to prevent and address community concerns, reduce risk, and assist larger processes that create positive social change. G RMs provide a formal avenue for affected people or stakeholders to engage with the project implementers or owners on issues of concern or unaddressed environmental and social impacts. People adversely affected (or about to be affected) by a development project will raise their grievances and dissatisfactions about actual or perceived environmental and social impacts in 134 order to find a satisfactory solution. Not only should affected persons (APs) be able to raise their grievances and be given an adequate hearing, but also satisfactory solutions should be found that mutually benefit both the APs and the project. It is equally important that APs have access to legitimate, reliable, transparent, and efficient institutional mechanisms that are responsive to their complaints. Objectiv es of Griev ance Red ress M echanism The objective of the G RM is to ensure that the views and concerns of those affected by the project activities are heard and acted upon in a timely, effective and transparent manner. Principles of GRM : • Protect beneficiaries’/partners rights to comment and complain; • Neutrality and equity while handling complaints; • Timing: short cycle, quick response to the critical complaints; • Transparency: Partners will be aware of the procedures; understand its purpose, have sufficient information on how to access it and understand how it works; • Confidentiality: Create an environment in which people are more likely to raise concerns, complain or stand in witness. Confidentiality assures that any information given is restricted In this project, the following grievance redress process will be followed. Step 1: Receip t of comp laint A verbal or written complaint from a complainant will be received by the head of the complaint hearing office and recorded in a complaints log. The log will indicate grievances, date lodged, action taken to address complaint or reasons the grievance was not acted on; information provided to complainant and date the grievance was closed. G rievances should be lodged at work hours, directly to the complaint hearing office. The process for lodging a complaint is outlined below:  Complaint hearing officer receives complaint(s) from complainant and records it in log.  Complaint hearing officer reads the recorded complaint to confirm correct detail of complaint has been documented.  Complainant signs the log to confirm grievance was accurately recorded. The head of the complaint hearing office will be the focal person for the G RM process and he/she will be the first point of contact to trigger the mechanism. 135 Step 2: Determination of correctiv e action A grievance can be solved at this stage, the complaint hearing office will determine a corrective action in consultation with the aggrieved person. Remedial action(s) and timeframe within which they must be accomplished has been described and the party responsible for implementing them will be recorded in the complaint log. G rievances will be resolved and status reported back to complainants within a week. If more time is required this will be communicated clearly and in advance to the aggrieved person. For cases that are not resolved within the stipulated time, detailed investigations will be undertaken and results discussed not more than 1 month from lodging a grievance. Step 3: Meeting with the comp lainant The proposed corrective action and the timeframe in which it is to be implemented will be discussed with the complainant within a week of receipt of the grievance. Max imum duration for the Consent to proceed with the corrective action will be sought from the complainant. Step 4: Imp lementation of correctiv e action Agreed corrective action will be undertaken by the project or its contractor within the agreed timeframe. The date of the completed action will be recorded in the log against the complainant’s grievance. Step 5: Verification of correctiv e action To verify satisfaction, the aggrieved person will be asked to return if not satisfied with the corrective action. Step 6: Action by ZNPHI and project contractors If the Work supervisor cannot solve the grievance, he will refer it to ZNPHI and contractor through the Supervising Engineer. It is ex pected all possible grievances can be solved at this level. 8.6.2 Chance finds procedure Requirements for chance find during construction Requirements for chance finds are outlined in National Heritage Conservation Commission (NHCC) state that: Any person, who discovers what appears to be an ancient heritage or relic shall- a. report his discovery to the Commission within fourteen days; b. suspend his operations in the immediate vicinity of his discovery until thirty days after the delivery of his report, unless the Commission authorises their continuance; and 136 c. deliver to the Commission as soon as practicable, or request the Commission to examine and remove, any object which is, or appears to be, a relic. Upon receipt of a report under section forty-two the Commission may- a. examine and remove any relic; b. allow the person to continue his activities; c. order suspension of the operations not in excess of thirty days to carry out an environmental impact assessment or archaeological survey or recovery analysis of the discovery areas; or d. order the engineering, mining or agricultural project to pay for the costs of the assessment, survey, or analysis. If the Commission does not exercise any of its powers under section forty-three the person may resume his operations thirty days after delivery of his report. Any relic whose ownership cannot be reasonably determined shall be deemed to belong to the Commission. The procedures to avoid damage to cultural property would include carrying consultations with the appropriate authorities and local inhabitants to identify known or possible sites during project planning. Construction procedure for dealing with “chance finds includes cessation of work until the significance of a “find” has been determined by the appropriate authorities and local inhabitants, and until fitting treatment of the site has been determined and carried out. The Contractor will be responsible for familiarizing themselves with the following “Chance Finds Procedures”, in case culturally valuable materials are uncovered during excavation, including:  Stop work immediately following the discovery of any materials with possible archaeological, historical, paleontological, or other cultural value, announce findings to project manager and notify relevant authorities;  Protect artefacts as well as possible using plastic covers, and implement measures to stabilize the area, if necessary, to properly protect artefact  Prevent and penalize any unauthorized access to the artefact  Restart construction works only upon the authorization of the relevant authorities. 8.7 Reporting Requirements As ZNPHI will be responsible for overall management of the proposed BSL3 lab, it will also be responsible for environmental and social safeguards compliance monitoring and reporting to pertinent regulatory agency and MOH on monthly basis. The report should comprehensively address among others the actions taken to fulfil the requirements of the ESIA and outstanding 137 issues, if any. It is responsible to conduct construction and operation phase environmental and social audits and share the audit reports to the regulatory agency and MOH. It is also expected to report, annual certification reports, any incidents, unintentional injuries and security breaches. 138 RE FE RE NCE S 1. Africa Centres for Disease Control and Prevention Strategy at a G lance (2017-2021) 2. African Union. Agenda 2063: the Africa we want. https://au.int/en/agenda2063/overview. (accessed 29 May, 2019) 3. Biological agents the principles, design and operation of Containment Level 4 facilities 4. Birds Advisor, 2015; Birds of Zambia http://www.zambia-advisor.com/birds-of- zambia.html. (Accessed, 15 December 2018). 5. CDC (1999); Centers for Disease Control and Prevention, “Biosafety in Microbiological and Biomedical Laboratories,” report by the Centers for Disease Control and Prevention and the National Institutes of Health, 4th Edition, Washington D.C. 6. CDC. (2009) Biosafety in Microbiological and Biomedical Laboratories 5th Edition. CDC Atlanta USA. 7. Chartier Y , editor (2014). Safe management of wastes from health-care activities. 2nd edition, World Health Organization. 8. https://countryeconomy.com/countries/groups/southern-african-development-community. (accessed 20 June 2018) 9. CSO, Industrial Production Statistics (CSO database) 10. CSO, International Trade Statistics (CSO database) 11. ECZ/LCC (1997). Solid waste management master plan for the city of Lusaka. 12. http://www.bu.edu/researchsupport/compliance/ibc/resources/biosafety-manual/chapter-05- laboratory-biosafety-practices/ 13. http://www.bu.edu/researchsupport/compliance/ibc/resources/biosafety-ma nual/chapter- 05-laboratory-biosafety-practices/ 14. Indaba Agricultural Policy Research Institute (IAPRI) 2016: Rural Agricultural Livelihoods Survey – 2015 Survey Report, February 2016. 15. IRG , 2011: Zambia Environmental Threats and Opportunities Assessment (ETOA) 16. JAICAF, 2008; Agriculture and forestry in Zambia present situation and issues for development 17. Johannessen, L. M. (1997). Management of health-care waste. In proceedings in environment‟97 conference, Egyptian Environmental Affairs Agency, Dokki-G iza, Cairo. Egyptian 18. Ministry of Health, Zambia Infection Prevention and Control G uidelines 2017 19. Ministry of Health. The National Health Care Waste Management Plan 2008-2012. Kenya 20. Ministry of Health. The National Health Care Waste Management Plan 2015-2021. Zambia 139 21. MoH/CBoH (1999). HIV /AIDS in Zambia: Background projections, impact and interventions. Lusaka, Zambia. 22. National Academies of Sciences, Engineering, and Medicine. 2018. Environmental Chemicals, the Human Microbiome, and Health Risk: A Research Strategy. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24960 23. OSHA Principal E mergency Response and Preparedness – Requirements and G uidance. OSHA Publication 3122 (2004). http://www.osha.gov/Publications/osha3122.pdf 24. Suggested G uiding Principles and Practices for The Sound Management of Hazardous Hospital Wastes, World Health Organization, 1999. 25. The Republic of Zambia (2013), Ministry of Local G overnment and Housing; Environmental and Social Impact Assessment (ESIA) for Water Supply; Lusaka Water Supply, Sanitation and Drainage (LWSSD) Project; Millenium challenge 26. WHO, G uidelines for Community Noise, World Health Organisation, 1999 27. World Bank G roup (WBG ), IFC. Environmental, Health, and Safety (EHS) G uidelines: G ENERAL EHS G UIDELINES for Health Care Facilities: WBG 2007. 28. World Bank Technical G uidance Note (1999). Municipal Solid Waste Incineration. 29. World Health Organization (1999). Safe Management of Wastes from Health-Care Activities. 30. World Health Organization (2005). Manual G . Preparation of national Infection Control and Waste Management Plans in sub-Saharan countries. 31. World Health Organization (2006). Management of waste from injection activities at the district level. G uidelines for district health managers. http://www.who.int/water_sanitation_health/publications/waste-from-injections/en/ 32. World Health Organization (2016). Diox ins and their effects on human health. Fact sheet: https://www.who.int/news-room/fact-sheets/detail/diox ins-and-their-effects-on-human- health 33. World Health Organization Regional Office for Africa (2016).Assessment tool for key processes associated with the design, construction, operation, maintenance and regulation of BSL-3 facilities in the WHO African region. 34. Zaki A.N (2010). Biosafety and biosecurity measures: management of biosafety level 3 facilities. Int J Antimicrob Agents, 36 Suppl 1, S70-4. 35. ZAWA, 2005; Information Sheet on Ramsar Wetlands, https://rsis.ramsar.org/RISapp/files/RISrep/ZM1580RIS.pdf (Accessed, 24th May 2005). 140 ANNE X 1: PROJE CT SCRE E NING AND GU IDANCE ON E NVIRONM E NTAL IM PACT ASSE SSM E NT 141 ANNE X 2: LAND ACQU ISITION DOCU M E NTS 142 143 144 ANNE X 3: GOOD LABORATORY PRACTICE S, SAFE TY AND DE SIGN FOR BSL 3 LABORATORY The containment laboratory – Biosafety Level 3 is designed and provided for work with Risk G roup 3 microorganisms and with large volumes or high concentrations of Risk G roup 2 microorganisms that pose an increased risk of aerosol spread. Biosafety Level 3 containment requires the strengthening of the operational and safety programmes over and above those for basic laboratories – Biosafety Levels 1 and 2. The guidelines given in this section are presented in the form of additions to those for basic laboratories – Biosafety Levels 1 and 2, which would therefore be applied before those specific for the containment laboratory – Biosafety Level 3. The major additions and changes are in: a) Code of practice b) Laboratory design and facilities c) Health and medical surveillance. Laboratories in this category would be registered or listed with the national or other appropriate health authorities. 1) Code of practice for the proposed BSL3 lab a. The international biohazard warning symbol and sign biohazard must be displayed on the doors of the rooms where microorganisms of Risk G roup 2 or higher risk groups are handled. b. Only authorized persons should be allowed to enter the laboratory working areas. c. Laboratory doors should be kept closed. d. Children should not be authorized or allowed to enter laboratory working areas. e. No animals should be admitted other than those involved in the work of the laboratory. f. The international biohazard warning symbol and sign displayed on laboratory access doors will identify the biosafety level and the name of the laboratory supervisor who controls access, and indicate any special conditions for entry into the area, e.g. immunization. g. Laboratory protective clothing will be of the type with solid-front or wrap-around gowns, scrub suits, coveralls, head covering and, where appropriate, shoe covers or dedicated shoes. Front-buttoned standard laboratory coats are unsuitable, as are sleeves that do not fully cover the forearms. Laboratory protective clothing will not be worn 145 outside the laboratory, and it would be decontaminated before it is laundered. The removal of street clothing and change into dedicated laboratory clothing may be warranted when working with certain agents (e.g. agricultural or zoonotic agents). h. Open manipulations of all potentially infectious material would be conducted within a biological safety cabinet or other primary containment device. i. Respiratory protective equipment may be necessary for some laboratory procedures or working with animals infected with certain pathogens. 2) Laboratory design and facilities for the proposed BSL3 lab The laboratory design and facilities for basic laboratories – Biosafety Levels 1 and 2 apply except where modified as follows: a. he laboratory will be separated from the areas that are open to unrestricted traffic flow within the building. Additional separation may be achieved by placing the laboratory at the blind end of a corridor, or constructing a partition and door or access through an anteroom (e.g. a double-door entry or basic laboratory – Biosafety Level 2), describing a specific area designed to maintain the pressure differential between the laboratory and its adjacent space. The anteroom would have facilities for separating clean and dirty clothing and a shower may also be necessary. b. Anteroom doors may be self-closing and interlocking so that only one door is open at a time. A break-through panel may be provided for emergency ex it use. c. Surfaces of walls, floors and ceilings would be water-resistant and easy to clean. Openings through these surfaces (e.g. for service pipes) would be sealed to facilitate decontamination of the room(s). d. The laboratory room will be sealable for decontamination. Air-ducting systems will be constructed to permit gaseous decontamination. e. Windows will be closed, sealed and break-resistant. f. A hand-washing station with hands-free controls would be provided near each ex it door. g. There would be a controlled ventilation system that maintains a directional airflow into the laboratory room. A visual monitoring device with or without alarm(s) would be installed so that staff can at all times ensure that proper directional airflow into the laboratory room is maintained. h. The building ventilation system would be so constructed that air from the containment laboratory – Biosafety Level 3 is not recirculated to other areas within the building. Air may be high-efficiency particulate air (HEPA) filtered, reconditioned and 146 recirculated within that laboratory. When ex haust air from the laboratory (other than from biological safety cabinets) is discharged to the outside of the building, it would be dispersed away from occupied buildings and air intakes. Depending on the agents in use, this air may be discharged through HEPA filters. A heating, ventilation and air- conditioning (HV AC) control system may be installed to prevent sustained positive pressurization of the laboratory. Consideration would be given to the installation of audible or clearly visible alarms to notify personnel of HV AC system failure. i. All HEPA filters would be installed in a manner that permits gaseous decontamination and testing. j. Biological safety cabinets would be sited away from walking areas and out of crosscurrents from doors and ventilation systems. k. The ex haust air from Class I or Class II biological safety cabinets, which will have been passed through HEPA filters, would be discharged in such a way as to avoid interference with the air balance of the cabinet or the building ex haust system. l. An autoclave for the decontamination of contaminated waste material would be available in the containment laboratory. If infectious waste has to be removed from the containment laboratory for decontamination and disposal, it would be transported in sealed, unbreakable and leak proof containers according to national or international regulations, as appropriate. m. Backflow-precaution devices would be fitted to the water supply. V acuum lines would be protected with liquid disinfectant traps and HEPA filters, or their equivalent. Alternative vacuum pumps would also be properly protected with traps and filters. n. The containment laboratory – Biosafety Level 3 facility design and operational procedures would be documented. 3) Laboratory E quipment The principles for the selection of laboratory equipment, including biological safety cabinets are the same as for the basic laboratory – Biosafety Level 2. However, at Biosafety Level 3, manipulation of all potentially infectious material would be conducted within a biological safety cabinet or other primary containment device. Consideration would be given to equipment such as centrifuges, which will need additional containment accessories, for example, safety buckets or containment rotors. Some centrifuges and other equipment, such as cell-sorting instruments for use with infected cells, may need additional local ex haust ventilation with HEPA filtration for efficient containment. 147 4) Health And M edical Surv eillance The objectives of health and medical surveillance programmes for basic laboratories – Biosafety Levels 1 and 2 also apply to containment laboratories – Biosafety Level 3, except where modified as follows: a) Medical ex amination of all laboratory personnel who work in containment laboratories – Biosafety Level 3 is mandatory. This would include recording of a detailed medical history and an occupationally-targeted physical examination. b) After a satisfactory clinical assessment, the examinee may be provided with a medical contact card stating that he or she is employed in a facility with a containment laboratory – Biosafety Level 3. 148 ANNE X 4: LABORATORY SE CU RITY AND E M E RGE NCY RE SPONSE GU IDANCE AT ZNPHI BSL-3 FACILITY Traditional biosafety guidelines for laboratories have emphasized use of optimal work practices, appropriate containment equipment, well-designed facilities, and administrative controls to minimize risk of worker injury and to ensure safeguards against laboratory contamination. In recent years, concern has increased regarding use of biologic materials as agents of terrorism. Risk assessments would include reviews of the following: 1) physical security 2) security of data and electronic technology systems 3) employee security 4) access controls to laboratory 5) procedures for agent inventory and accountability 6) shipping/transfer and receiving of select agents 7) unintentional incident and injury policies 8) emergency response plans and 9) policies that address breaches in security. Therefore, for the BSL3 that will be constructed, ZNPHI will prepare security and emergency response plan and it would be an integral part of daily operations. All employees would be well-trained and equipped, and at least, the plan would be reviewed annually.  risk and threat assessment;  facility security plans;  physical security;  data and electronic technology systems;  security policies for personnel;  policies regarding accessing the laboratory;  specimen accountability;  receipt of agents into the laboratory;  transfer or shipping of select agents from the laboratory;  emergency response plans; and  reporting of incidents, unintentional injuries and security breaches. Definitions Threat assessment: A judgment, based on available information, of the actual or potential threat of malevolent action. 149 Vulnerability: An exploitable capability, security weakness, or deficiency at a facility. Exploitable capabilities or weaknesses are those inherent in the design or layout of the biologic laboratory and its protection, or those ex isting because of the failure to meet or maintain prescribed security standards when evaluated against defined threats. V ulnerability assessment: A systematic evaluation process in which qualitative and quantitative techniques are applied to arrive at an effectiveness level for a security system to protect biologic laboratories and operations from specifically defined acts that can oppose or harm a person’s interest. 1. Risk Assessment Recommendation: ZNPHI will conduct a risk assessment and threat analysis of the BSL3 lab as a precursor to the security plan. Background: A threat analysis, the first step in determining risk, identifies and evaluates each threat on the basis of different factors (e.g., the capability and intent to attack an asset, the likelihood of a successful attack, and the attack’s probable lethality). Risk management is the deliberate process of understanding risk (i.e., the likelihood that a threat will harm an asset with certain severity of consequences) and deciding on and implementing actions to reduce that risk. Risk management principles are based on acknowledgment that: 1) although risk usually cannot be eliminated, it can be reduced by enhancing protection from validated and credible threats, 2) although threats are possible, certain threats are more probable than others and 3) all assets are not equally critical. Therefore, each facility would implement certain measures to enhance security regarding select agents. ZNPHI BSL3 lab would conduct a risk assessment and threat analysis of its assets and select agents. The threat would be defined against the vulnerabilities of the laboratory to determine the necessary components of a facility security plan and system. The risk assessment would include a systematic approach in which threats are defined and vulnerabilities are examined; risks associated with those vulnerabilities are mitigated with a security systems approach. ZNPHI would ensure the security plan includes collaboration between senior management, scientific staff, human resource officials, information technology (IT) staff, engineering officials and security officials. This coordinated approach is critical to ensuring that security recommendations provide a reasonable and adequate assurance of laboratory security without unduly impacting the scientific work. 150 2. Facility Security Plans for ZNPH I BSL3 Lab Recommendation: ZNPHI will establish the BSL3 lab security plan. ZNPHI will develop a comprehensive security plans addressing: physical security, data and IT system security, security policies for personnel, policies for accessing select agent areas, specimen accountability, receipt of select agents into the laboratory, transfer or shipping of select agents from the laboratory, emergency response plans, and reporting of incidents, injuries and breaches. Based on the risk assessments, ZNPHI would develop security policies. Security plans would include measures that address physical security of building and laboratory areas. Policies would also address concerns associated with access, use, storage, and transfer of sensitive data. If sensitive electronic data are present, IT specialists will assess the security of hardware and software products in addition to the security of local area networks. At least annually, ZNPHI will review safety, security and IT policies and procedures for consistency and applicability. These procedures would also be reviewed after any incident or change in regulations. Necessary changes would be incorporated into the revised plans and communicated to all. Laboratory supervisors would ensure that all laboratory workers and visitors understand security requirements and that all employees are trained and equipped to follow established procedures. The security plan would be an integral part of daily operations. New employees would receive training when they first begin work, and all employees would receive training at least annually thereafter. Training would be updated as policies and procedures change. All training would be documented by maintaining records of training schedules and employee attendance. Security plans would receive periodic performance testing to determine their effectiveness. Test procedures can vary from a simple check of keys, locks and alarms to a full-scale laboratory or facility ex ercise. 3. Security Policies for ZNPHI BSL3 lab Personnel Recommendation: ZNPHI will establish security-related policies for all personnel working in the BSL3 lab. The BSL3 lab administrators would be familiar with all laboratory workers. ZNPHI would also establish a policy for screening employees who require access to select agent areas to include full- and part-time employees, contractors, emergency personnel and visitors. Additional screening might be necessary for employees who require access to other types of sensitive or secure data and work areas. These screening procedures will commensurate with the sensitivity of the data and work areas (e.g., federal security clearances 151 for government employees and contractors). ZNPHI will also ensure that all workers approved to get access to select agents (e.g., students, research scientists and other short-term employees) wear visible identification badges that include a photograph, wearer’s name and an expiration date. The lab administrators would consider using easily recognizable marks on the identification badges to indicate access to sensitive or secure areas. 4. ZNPHI BSL3 Lab Access Control Recommendation: ZNPHI would strictly control access to areas where selected agents are used or stored. By taking different measures, including:  - Consolidating laboratory work areas to implement security measures more effectively.  - Separating selected agent areas from the public areas of the buildings.  - Locking all select agent areas when unoccupied.  - Using keys or other security devices to permit entry into these restricted areas. Methods of secure access and monitoring controls can include key or electronic locking pass keys, combination keypad, use of lock-boxes to store materials in freezers or refrigerators, video surveillance cameras, or other control actions. In addition, protocols for periodically changing combination keypad access numbers would be developed for max imum protection. Again, regular inspections will be conducted for graded levels of security protection on the basis of site-specific risk and threat analysis. This security can be accomplished through card access systems, biometrics, or other systems that provide restricted access. This would also involve:  Locking all freezers, refrigerators, cabinets, and other containers where select agents are stored when they are not in direct view of a laboratory worker.  Limiting access to select agent areas to authorized personnel. All others entering select agent areas must be escorted and monitored by authorized personnel.  Recording all entries into these areas, including entries by visitors, maintenance workers, service workers, and others needing one-time or occasional entry.  Limiting routine cleaning, maintenance, and repairs to hours when authorized employees are present and able to serve as escorts and monitors.  Establishing procedures and training for admitting repair personnel or other contractors who require repetitive or emergency access to select agent areas. 152  Ensuring visitors are issued identification badges, including name and expiration date, and escorted and monitored into and out of select agent areas. Such visits would be kept to a minimum.  Ensuring procedures are in place for reporting and removing unauthorized persons. These procedures would be ESMP through collaboration among senior scientific, administrative, and security management personnel. These procedures would be included in security training and reviewed for compliance at least annually. 5. Select Agent Accountability Recommendation: ZNPHI would establish a system of accountability for select agents. A procedure to ensure adequate control of select agents and maintain up-to-date inventory of seed stocks, toxins, and agents in long-term storage would be established. Records would include data r egarding the agent’s location, use, storage method, inventory, external transfers (sender/receiver, transfer date, and amount), internal transfer (sender/receiver, transfer date, amount), further distribution, and destruction (method, amount, date, and a point of contact). It will also establish procedures that maintain accurate and up-to-date records of authorizations for entry into limited access areas (i.e., a current list of persons who possess door keys and those who have knowledge of keypad access numbers or the security system). 6. Receiv ing Select Agents at ZNPHI BSL3 lab Recommendation: ZNPHI will develop procedures for bringing select agent specimens into the laboratory. A centralized receiving area for select agents is recommended to max imize safety and minimize security hazards associated with damaged or unknown packages. The BSl3 lab would establish procedures for inspecting all packages (i.e., by visual or noninvasive techniques) before they are brought into the laboratory area. Suspicious packages would be handled as prescribed by federal and Addis Ababa law enforcement agencies. Biologic safety cabinet or other appropriate containment device would be used when opening packages containing specimens, bacterial or virus isolates, or tox ins. Packages would be opened by only trained and authorized personnel. 153 7. Transfer or Shipping of Select Agents Recommendation: ZNPHI would develop procedures for transferring or shipping select agents from the laboratory. ZNPHI would adopt package, label, and transport select agents in conformance with all applicable local, federal, and international transportation and shipping regulations. Materials that are transported by airline carrier would also comply with packaging and shipping regulations set by the International Air Transport Association (IATA). Personnel who pack, handle, and ship these agents (including import and export) would be subject to all applicable training. The responsible facility official would be notified of all select agent transfers, internal or external. ZNPHI would ensure that required permits (e.g., granted by the pertinent Ethiopian environmental and health regulatory organs and IATA) are obtained before select agents are prepared for transport. Standard operating procedures would be in place for import and export activities. Contaminated or possibly contaminated materials would be decontaminated before they leave the laboratory area. Avoid hand-carrying select agents when transferring them to other external facilities. If select agents are to be hand carried on common carriers, all applicable packaging, transport, and training regulations would be followed. ZNPHI would develop and follow a protocol for intra-facility transfer of all select agents. 8. E mergency Response Plans Recommendation: ZNPHI would develop and integrate laboratory emergency plans with facility wide plans. These plans would also include such adverse event assessments as bomb threats, severe weather (e.g floods, earthquakes, power outages, and other natural or man-made disasters). While developing the plans, ZNPHI would include the BSL3 administrators, scientific directors, principal investigators, laboratory workers, maintenance and engineering support staff, facility safety officers, and facility security officials in emergency planning. Include provisions for immediate notification of and response by laboratory directors, laboratory workers, safety office personnel, or other knowledgeable persons when an emergency occurs. ZNPHI BSL3 will establish advance coordination with local police, fire, and other emergency responders to assist community emergency responders in planning for emergencies in select agent laboratory and animal areas. Discussion would address security concerns associated with sharing of sensitive information regarding secure work areas. Consider circumstances that might require the emergency relocation of select agents to another secure location. Reevaluate and train employees and conduct exercises of the emergency response plan at least annually. 154 9. Incident Reporting Recommendation: ZNPHI would establish a protocol for reporting adverse incidents. It would also ensure that the BSL3 laboratory administrators, in cooperation with facility safety, security, and public relations officials, have policies and procedures in place for reporting and investigating unintentional injuries, incidents (e.g., unauthorized personnel in restricted areas, missing biologic agents or tox ins, and unusual or threatening phone calls), or breaches in security measures. Pertinent environmental and health regulatory organs in Ethiopia would be notified immediately if select agents are discovered to be missing, released outside the laboratory, involved in worker exposures or infections, or misused. Additionally, all incidents involving select agents (e.g., occupational exposure or breaches of primary containment) would be reported to local public health authorities. 155 ANNE X 5: STAKE HOLDE R CONSU LTATIONS 156 157 158 159 160 161 162 163 164 165 166 167 168 ANNE X 6: M INU TE S OF THE PU BLIC STAKE HOLDE R CONSU LTATION THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka Minutes of the Stakeholder Consultation on the Project to Construct, Equip, and Staff the Zambia National Public Health Institute Laboratory & Office Complex. Held on 16th July 2019 in the Global Fund Boardroom, Ministry of Health Headquarters, Ndeke house, Lusaka, Zambia. 169 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka AGENDA The agenda was read and adopted as follows: 1. Welcome remarks and Introductions 2. Project Overview a. Background and Rationale b. Project Components 3. Feedback from invited stakeholders 4. Any other business MEETING PROCEEDINGS OPENING REMARKS The moderator Mr Augustine Seyuba called the meeting to order at 10:15AM and welcomed all in attendance. He noted the presence of some dignitaries including Princess Cholwe Nkomeshya, the representative from the Busoli Royal Establishment (BRE); Dr Chitalu Chilufya, the Honourable Minister of Health; and Ms Kakulubelwa Mulalelo, the Permanent Secretary in charge of Administration at the Ministry of Health. After a round of introductions, the meeting convenor, Dr Mukonka, Director of the Zambia National Public Health Institute (ZNPHI) was called upon to guide on how the meeting would proceed. Dr Mukonka expressed happiness at the wide representation of stakeholders ranging from community members, local leaders and government agencies (Appendix 1). He informed all that the meeting would be chaired by the Honourable Minister of Health. He then went on to invite PS Mulalelo, who guided that in the consultative spirit of the meeting, all stakeholders were free to ask questions on any matter related to the project, express any concerns and make submissions. She called upon the Honourable Minister of Health to officially open and chair the rest of the meeting. The Honourable Minister welcomed all stakeholders to the meeting and thanked them for taking time off their schedules to consider and address issues related to the proposed project. The Minister stressed the need to secure the health of investments in the country against 170 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka public health risks and events. He emphasised that the current administration under the leadership of His Excellency Dr Edgar Chagwa Lungu has identified the health of the citizenry as a fundamental pillar in human and national development, as it guarantees a healthy and productive workforce to drive and sustain socioeconomic development. The Minister took time to outline the broad vision of the government and how the health sector fits and contributes to its attainment. He explained that the Zambian Government is on a path of health-sector transformation in line with the Vision 2030, Seventh National Development Plan (7NDP), and the Patriotic Front Party Manifesto. Based on this, the MoH is comprehensively building the health system to attain universal health coverage, anchored on 8 pillars: (i) Service Delivery; (ii) human resources for health; (iii) infrastructure and equipment; (iv) medicines and drugs; (v) research; (vi) health information systems; (vii) governance and strong leadership; and (viii) healthcare financing. The Minister expounded that under the Service Delivery pillar, the MoH was utilising a primary healthcare approach, spanning the entire continuum of care (preventive, promotive, curative, rehabilitative, and palliative care). A key component of this is public health security, which the government has taken seriously by establishing the Zambia National Public Health Institute (ZNPHI) as a specialised technical arm to lead in all matters of disease intelligence, epidemic preparedness and response to epidemics and events of public health significance. Addressing health security is vital in safeguarding socioeconomic investments in the country. The Minister pointed out that in this regard, the World Bank, a key ally of the Zambian government has come in to help strengthen public health security through establishing infrastructure including the first national public health laboratory at biosecurity level 3 (BSL3) laboratory, and other support to strengthen surveillance and disease control systems. Upon completion, the infrastructure will not only benefit Zambia, but the Southern Africa region as a whole. Drawing on examples from the experience of West Africa during the Ebola outbreak, the Minister reiterated the importance of strong public health security in the country. He guided that a robust public health security shields the health of the citizenry, and it also shields the infrastructure of the nation. An epidemic has the potential to reverse, within a short period, industrial and economic gains that could have taken years to attain. Therefore, Zambia needs a public health laboratory support system that is alert in order to protect the 171 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka health of the nation and that of the SADC region as is expected of Zambia by the African Union. The Minister concluded by making a clarion call to all stakeholders to deliberate freely and objectively assess all aspects of the project, while recognizing that this was an opportunity to enhance national health security, which should be judged favourably by posterity. PROJECT OVERVIEW The ZNPHI Director Dr Mukonka gave a powerpoint presentation (Appendix 2) to the stakeholders and distinguished guests detailing the project. Background and Rationale Dr Mukonka began the presentation by clarifying that the steps being taken by Zambia to address health security through the ZNPHI were in fact linked to the wider vision of the African Union to take ownership and harness capacity on the continent for health security. He explained to the meeting that following the events of the 2014-2016 Ebola outbreak in west Africa, the AU heads of state and government were so moved by some of the dehumanising situations and practices that they decided to establish the Africa Centers for Disease Control and Prevention (Africa CDC) to provide leadership and coordination. Operationally the Africa CDC is operationalised through the Secretariat based in Addis Ababa, five Regional Collaborating Centers, of which Zambia hosts for Southern Africa, and National Public Health Institutes at individual country level. This is how the ZNPHI links to the Africa CDC vision and operational model. Director further explained the rationale behind establishment of the ZNPHI as a specialised disease intelligence wing in the health sector, including its mandate and current structure / clusters. He noted that all the work areas of the ZNPHI require a strong laboratory base in order to be effective. Dr Mukonka outlined the mandate of the Institute in four points: (i) To preserve the country’s health security; (ii) To efficiently prevent disease transmission, conduct surveillance and be prepared to respond to health threats and outbreaks; (iii) To build national capacity to detect and respond effectively to disease threats and outbreaks, based on scientific evidence; and (iv) To host the Africa CDC RCC for Southern Africa. 172 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka Dr Mukonka went further to highlight the national and regional burden and profile of disease, indicating how disease outbreaks are not restricted by, nor do they adhere to country boundaries. He noted that currently Zambia currently lacks a dedicated Public Health Laboratory system and depends on clinical laboratories for the public health functions. However these hospital-based labs have a different primary mandate of supporting diagnosis & clinical management of patients. Furthermore, their test profiles are limited, with functions being segmented. Often they are understaffed and get overstretched, particularly during outbreak situations, leading to delays in sample processing and reporting. Additionally, there is a human health sector bias. The current setup results in huge gaps in the backing required for epidemiological surveillance. Dr Mukonks thus stressed the Zambia’s need for a dedicated National Public Health laboratory System that incorporates some of the already existing competencies and laboratories. The requirement for a dedicated national public health laboratory system was also necessitated by the fact that ZNPHI is an evidence-based institution that depends heavily on objective scientific data. Furthermore, the regional obligations as RCC host require strong national infrastructure / capacity to anchor and support other member states. To address this, the ZNPHI through the Ministry of Health has been engaging the World Bank for over 16 months to obtain funding under the Bank’s Africa CDC Regional Investment Financing Program (ACDCP). The ACDCP is a regional project that aims to strengthen Africa CDC to improve networks for timely infectious disease detection and response. This will be through supporting vital institutional capacity-building within three institutions: the Africa CDC headquarters, the Ethiopian National Public Health Institute (EPHI) and the ZNPHI. Project Components Dr Mukonka indicated that Zambia was one of 3 institutions that had been given an opportunity to apply for support from the World Bank under the ACDCP. The Zambia component of the ACDCP will allow Zambia to obtain concessional credit under the international development assistance (IDA) scheme. The funds, worth $90M, will be utilised as an investment in critical infrastructure, equipment, human resource development, and strengthening of systems for disease intelligence, preparedness and response to public health threats. 173 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka The components of the project were explained as: Infrastructure will be a Biosafety Level 3 (BSL-3) laboratory suite, biobank, Proficiency Testing Panel Production Center offices, Public Health Emergency Operations Center (PHEOC), ICT suite, training rooms, conference facilities, library / resource center to support ZNPHI and RCC operations. The project will also cater for other features such as a power substation, parking facilities, landscaping, perimeter fence and other security features. More than 70% of the project will go towards putting up and equipping this state-of-the art infrastructure. The meeting was informed that the infrastructure would be set up in Chongwe District where 10 hectares of land had been secured from the National Institute for Scientific and Industrial Research (NISIR) in Silver rest area. A map was displayed showing the proposed project site. Apart from infrastructure development other components of the project are earmarked to address:  Laboratory Systems strengthening: In addition to the core infrastructure (BSL-3 laboratory suite, support laboratories, animal health laboratory, Biobank, biomedical equipment maintenance center; and a Proficiency Testing Panel Production Center), the project will strengthen laboratory Quality Management Systems, Microbiology skills, Biosafety/biosecurity, and specimen referral system. The infrastructure will also be utilised for training and skills development.  Enhancement of Disease Intelligence through cross border surveillance initiatives, Event Based Surveillance, expansion of Sentinel Surveillance sites for selected human and animal health diseases/conditions and roll out of the Integrated Disease Surveillance and Response (IDSR) system.  Emergency Preparedness and Response capacity by providing and operationalising a Public Health Emergency Operations Center (PHEOC) to address both national and regional response coordination capability. In line with the International Health regulations (IHR 2005) requirements, aspects relating to strengthening of points of entry and port health will also be addressed. 174 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka  Information systems, through the establishment, equipping and maintenance of an ICT suite and harmonised data system, Data repository, research skills, and expanding coverage of The Health Press Zambia journal.  Human Resources Development through expansion of the Field Epidemiology Training Program (FETP), specialised skills training, and targeted professional & semi- professional training.  Governance and operational frameworks to facilitate development of guidelines, MoUs and standards for coordination. Dr Mukonka summed up the benefits of the national investment through the project as:  State-of-the-art advanced laboratory facilities which will be accessible for public health use, and also support researchers, academics & regional member states  Availability of office space for ZNPHi and the SA-RCC  High biocontainment infrastructure for handling special pathogens  Facilities for training high quality professionals & specialists – scientists, disease surveillance and response experts, epidemiologists and others  Fully-fledged PHEOC for emergency response coordination  Platform for sharing information including disease profiles/trends, risk assessment, and Antimicrobial Resistance patterns  Opportunities for research  Support for External Quality Assurance programs  Repository for biobanking and preservation of African reference materials and strains for Research & Development of vaccines, therapeutics and diagnostics  ICT suite as a centre for training, managing and sharing data (data warehousing, informatics, computational biology, etc)  Infrastructure and other support RCC operationalisation & coordination of the Regional Integrated Surveillance and Laboratory Network (RISLNET)  For the local community, employment would be created during the construction phase of the project, and also when the facility commences operations. 175 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka It was noted that the model for operationalising the national public health laboratory system would comprise a biosafety level 3 (BSL-3) National Reference laboratory situated in Lusaka province supported by 3 regional laboratories, and also incorporating some already existing clinical, academic, research, NGO and any other laboratories based on competencies and comparative advantage. It will address public health issues in a multisectoral One Health manner including animal health environment, nutrition and other relevant areas. In concluding his presentation, Dr Mukonka showed pictures and a video depicting the layout and preliminary design concept for the Laboratory and office complex. He pointed out that the project had a heavy infrastructure arm and emphasised that all relevant national and applicable international laws, standards, guidelines and regulations were being followed to ensure that both the environment and people in the area are protected during and after the construction, and also when the facility comes into operation. As such an important aspect considered carefully was the management of the different types of waste materials that the facility would be generating. It was disclosed that various agencies responsible for ensuring that the waste was managed properly were being engaged and the project would also adhere to the very strict international safeguards standards requirements of the funders, the World Bank. Other best practices and standards set by bodies such as the World Health Organisation (WHO) and US CDC were being referenced and would guide the technical designs and operations of the facility. FEEDBACK FROM STAKEHOLDERS The moderator Mr Augustine Seyuba, opened the floor for reactions and/or questions. The following were raised: 1. The representative from the Food and Drugs Control Laboratory (FDCL) asked for clarity on how the multiple functions at the proposed laboratory complex will link with the functions already being played by specific entities, such as the FDCL which among other areas looks at food safety and toxicology. Response: Dr Mukonka remarked that the National Public Health Laboratory was not meant to necessarily replace existing capacities, but rather enhance them. The NPHL would be part of a network of laboratories that will also incorporate some existing 176 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka capacities based on competitive advantage. Furthermore the project would provide additional capacity beyond what is currently available in existing institutions. 2. The representative from the Tropical diseases Research Center (TDRC) asked what considerations would be taken into account in dividing the country into the proposed three sub-regions in the context of the planned National Public Health Laboratory system . Response: Dr Mukonka guided that risk mapping would guide the division of the country into the respective regions. This would be to ensure that each part of the country was assigned due attention, as informed by both identified and potential public health threats in each respective region. The availability of laboratory capacity would be another factor, although the vision was to ensure that where capacity didn’t yet exist, this would eventually be established as the NPHL system is expanded. 3. The representative from the National Biosafety Authority (NBA) asked what capacity the biobank was planned have and whether there were plans to generate sequence data, and if so what mechanisms were being considered to safeguard such information. Response: Dr Kunda Musonda, Head of Laboratory Systems and Networks at ZNPHI reiterated that the project would provide adequate capacity for storage of a range of samples, isolates and other reference materials to support research and understanding of diseases in the local context. This would also provide a resource for developing appropriate diagnostic tests, therapeutic agents and vaccines. The biobank would be certified and operate in accordance with the regulations set by the National Health Research Authority (NHRA) and in conformity with international best practice. As for sequencing, provision has been made for molecular biology a core laboratory as well as a bioinformatics suite to support the modern diagnostic capabilities. This will be supported by the ICT capabilities which the project is also funding. Biosecurity and biosafety issues will also be addressed from the engineering designs, policies, procedures, administrative controls and infection control and waste management protocols. Biosecurity has been recognised as a gap through the JEE and the Africa CDC has launched a continental initiative to improve the capacities in this area. To this end the SA-RCC convened a regional meeting in June 2019 to devise strategies of improving biosafety and biosecurity in Member States, as per JEE requirements. A key 177 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka aspect addressed was the need to develop lists of High Consequence Agents and Toxins (HCATs) as well as to develop relevant legislation on regulating use/stocking of these HCATs. Zambia is fully participating in these initiatives and when developed and consensus reached at national, regional and continental level, these shall also guide practices in the laboratory facility. Furthermore, relevant security systems have been factored into the project to ensure that only those with the required level of clearance can access certain areas of the laboratory, or access certain information. 4. A resident from Silver rest area Ms Sharon Chuni, and Chief Lands Officer at the Ministry of Lands and Natural Resources (MLNR) requested for a detailed description of the proposed location of the project site within Silver rest area. Response: Dr Mukonka reviewed a satellite image of the area, and outlined key landmarks. He indicated that the proposed project site is adjacent to the UNZA farm on Palabana road (D153), and the surrounding area is generally farmland. He indicated that the site lies at the junction of the recently tarred road which branches off southwards from the Great east road at Silver Rest Primary School and Palabana road (D153). Key social receptors in the area are located north east of the site and are: (i) a Police Post (approximately 1 Km away); (ii) Silver Rest Gardens Residential Estate (about 3.4 Km away); and (iii) Silver Rest Primary School (approximately 5.17 Km away). 5. The representative of Her Royal Highness Chieftainess Mukamambo II, Princess Cholwe Nkomeshya, expressed her elation at that the Government had considered setting up the project in the Busoli Chiefdom. She pledged full support for the project by the Busoli Royal Establishment and indicated that the BRE was full of expectation that once complete the laboratory would greatly help to answer health challenges faced by the people in the Chiefdom and across the entire country and Southern Africa region. She indicated that the BRE was in support of the efforts by the Ministry of Health to safeguard the health and security of the country’s residents. Princess Cholwe also indicated interest in showing the detailed powerpoint presentation directly to Her Royal Highness Senior Chieftainess Nkomesha Mukamambo II to enable her fully appreciate the scale of the modern infrastructure being proposed to be established in the chiefdom. She requested 178 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka the ZNPHI team to contact the Busoli palace when they are ready for a special session with Her Royal Highness the Chieftainess. ANY OTHER BUSINESS (A.O.B) There being no further interventions, the Honoyrable Minister and Princess Cholwe led the meeting participants to have a group picture taken (Appendix 3). CLOSING REMARKS In concluding the meeting, the Honourable Minister thanked the various stakeholders supporting the project. He went further to recognise all the Cooperating Partners and their continued support to the Ministry of Health in its endeavour to deliver healthcare to the country and attain Universal Health Coverage. The Minister thanked the BRE through Princess Cholwe for the notable support and blessing to proceed with the project. He hailed the longstanding progressive partnership the Busoli Chiefdom had with the Ministry of Health and Government at large. The meeting was formally closed at 12:20 hours. ______________________________ _____________________________ Dr Victor Mukonka Dr Raymond Hamoonga Meeting Convenor Meeting Rapporteur 18 July 2019 18 July 2019 179 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka APPE NDIX 1: ATTE NDANCE LIST 180 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 181 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 182 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 183 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka APPE NDIX 2: POWE RPOINT PRE SE NTATION M ADE TO STAK E HOLDE RS BY DIRE CTOR – ZNPH I 184 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 185 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 186 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 187 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 188 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 189 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 190 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 191 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 192 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 193 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 194 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 195 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka 196 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka APPE NDIX 3: PICTU RE GALLE RY The Honourable Minister of Health Dr Chitalu Chilufya addressing the stakeholders Stakeholders following the meeting proceedings 197 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka ZNPHI Director, Dr Victor Mukonka, discussing the project Meeting stakeholders listening to proceedings 198 THE ZAMBIA NATIONAL PUBLIC HEALTH INSTITUTE MINISTRY OF HEALTH 13 Reedbuck road, Kabulonga, Lusaka The Honourable Minister of Health Dr Chitalu Chilufya sharing a light moment with Princess Cholwe of the Busoli Royal Establishment Meeting participants pose for a group photograph 199 ANNE X 7: PROTOCOL FOR TRANSPORTATION OF INFE CTIOU S SU BSTANCE S Introduction Human and animal specimens are collected and shipped within countries and across international borders for a variety of reasons, including disease investigations, clinical trials, surveillance studies, antidoping testing, routine analyses, etc. The protocol provides information for;  classifying infectious substances for transportation and ensuring their safe packaging.  facilitating compliance with applicable international regulations for the transport of infectious substances and patient specimens by all modes of transport, both nationally and internationally. It is obligatory upon shippers to ensure packaging and shipping conditions meet regulatory requirements to preserve the integrity of materials and facilitate their timely arrival at destination. The protocol also emphasizes on the importance of developing a working relationship between those involved – the sender, the carrier and the receiver – in order to provide for safe and expeditious transport of these materials. It is adopted from WHO G uidance on regulations for the transport of infectious substances 2015 –2016. Classification Dangerous goods are assigned UN numbers and proper shipping names according to their hazard classification and their composition. Proper shipping names are used to clearly identify the dangerous article or substance. Infectious substances are classified in Division 6.2 and assigned to UN 2814, UN 2900, UN 3291 or UN 3373, as appropriate. Infectious substances are divided into the following categories: Category A An infectious substance which is transported in a form that, when exposure to it occurs, is capable of causing permanent disability, life-threatening or fatal disease in otherwise healthy humans or animals. 200 Note: An exposure occurs when an infectious substance is released outside of the protective packaging, resulting in physical contact with humans or animals. a) Infectious substances meeting these criteria which cause disease in humans or both in humans and animals shall be assigned to United Nations number UN 2814. Infectious substances which cause disease only in animals shall be assigned to UN 2900. b) Assignment to UN 2814 or UN 2900 shall be based on the known medical history and symptoms of the source human or animal, endemic local conditions, or professional judgement concerning individual circumstances of the source human or animal. Note 1: The proper shipping name for UN 2814 is INFECTIOUS SUBSTANCE, AFFECTING HUMANS. The proper shipping name for UN 2900 is INFECTIOUS SUBSTANCE, AFFECTING ANIMALS only Category B An infectious substance which does not meet the criteria for inclusion in Category A. Infectious substances in Category B shall be assigned to UN 3373. Note: The proper shipping name of UN 3373 is “BIOLOG ICAL SUBSTANCE, CATEG ORY B” E xemptions Substances that do not contain infectious substances or that are unlikely to cause disease in humans or animals are not subject to dangerous goods regulations, unless they meet the criteria for inclusion in another class. Substances containing microorganisms which are non-pathogenic to humans or animals are not subject to dangerous goods regulations, unless they meet the criteria for inclusion in another class. Substances in a form that any present pathogens have been neutralized or inactivated such that they no longer pose a health risk are not subject to dangerous goods regulations, unless they meet the criteria for inclusion in another class. Note: Medical equipment which has been drained of free liquid is deemed to meet the requirements of this paragraph and is not subject to dangerous goods regulations. Environmental samples (including food and water samples) which are not considered to pose a significant risk of infection are not subject to dangerous goods regulations, unless they meet the criteria for inclusion in another class. 201  Dried blood spots, collected by applying a drop of blood onto absorbent material are not subject to dangerous goods regulations. Faecal occult blood screening samples are not subject to dangerous goods regulations.  Blood or blood components which have been collected for the purposes of transfusion or for the preparation of blood products to be used for transfusion or transplantation and any tissues or organs intended for use in transplantation as well as samples drawn in connection with such purposes are not subject to dangerous goods regulations.  Human or animal specimens (patient specimens) for which there is minimal likelihood that pathogens are present are not subject to dangerous goods regulations if the specimen is transported in a packaging which will prevent any leakage and which is marked with the words “Exempt human specimen” or “Exempt animal specimen”, as appropriate. The packaging should meet the following conditions: a) The packaging should consist of three components: i) a leak-proof primary receptacle(s); ii) a leak-proof secondary packaging; and iii) an outer packaging of adequate strength for its capacity, mass and intended use, and with at least one surface having minimum dimensions of 100 mm × 100 mm; b) For liquids, absorbent material in sufficient quantity to absorb the entire contents should be placed between the primary receptacle(s) and the secondary packaging so that, during transport, any release or leak of a liquid substance will not reach the outer packaging and will not compromise the integrity of the cushioning material; c) When multiple fragile primary receptacles are placed in a single secondary packaging they should be either individually wrapped or separated to prevent contact between them. Note 1: An element of professional judgment is required to determine if a substance is exempt under this paragraph. That judgment should be based on the known medical history, symptoms and individual circumstances of the source, human or animal, and endemic local conditions. Examples of specimens which may be transported under this paragraph include the blood or urine tests to monitor cholesterol levels, blood glucose levels, hormone levels, or prostate specific antigen (PSA); those required to monitor organ function such as heart, liver or kidney function for humans or animals with non-infectious diseases, or therapeutic drug monitoring; those conducted for insurance or employment purposes and are intended to determine the presence of drugs or alcohol; pregnancy test; biopsies to detect cancer; and antibody detection 202 in humans or animals in the absence of any concern for infection (e.g. evaluation of vaccine induced immunity, diagnosis of autoimmune disease, etc.). Note 2: For air transport, packagings for specimens exempted under this paragraph shall meet the conditions in (a) to (c). Except for: a) Medical waste (UN 3291); b) Medical devices or equipment contaminated with or containing infectious substances in Category A (UN 2814 or UN 2900); and c) Medical devices or equipment contaminated with or containing other dangerous goods that meet the definition of another hazard class, medical devices or equipment potentially contaminated with or containing infectious substances which are being transported for disinfection, cleaning, sterilization, repair, or equipment evaluation are not subject to the provisions of dangerous goods regulations if packed in packagings designed and constructed in such a way that, under normal conditions of transport, they cannot break, be punctured or leak their contents. Packagings shall be designed to meet specific construction requirements – this is not considered further in these guidelines. These packagings shall meet general packaging requirements not considered further in these guidelines, and be capable of retaining the medical devices and equipment when dropped from a height of 1.2 m. For air transport, additional requirements may apply. The packaging shall be marked “USED MEDICAL DEV ICE” or “USED MEDICAL EQUIPMENT”. When using overpacks, these shall be marked in the same way, ex cept when the inscription remains visible. Biological p roducts For the purposes of transport, biological products are divided into two groups: a) those which are manufactured and packaged in accordance with the requirements of appropriate national authorities and transported for the purposes of final packaging or distribution, and use for personal health care by medical professionals or individuals. Substances in this group are not subject to dangerous goods regulations; b) those which do not fall under paragraph (a) and are known or reasonably believed to contain infectious substances and which meet the criteria for inclusion in Category A 203 or Category B. Substances in this group shall be assigned to UN 2814, UN 2900 or UN 3373, as appropriate. Note: Some licensed biological products may present a biohazard only in certain parts of the world. In that case, competent authorities may require these biological products to be in compliance with local requirements for infectious substances or may impose other restrictions. Genetically modified microorganisms and organisms G MMOs or G MOs that do not meet the definition of tox ic substances or infectious substances shall be assigned to UN 3245. G MMOs and G MOs assigned to UN 3245 shall be shipped following Packing Instruction P904 (ICAO/IATA PI959) – this is not considered further in these guidelines. Note: The proper shipping name for UN 3245 is “G ENETICALLY MODIFIED MICROORG ANISMS” or "G ENETICALLY MODIFIED ORG ANISMS". M edical or clinical w astes Medical or clinical wastes containing Category A infectious substances shall be assigned to UN 2814 or UN 2900 as appropriate. Medical or clinical wastes containing infectious substances in Category B, or which are reasonably believed to have a low probability of containing infectious substances, shall be assigned to UN 3291 and shipped following Packing Instruction P621 (ICAO/IATA PI622) – this is not considered further in these guidelines. For the assignment, international, regional or national waste catalogues may be taken into account. NOTE : The proper shipping name for UN 3291 is “CLINICAL WASTE, UNSPECIFIED, N.O.S.” or "(BIO) MEDICAL WASTE, N.O.S." or "REG ULATED MEDICAL WASTE, N.O.S.". Decontaminated medical or clinical wastes which previously contained infectious substances are not subject to dangerous goods regulations unless they meet the criteria for inclusion in another class. The bulk transport of wastes of Division 6.2 (UN 3291) is permitted according to provisions not further considered in these guidelines. 204 Infected animals Unless an infectious substance cannot be consigned by any other means, live animals shall not be used to consign such a substance. A live animal which has been intentionally infected and is known or suspected to contain an infectious substance shall only be transported under terms and conditions approved by the competent authority. Animal material affected by pathogens of Category A or which could be assigned to Category A in cultures only, shall be assigned to UN 2814 or UN 2900 as appropriate. Animal material affected by pathogens of Category B other than those which would be assigned to Category A if they were in cultures shall be assigned to UN 3373. The bulk transport of animal material containing infectious substances (UN 2814, 2900 and 3373) is authorized according to provisions not further considered in these guidelines. General p reparation of shipments for transport Due to the different hazards posed by Category A infectious substances (UN 2814 and UN 2900) and Category B infectious substances (UN 3373), there are variations in the packaging, labelling and documentation requirements for the two categories. The packaging requirements are determined by UNCETDG and are set out as Packing Instructions P620 and P650, reproduced. The requirements are subject to change and regular upgrade by the organizations mentioned. The current packaging requirements are described below. Note 1: Hand carriage of Category A and Category B infectious substances and transport of these materials in diplomatic pouches are strictly prohibited by international air carriers. Note 2: Inner packaging containing infectious substances shall not be consolidated with inner packagings containing unrelated types of goods. Shippers of infectious substances shall ensure that packages are prepared in such a manner that they arrive at their destination in good condition and present no hazard to persons or animals during transport. Basic triple packaging system This system of packaging shall be used for all infectious substances. It consists of three layers as follows: 205  Primary receptacle. A primary watertight, leak-proof receptacle containing the specimen. The receptacle is packaged with enough absorbent material to absorb all fluid in case of breakage or leakage.  Secondary packaging. A second durable, watertight, leak-proof packaging to enclose and protect the primary receptacle(s). Several cushioned primary receptacles may be placed in one secondary packaging, but sufficient additional absorbent material shall be used to absorb all fluid in case of breakage or leakage.  Outer packaging. Secondary packaging are placed in outer shipping packaging with suitable cushioning material. Outer packaging protect their contents from outside influences, such as physical damage, while in transit. The smallest overall external dimension shall be 10 x 10 cm. Each completed package is normally required to be correctly marked, labelled and accompanied with appropriate shipping documents (as applicable). The requirements for these aspects are described below. Packaging, labelling and documentation requirements for infectious substances in Category A Packaging An infectious substance category A which is transported in a form that, when exposure to it occurs, is capable of causing permanent disability, life-threatening or fatal disease in otherwise healthy humans or animals. Infectious substances in Category A may only be transported in packaging that meets the United Nations class 6.2 specifications and complies with Packing Instruction P620. This ensures that strict performance criteria are met; tests for compliance with these criteria include a 9-metre drop test, a puncture test, a pressure test and a stacking test. The outer packaging shall bear the United Nations packaging specification marking (Figure 2), which indicates that the packaging has passed the performance tests to the satisfaction of the competent authority. The primary receptacle or the secondary packaging shall be capable of withstanding a pressure differential of not less than 95 kPa. The United Nations packaging specification marking alone does not indicate that a test for this has been undertaken, and packaging users should ask their suppliers whether the completed package meets this requirement. Carriers and forwarding agents shall supply details of local suppliers or local companies that can provide such information. 206 Figure 1. Example of triple packaging system for the packaging and labelling of Category A infectious substances M arking Packages are marked to provide information about the contents of the package, the nature of the hazard, and the packaging standards applied. All markings on packages or overpacks shall be placed in such a way that they are clearly visible and not covered by any other label or marking. Each package shall display the following information on the outer packaging or the overpack. • the shipper’s (sender’s, consignor’s) name and address • the telephone number of a responsible person, knowledgeable about the shipment • the receiver’s (consignee’s) name and address • the United Nations number followed by the proper shipping name (UN 2814 “INFECTIOUS SUBSTANCE, AFFECTING HUMANS” or UN 2900 “INFECTIOUS SUBSTANCE, AFFECTING ANIMALS only”, as appropriate). Technical names need not be shown on the package. • temperature storage requirements (optional) • when dry ice or liquid nitrogen is used: the technical name of the refrigerant, the appropriate United Nations number, and the net quantity. 207 Labelling There are two types of labels: 1. hazard labels in the form of a square set at an angle of 45° (diamond- shaped) are required for most dangerous goods in all classes; 2. handling labels in various shapes are required, either alone or in addition to hazard labels, for some dangerous goods. Specific hazard label(s) shall be affix ed to the outside of each package for all dangerous goods to be shipped (unless specifically exempted). Figure 2. Hazard label for Category A infectious substances and for genetically modified microorganisms and organisms that meet the definition of an infectious substance, Category A Minimum dimensions: 100 × 100 mm (for small packages: 50 × 50 mm) No. of labels per package: 1 Colour: Black and white The words “INFECTIOUS SUBSTANCE” shall be shown. The statement “In case of damage or leakage immediately notify a Public Health Authority” is required in some countries Figure 3 . Hazard label for certain noninfectious genetically modified microorganisms and organisms (UN 3245) and for carbon diox ide, solid (dry ice) (UN 1845); substances packed in 208 dry ice (see section on Refrigerants) shall bear this label in addition to the primary risk label (e.g. the label shown in Shipping empty packaging’ Before an empty package is returned to the shipper, or sent elsewhere, it must be appropriately disinfected or sterilized to nullify any hazard. Any label or marking indicating that it had contained an infectious substance shall be removed or covered. Figure 4. Example of a completed shipper’s Declaration for Dangerous Goods Documentation The following shipping documents are required. To be prepared and signed by the shipper: • for air: the shipper’s Declaration for Dangerous G oods (Figure 8 shows an ex ample) • a packing list/proforma invoice that includes the receiver’s address, the number of packages, detail of contents, weight, value (Note: for international transport, a minimal value shall be indicated, for customs purposes, if the items are supplied free of charge) • an import and/or export permit and/or declaration if required To be prepared by the shipper or the shipper’s agent: • an air waybill for air transport or equivalent documents for road, rail and sea shipments. 209 For UN 2814 and UN 2900, an itemized list of contents shall be enclosed between the secondary packaging and the outer packaging. For the purposes of documentation, the proper shipping name shall be supplemented with the technical name. Technical names need not be shown on the package. When the infectious substances to be transported are unknown, but suspected of meeting the criteria for inclusion in category A and assignment to UN 2814 or UN 2900, the words “suspected Category A infectious substance” shall be shown, in parentheses, following the proper shipping name on the transport document, but not on the outer packagings. Packaging, labelling and documentation requirements for infectious substances in Category B Packaging An infectious substance which does not meet the criteria for inclusion in Category A. Infectious substances in Category B shall be assigned to UN 3373 The triple packaging system continues to apply, including for local surface transport. Testing documents are not required, however. To ensure correct preparation for transport, packaging manufacturers and subsequent distributors shall provide clear instructions to the consignor or persons preparing packages (e.g. patients) on how the packaging should be filled and closed. For surface transport there is no max imum quantity per package. Figure 5: Example of the triple packaging system for the packing and labelling Category B infectious substances (adopted from WHO) 210 For air transport: • no primary receptacle shall exceed 1 litre and the outer packaging must not contain more than 4 litres(for liquids) • except for packages containing body parts, organs or whole bodies, the outer packaging must not contain more than 4 kg (for solids). Provided all the requirements of P650 are met, there are no other transport requirements. P650 incorporates all that is needed to make a shipment for Category B infectious substances. M arking Each package shall display the following information: • for air: the shipper’s (sender’s, consignor’s) name, address and telephone number • for air: the telephone number of a responsible person, knowledgeable about the shipment • the receiver’s (consignee’s) name, address and telephone number • the proper shipping name (“BIOLOG ICAL SUBSTANCE, CATEG ORY B”) adjacent to the diamond-shaped mark shown in Figure 10 • temperature storage requirements (optional). The marking shown in Figure 10 is used for shipments of Category B infectious substances. Figure 6. Marking for infectious substances of Category B • Minimum dimension: the width of the line forming the square shall be at least 2 mm, and the letters and numbers shall be at least 6 mm high. For air transport, each side of the square shall have a length of at least 50 mm 211 • Colour: none specified, provided the mark is displayed on the external surface of the outer packaging on a background of contrasting colour and that it is clearly visible and legible • The words “BIOLOG ICAL SUBSTANCE, CATEG ORY B” in letters at least 6 mm high shall be displayed adjacent to the mark. Note: For air transport :  when dry ice (solid carbon diox ide) is used (see section on Refrigerants), the label shown in Figure 4 shall be applied  for cryogenic liquids (see section on Refrigerants) the labels shown in Figures 5 and 6 shall also be affix ed. Documentation Dangerous goods documentation (including a shipper’s declaration) is not required for Category B infectious substances. The following shipping documents are required. To be prepared and signed by the shipper (sender, consignor): • for international shipments: a packing list/proforma invoice that includes the shipper's and the receiver’s address, the number of packages, detail of contents, weight, value (Note: the statement “no commercial value” shall appear if the items are supplied free of charge) • an import and/or export permit and/or declaration if required. To be prepared by the shipper or the shipper’s agent: • an air waybill for air transport or equivalent documents for road, rail and sea journeys. Refrigerants Refrigerants may be used to stabilize infectious substances in Categories A and B during transit. • Packed infectious substances requiring cooling assigned to packing instructions P620 or P650 shall meet the appropriate requirements of that packing instruction. • Ice, ice pads or dry ice shall be placed outside the secondary receptacle or in an outer packaging or in an overpack. • Wet ice shall be placed in a leak-proof container; the outer packaging or overpack shall also be leak-proof. 212 • Dry ice must not be placed inside the primary or secondary receptacle because of the risk of explosions. A specially designed insulated packaging may be used to contain dry ice. The packaging must permit the release of carbon diox ide gas if dry ice is used. Packing instruction P003 (ICAO/IATA PI954) shall be observed. • The secondary receptacle shall be secured within the outer package to maintain the original orientation of the inner packages after the refrigerant has melted or dissipated. • If dry ice is used to ship infectious substances in Category A, the details shall appear on the shipper’s Declaration for Dangerous Goods. If dry ice is used to ship infectious substances in Category B or Exempt samples, the shipper’s Declaration of Dangerous G oods is not required. In any case, the outermost packaging shall carry the hazard label for dry ice (see Figure 4), the appropriate markings, including the UN number and the proper shipping name followed by the words “AS COOLANT”, for example: UN 1845, CARBON DIOXIDE,SOLID, AS COOLANT. and an indication of the net quantity of dry ice in kilograms. • If liquid nitrogen is used as a refrigerant, special arrangements shall be made in advance with the carrier. Primary receptacles shall be capable of withstanding extremely low temperatures, and packaging and documentation requirements for liquid nitrogen shall be observed. In particular, the outermost packaging shall carry the hazard label for liquid nitrogen (see Figure 5). For air transport, the handling label for cryogenic liquids shall also be affix ed (see Figure 6) – this is not considered further in these guidelines. • When shipping with liquid nitrogen, "dry shippers" can be used. Correctly prepared "dry shippers" do not contain free liquid nitrogen. While liquid nitrogen is a regulated dangerous good, a properly prepared "dry shipper" is not. When shipping with "dry shippers", the dangerous goods label for class 2 (non-flammable, non-tox ic gases) is NOT required. Shippers must properly mark and label the outside of dry shipper packages containing infectious substances. Appropriate documentation should discuss the presence of infectious substances. For Category A this information will be included in the Dangerous G oods Declaration. For Category B and Exempt packages this information should be provided on the Air Waybill. Training All personnel involved in transport shall undergo appropriate training. For the transport of Category A infectious substances, personnel must undergo training in accordance with the modal requirements. This shall involve attending approved courses and passing examinations. 213 For the transport of Category B infectious substances there is a requirement that clear instructions on the use of the packaging are supplied to the user; this is regarded as sufficient “training” for the shipping of these substances. However, if such specimens are consigned with other dangerous goods (e.g. flammable liquids, radioactive materials, liquefied gases, etc.), then personnel must be trained in the proper procedures for their transport. Training and awareness are important for all personnel involved in the transport of Category B infectious substances. Only through appropriate guidance and training can shippers ensure that the classification of the substance to be shipped is correct, and that proper packaging is selected and prepared. Carriers and other employers of transport workers shall train their personnel in the appropriate procedures for recognizing and handling packages containing infectious substances and in how to address spills and protect themselves from exposure. Records of training received shall be kept by the employer and made available to the employee or competent authority, upon request. Transport planning The efficient transport and transfer of infectious substances requires good coordination between the sender, the carrier and the receiver to ensure that the material is transported safely and arrives on time and in good condition. Such coordination depends upon well-established communications and a good working relationship between the three parties. The carriage of any goods whether dangerous or not, is a commercial matter for a carrier. The dangerous goods rules described in these guidelines reflect governmental legal requirements. If a carrier does not wish to carry particular goods is under no legal obligation to do so. Many carriers (airlines, haulers and shipping lines) are “private carriers” and have the right to refuse to carry goods or add additional requirements. Provided such conditions do not conflict with the legal requirements, this type of action is not illegal. ICAO and IATA list the main carrier restrictions in force among airlines. Some airlines will not carry dangerous goods at all, while others will carry only a very limited range of goods. The shipper (sender, consignor), carrier and the receiver (consignee) have specific responsibilities in ensuring successful transportation. 214 The shipper (sender, consignor) The shipper has the responsibility to ensure the correct classification, packaging, labelling, and documentation of all infectious substances destined for transport: • Makes advance arrangements with the receiver including investigating the need for import/export permits • Makes advance arrangements with the carrier to ensure: o that the shipment will be accepted for appropriate transport o that the shipment (direct transport if possible) is undertaken by the most direct routing • Prepares necessary documentation, including permits, dispatch and shipping documents • Notifies the receiver of transportation arrangements once these have been made, well in advance of the expected arrival time. The carrier • Provides advice to the sender regarding the necessary shipping documents and instructions for their completion • Provides advice to the sender about correct packaging • Assists the sender in arranging the most direct routing and then confirms the routing • Maintains and archives the documentation for shipment and transport. The receiv er (consignee) • Obtains the necessary authorization(s) from national authorities for the importation of the material • Provides the sender with the required import permit(s), letter(s) of authorization, or other document(s) required by the national authorities • Arranges for the most timely and efficient collection on arrival • Should acknowledge receipt to the sender. Shipments should not be dispatched until: • Advance arrangements have been made between the sender, carrier and receiver • The shipper has confirmed with the national authorities that the material may be legally exported • The receiver has confirmed with the national authorities that the material may be legally imported 215 • The receiver has confirmed that there will be no delay incurred in the delivery of the package to its destination. Requirements for air mail  Infectious substances in Category A will not be accepted for shipment through postal services.  Infectious substances in Category B may be shipped by registered air mail, and the Universal Postal Union recommends the following procedure. i) The basic triple packaging system is used with the same requirements as for other means of transport ii) . The address label shall display the word “Lettre” or “Letter” and the green Customs Declaration Label for Postal Mail is required for international mailing. iii) “BIOLOG ICAL SUBSTANCE, CATEG ORY B” shall be identified with the white diamond label with black letters “UN 3373” (see Figure 10). iv) Local/international restrictions may be in force. Prior contact should therefore be made with the national public operator to ascertain whether the packaged material will be accepted by the postal service in question. Spill clean-up procedure The appropriate response in the event of exposure to any infectious substance is to wash or disinfect the affected area as soon as possible, regardless of the agent. Even if an infectious substance comes into contact with non-intact skin, washing of the affected area with soap and water or with an antiseptic solution can reduce the risk of infection. Medical advice should be obtained any time there is a suspected exposure to infectious substances resulting from a damaged package. The following procedure for clean-up can be used for spills of all infectious substances including blood. The person must be trained on such procedure before performing these steps: 1. Wear gloves and protecting clothing, including face and eye protection if indicated. 2. Cover the spill with a cloth or paper towels to contain it. 3. Pour an appropriate disinfectant over the cloth or paper towels and the immediately surrounding area (5% bleach solutions are generally appropriate, but for spills on aircraft, quaternary ammonium disinfectants should be used). 4. Apply the disinfectant concentrically beginning at the outer margin of the spill area, working towards the centre. 216 5. After about 30 min, clear away the materials. If there is broken glass or other sharps are involved, use a dustpan or a piece of stiff cardboard to collect the materials and deposit them into a puncture-resistant container for disposal. 6. Clean and disinfect the area of the spillage (if necessary, repeat steps 2 –5). 7. Dispose of contaminated materials into a leak-proof, puncture-resistant waste disposal container. 8. After successful disinfection, report the incident to the competent authority and inform them that the site has been decontaminated (see Incident reporting below). Incident reporting Reports of infections resulting from transport-related exposures shall be documented. Incidents shall be reported to the health authorities (safety officer and Laboratory Quality Manager) and transport authorities. This applies to both categories of infectious substances, but particularly to those in Category A. 217 ANNE X 8: OVE RVIE W OF THE M ANCHINCHI SE WE RAGE TRE ATM E NT PLANT Coutesy of The Sewerage Services Department, Engineering Division, Lusaka Water and Sewerage Company The Manchinchi WWTP was constructed in the 1950s and expanded in the 1960s and 1970s. The plant is a conventional biological treatment plant with a current treatment capacity of up to 36,000m3 per day, but is earmarked for capacity upgrade to over 60,000m3. The plant employs the following unit processes: • Septage hauling drop off facility for septic and industrial waste • Head-works, including bar screens and grit removal; • Primary clarification using circular clarifiers; • Secondary treatment using trickling filters; • Secondary clarification using circular clarifiers; and • Anaerobic digesters, ox idation tanks and drying beds to treat sludge. The treated effluent and combined sewer bypass is discharged directly into a gravity sewer that drains into the G arden Ponds. The treated effluent is not disinfected prior to discharge; rather the G arden Ponds are designed to naturally disinfect the treated wastewater and reduce coliform indicator organisms to acceptable levels. Treatment Process The treatment plant receives domestic waste from the collection network as well as septage from vacuum tankers. The waste is screened at the head-works to remove coarse objects and other solid waste. It then goes through the grit removal system to remove sand and other forms of grit. The flow is split into four streams for further treatment. Each stream has a clarifier that settles suspended solids out of the liquid phase. The settled solids form the sludge which is pumped for further treatment. 218 Liquid The liquid phase goes to the trickling filters for aerobic bacterial action which reduces the dissolved organic content of the water. The process also forms humus which is settled out at the secondary clarifiers. The humus contains large quantities of beneficial bacteria thus is pumped back into the in-coming flow to avoid loss of the bacteria. The flow is then channeled by gravity to some maturation ponds. The maturation ponds are designed to reduce the micro organism content of the water through exposure to sun. The flow then leaves the treatment system into a natural drainage stream. Solid The sludge that is removed at the primary clarifier is pumped to the thickener for further solid - liquid separation after which it is pumped to the sludge digesters where it is retained for period of about three months for complete stabilization in an anaerobic environment. The stabilized sludge then flows to an ox idation before being channeled into drying beds for sun drying. As the drying beds are not covered the sludge is stored in a lagoon in the rainy season. Dried, treated sludge is sold to the public for use as a soil conditioner 219 220 Waste Water Treatment Processes The Manchinchi sewage treatment in Lusaka5 is a conventional trickling filter type. Within the stages of sewage treatment, there are different steps and methods that can be employed to treat the water6 . These include: Preliminary treatment, Primary sedimentation, Biological treatment and Secondary sedimentation and Sludge treatment. Preliminary Treatment Ideally, wastewater flows by gravity to the Manchinchi treatment plant, which is typically located at the lowest feasible point with respect to the sources of wastewater. The purpose of preliminary treatment is the removal of large floating objects (rags, maize cobs, pieces of 7 wood, etc.) and heavy inorganic particles (sand and grit). The preliminary stage has three operations; Screening, Sand or G rit removal and Comminution. 5 Full report available at https://www.academia.edu/25613866/DRINKING_WATER_TREATMENT_AND_WASTE_WATER_TREATMENT_PRO CESSES_IN_LUSAKA 6 Pescod, M. B. "Wastewater Treatment." Wastewater Treatment and Use in Agriculture. Rome: FAO, 1992. 7 Hogan, Michael C. "Sewage Treatment." Encyclopedia of Earth. The Encyclopedia of Earth, 27 May 2010. 221 Screening Screening is the first step in the preliminary treatment of the wastewater. The water flows through screens which filter out large, medium, and smaller objects from the liquid. Usually three different mesh sizes are used. The mesh size of the largest grid is about 5.0 centimeters, and it is used to remove large objects, such as branches and cloth. The mesh sizes of the second and third grids range between 0.5 to 3.0 centimeters, and 1.5 to 3.0 millimeters, respectively . A screen of steel bars is mostly used with spacing between the bars of 20 – 40mm. At Manchinchi waste water treatment plant, the waste from the screens is raked manually and dewatered then the local council collects it. Figure 21 Screens Grit Remov al G rit is the heavy inorganic fraction of sewage solids which may include sand, pieces of glass or metal. It has much higher settling velocity than organic sewage solids. Due to this difference, grit can be separated from the rest of the sewage. Using this grit removing process will decrease the chances of damaging any type of mechanical system that may be used in the following steps8 . 8 Vesilind, P. Aarne. Wastewater Treatment Plant Design. Alex andria, VA: Water Environment Federation, 2003 . 222 Comminution A comminutor is a self-cleansing machine which cuts up the sewage solids into very small pieces. It’s usually a rotating drum with cutter bars and cutting teeth, which engage with stationary steel Figure 22 Comminutor Primary Sedimentation Tank The step that follows preliminary treatment in the conventional process is primary sedimentation. As opposed to grit removal, we want to separate, by gravity, as much as possible of the organic solids. This removal of solids from the liquid phase is also called clarification, and the sedimentation tanks are sometimes referred to as clarifiers. A high degree of clarification is required to reduce the load on the biological treatment process and this is the purpose of primary sedimentation. The efficiency of primary treatment is determined by the suspended solids fed into the bio filters and eventually the secondary sedimentation tank. 223 Biological Treatment (Bio-Filters) The physical treatment processes (preliminary treatment and primary sedimentation) are followed by biological processes in conventional treatment plant at Manchinchi. This stage simulates what actually happens in nature, where microorganisms break down organic waste in water. There are three main approaches that can be used in this stage; fix ed film, suspended film and lagoon systems9 . The Machinchi waste water treatment plant uses the trickling filters. Trickling filters are also known as Bio filters. Bio filters are made up of a bed of hard granite stone of about 30-60 mm grading, usually 1.8m deep over which settled sewage is sprinkled. Trickling filter is a circular bed of coarse aggregate without sand. Settled sewage from primary sedimentation tank is distributed over the bed and trickles down over the surface of the aggregate media. On these surfaces, a microbial film develops, and the bacteria which constitute most of this film ox idize the organic matter in the sewage as it flows past, surrounded by air. Over time, a biofilm in the appropriate environment will grow and become strongly attached to the surface it lives on [5]. The microbial film on the filter media always grow and bacterial cells are washed away from it in great numbers by hydraulic action of the sewage. These cells create a new kind of sludge of organic nature, which ex erts new BOD to the effluent, when the cells die. This sludge must be removed before the effluent is finally discharged. That is why the secondary sedimentation tank is needed. The settled sludge from this biological treatment tank is also called Humus. At Manchinchi sewage treatment plant, the effluent draining from a bed is almost clear, although it always contains suspended matter mainly resulting from the breaking away of particles of active film from the stones. The result of effective primary plus secondary treatment is removal of about 90% of the organic matter, virtually all pathogens, and most solids. Between 10% and 20% of the nitrogen is also automatically removed because the decomposer bacteria require this much for their own growth. 9 Deibel, PH.D, Virginia, and Jean Schoeni, PH.D. "Develop a Defense Against Biofilms." Food Safety Magazine Jan. 2003. Web. 18 Jan. 2012. 224 Figure 23 Bio Filter Secondary Sedimentation Tank In secondary sedimentation tank, the aim is to remove sludge that has formed during the biological process. Solids are removed by sedimentation, while oils and grease are removed by skimming (Hogan, 2010). “Approx imately 25% to 50% of the incoming biochemical ox ygen demand (BOD), 50% to 70% of the total suspended solids (SS), and 65% of the oil and grease are removed during primary treatment”. Sludge Treatment G reat amounts of sludge are produced in conventional sewage treatment from raw sewage that settles out in primary and secondary plants at manchinchi. The sludge contains great amount of organic matter that is biodegradable. The pollution potential of sludge is greater than that of the liquid effluent of the plant, because a great part of the pathogenic microorganisms that were once in the sewage are now concentrated in the sludge. Sludge therefore creates a difficult disposal problem and is also quite bulky. It is obvious that sludge must be treated prior to its disposal. Treatment involves biological processes known as Digestion. The gas produced by the digestion process is usually about 70% methane and the rest CO2 and inert gases. Thus the gas is combustible and a valuable by- product of sludge treatment. The two principal uses are for heating and for power generation. 225 It should be mentioned here that the Manchinchi Waste Wastewater Treatment Plant does not produce any biogas as a result of malfunctioning bio-digesters. The treated sludge is then dewatered, as the moisture content is still high. The Manchinchi wastewater treatment plant consists of preliminary and primary treatment to remove solids, secondary treatment to reduce the organic content, and disinfection in the maturation ponds to kill pathogens prior to discharge of the treated effluent into the Ngwerere stream. Figure 24 Dried Sludge 226