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INTEGRATED SAFEGUARDS DATA SHEET 
CONCEPT STAGE 
Report No.:  AC1363 
 
Date ISDS Prepared/Updated: March 21, 2005 
 
I.  BASIC INFORMATION 
 
A.  Basic Project Data 
 
Country: Eritrea 
Project ID: P094694 
Project Name: Eritrea HIV/AIDS/STI, TB, 
Malaria and Reproductive Health Project 
(HAMSET II) 
Task Team Leader: Christopher D. Walker 
Estimated Appraisal Date: April 26, 2005 
Estimated Board Date: June 23, 2005 
Managing Unit: AFTH1 
Lending Instrument: Specific Investment 
Loan 
Sector: Health (70%); Other social services 
(15%); Sub-national government 
administration (10%); Central government 
administration (5%) 
Theme: HIV/AIDS (P); Other 
communicable diseases (P); Population and 
reproductive health (P); Health system 
performance (S); Participation and civic 
engagement (S) 
Safeguard Policies Specialists in the task team:  Amadou Konare 
Loan/Credit amount ($m.):  
IDAP: 24 
Other financing amounts by source:  
($m) 
B.  Project Objectives [from section 2 of PCN] 
 
The proposed project's development objectives are to: (i) reduce the spread of HIV/AIDS/STI in 
high-risk groups as well as the general population through a multi-sector approach which aims at 
scaling up prevention, diagnosis, care, and support services for HIV/AIDS, with a renewed focus 
on the most high-risk populations, (ii) expand DOTS coverage, improve case detection and 
treatment outcomes for TB; (iii) prevent any increase in malaria mortality and morbidity from 
the current low level, and (iv) improve RH outcomes. During project preparation, the task team 
and the GOE will agree on proxy indicators for each area and determine specific overall targets. 
 
C.  Project Description [from section 3 of PCN] 
 
The proposed HAMSET II (IDA grant US$ 24 million) would have four components: 
(1) 
Multi-sectoral response (US$ 3 million)
:
this component supports key (non-health) line 
ministries, local governments and civil society organizations to scale up prevention 
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(including behavior change communication or BCC), care and support interventions for 
HIV/AIDS/STIs, malaria, TB and RH.  
(2) 
Health sector response (US$ 12 million):
 this has four sub-components 
–
HIV/AIDS/STI (US$ 3 million), TB (US$ 2 million), malaria (US$ 2 million)  and RH 
(US$ 5 million). Each sub-component would include the following activities: 
a. 
Improve the information base for decision making (including disease surveillance, 
surveys, operational research, etc.) 
b.  Scale up prevention interventions (especially technical support in behavior change 
communication for the multi-sectoral response and community initiatives) 
c. 
Scale up diagnostic, treatment, care and support services  
(3) 
Community response (US$ 5 million)
:
this component aims to scale up and consolidate 
community-managed response initiatives to address HAMSET diseases and RH.    
(4) 
Project coordination, capacity building and M&E (US$ 4 million)
:
In particular, 
capacity building would include support for pre-service and in-service training 
 
D.  Project location (if known) 
 
Project activities will be implemented nationwide. 
 
E.  Borrower’s Institutional Capacity for Safeguard Policies [from PCN] 
 
The Borrower has demonstrated institutional capacity for safeguard policies as evidenced in the 
following: 
 
(i) 
A Health Care Waste Management Plan (HCWMP) was already developed and 
approved under the Eritrea Health Project and HAMSET I. It has been implemented 
since October 2004. The Ministry of Health, the agency responsible for HCWMP 
implementation, has established a task force to ensure the dissemination of the plan as 
well as compliance by all health facilities in the country. 
(ii) 
Bank supervision confirmed that in the two regional hospitals financed by IDA under 
the Eritrea Health Project, all the applicable requirements of the HCWMP have been 
met.  
(iii) 
Under HAMSET I, the MOH launched a Rapid-Result Initiative in Halibut hospital 
(the largest referral hospital in the country) to improve safe injection practices and 
management of sharps and medical waste. Within 100 days, all the targets were 
achieved and there was no occupational needle stick injury. This initiative has now 
been scaled up to referral hospitals in five out of six zobas. 
(iv) 
Under HAMSET I, MOH has been able to comply with (a) the recommendations 
made by the Environmental Assessment (EA) and (b) DCA’s legal covenant related 
to the use of DDT under the project.      
 
II.   SAFEGUARD POLICIES THAT MIGHT APPLY 
 
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Applicable?
Safeguard Policy 
If Applicable, How Might It Apply? 
[x] 
Environmental Assessment
(
OP
/
BP
4.01) 
The proposed project involves risks associated with the handling and disposal of 
medical wastes.   Normally, the risks associated with medical waste management 
and disposal will prompt the project to prepare a Medical Waste Management 
Plan (MWMP).   However, because of the existence of a national MWMP, 
prepared under HAMSET I, this project, HAMSET II, is only required to re-
disclose, the existing MWMP in 
–country and at Bank InfoShop. Re-disclosure of 
the MWMP will take place in the said-locations prior to disbursement.     
[
]
Natural Habitats
(
OP
/
BP
4.04) 
[x] 
Pest Management
(
OP 4.09
)
The proposed project will finance insecticides for malaria control activities. The 
overall use of insecticides is relatively small (e.g. for the impregnation of bed 
nets) , and only safe compounds approved by the World Health Organization 
Pesticide Evaluation Scheme (WHOPES) will be used, namely temphos (a 
larvicide) and pyrethroid. DDT will not be procured under the project.  . This, 
under normal circumstances, prompts the project to prepare a Vector Control 
Plan.  However, because of the existence of an Environmental and Social Impacts 
Assessment, prepared under HAMSET I – which adequately discusses pesticides 
use and management issues and mitigation measures – the project should re-
disclose and use provisions of the same instrument as guidance, in lieu of 
preparing a new vector control plan.  The re-disclosure of the EA will take place 
in-country and at Bank InfoShop, prior to disbursement. 
[
]
Involuntary Resettlement
(
OP
/
BP
4.12) 
[
]
Indigenous Peoples
(
OD 4.20
)
[
]
Forests
(
OP
/
BP
4.36) 
[
]
Safety of Dams
(
OP
/
BP
4.37) 
[
]
Cultural Property
(draft OP 4.11 - 
OPN 11.03
)
[
]
Projects in Disputed Areas
(
OP
/
BP
/
GP
7.60)
*
[
]
Projects on International Waterways
(
OP
/
BP
/
GP
7.50) 
Environmental Assessment Category:
 
[
]
A
[X] B   [ ] C   [ ] FI   [ ] TBD  
*
By supporting the proposed project, the Bank does not intend to prejudice the final determination of the parties' claims on the 
disputed areas
 
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If TBD, explain determinants of classification and give steps that will be taken to determine that 
EA category (mandatory): 
 
III.   SAFEGUARD PREPARATION PLAN 
 
A.  Target date for the Quality Enhancement Review (QER), at which time the PAD-stage ISDS 
would be prepared. 
 
As agreed/authorized at the PCN review meeting held on March 16, 2005, the task team has 
received a QER waiver, as permitted under the AFR guidelines on Repeater and Second Round 
HIV/AIDS projects. 
 
B.  For simple projects that will not require a QER, the target date for preparing the PAD-stage 
ISDS 
 
The target date for this task is April 12, 2005. 
 
C.  Time frame for launching and completing the safeguard-related studies that may be needed.  
The specific studies and their timing
1
should be specified in the PAD-stage ISDS. 
 
Only two safeguard-related studies are needed for this project, namely the HCWMP and the EA 
for insecticides. As noted above, both have already been prepared, approved and disseminated 
under the Eritrea Health Project and HAMSET I. They are now under implementation. HCWMP 
and EA will be re-disclosed under the HAMSET II in-country and through the InfoShop prior to 
project appraisal. 
 
The safeguard responsibility for this project was transferred to the sector unit (AFTH1) on March 
21, 2005. 
 
IV.  APPROVALS 
 
Signed and submitted by: 
 
Task Team Leader: 
Christopher D. Walker 
Date 3/21/05 
Approved by: 
 
Regional Safeguards Coordinator: 
Name: Thomas E. Walton 
Date 3/21/05 
Comments 
Sector Manager: 
Name: Dzingai Mutumbuka 
Date 3/21/05 
Comments 
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Reminder: The Bank's Disclosure Policy requires that safeguard-related documents be disclosed before appraisal (i) at the 
InfoShop and (ii) in-country, at publicly accessible locations and in a form and language that are accessible to potentially affected 
persons.
 
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