Page 1 INTEGRATED SAFEGUARDS DATA SHEET CONCEPT STAGE Report No.: AC4122 Date ISDS Prepared/Updated: 01/08/2009 I. BASIC INFORMATION A. Basic Project Data Country: Lesotho Project ID: P107375 Project Name: Lesotho HIV and AIDS Technical Assistance Project Task Team Leader: Feng Zhao Estimated Appraisal Date: February 9, 2009 Estimated Board Date: April 21, 2009 Managing Unit: AFTH1 Lending Instrument: Technical Assistance Loan Sector: Health (60%);Other social services (23%);Sub-national government administration (10%);Central government administration (7%) Theme: HIV/AIDS (P);Health system performance (P);Participation and civic engagement (P);Decentralization (S);Other accountability/anti-corruption (S) IBRD Amount (US$m.): 0.00 IDA Amount (US$m.): 5.00 GEF Amount (US$m.): 0.00 PCF Amount (US$m.): 0.00 Other financing amounts by source: BORROWER/RECIPIENT 0.00 0.00 B. Project Objectives [from section 2 of PCN] The project aims at building capacity of government agencies and civil society organizations at both the national and local level to support: (i) the implementation of the National HIV and AIDS Strategic Plan (NSP); and (ii) the scaling up of the coverage of effective interventions in an effort to contain and reverse the epidemic. C. Project Description [from section 3 of PCN] Component 1: Improved institutional capacity and organizational efficiency to implement the multisectoral response. This component aims at supporting the National AIDS Commission (NAC), Ministry of Health & Social Welfare (MOHSW), Ministry of Finance and Development Planning (MOFDP), other line ministries, and civil society organizations (CSOs) in their roles in implementing the NSP with a focus on effective preventive and behavior interventions. Specifically, the component will: (i) provide financial and technical support to the HIV mainstreaming in line ministries and relevant sectors; (ii) strengthen NAC’s management and coordination capacity to coordinate the implementation of the NSP; (iii) develop financial Page 2 management skills in the CSOs so that they can mobilize and use resources efficiently; (iv) strengthen the country’s HIV and AIDS research capacity to generate timely and accurate evidence to guide the national response; and (v) support the development of the HIV resource tracking system and assist HIV expenditure analysis. Component 2: Improved capacity to scale up the health sector response. This component mainly supports implementers in the health sector (both MOHSW and NGOs) to build capacity for delivering essential and effective HIV/AIDS and Tuberculosis (TB) services. Specifically, it will: (i) support the scaling up of the existing programs proven to be effective, such as Prevention of Mother-to-Child Transmission (PMTCT), Know-Your-Status (KYS), HIV testing and counseling, etc.; (ii) strengthen the health information system and research capacity; (iii) assist in updating the outdated Public Health Order (1972) to provide an over-arching legal framework for the provision of health services; and (iv) strengthen the national TB programs and support the integration of TB and HIV programs. Component 3: Strengthened systems and coordinated efforts to implement the decentralized local response. This component intends to build capacity and provide technical assistance to implementers (including both governmental and civil society implementers) at the district and community levels to implement HIV/AIDS activities. As the current local response is vertically- organized and fragmented, this component will be the most challenging component among the three components. Specifically, it will: (i) build the skills and capacity of district and community council structures to implement the Essential HIV and AIDS Service Package (ESP); (ii) strengthen the operational capacity of the local civil society organizations to provide HIV and TB services at the community level; and (iii) enhance the management capacity of the District AIDS Committee and the proposed Community AIDS Committee and use them as the gateway to harmonize HIV and TB activities at the local level. D. Project location (if known) National, district and community levels. E. Borrower’s Institutional Capacity for Safeguard Policies [from PCN] A National Health Care Waste Management Plan has been under implementation since 2005. The Environmental Health Unit of the Ministry of Health and Social Welfare (MOHSW) provides technical leadership in the implementation of the plan. Hospital and national health care waste management (HCWM) committees have been established. The national HCWM committee meets quarterly in order to advise the MOHSW on HCWM issues, assist in the monitoring and evaluation of HCWM activities, and oversee progress in the operation of Hospital HCWM committees. Support for medical waste management activities and capacity building is being provided under the current Health Sector Reform Project (HSRP) Phase II. F. Environmental and Social Safeguards Specialists Ms Lungiswa Thandiwe Gxaba (AFTEN) Page 3 II. SAFEGUARD POLICIES THAT MIGHT APPLY Safeguard Policies Triggered Yes No TBD Environmental Assessment (OP/BP 4.01) X The proposed project will provide technical assistance and capacity building and will not directly support implementation. However, since the project aims to improve access to health services, an increase in the amount of medical waste generated by health facilities is anticipated. As a result, OP/BP 4.01 is triggered and requires the preparation of a Medical Waste Management Plan. Natural Habitats (OP/BP 4.04) X Forests (OP/BP 4.36) X Pest Management (OP 4.09) X Physical Cultural Resources (OP/BP 4.11) X Indigenous Peoples (OP/BP 4.10) X Involuntary Resettlement (OP/BP 4.12) X Safety of Dams (OP/BP 4.37) X Projects on International Waterways (OP/BP 7.50) X Projects in Disputed Areas (OP/BP 7.60) X Environmental Category: B - Partial Assessment III. SAFEGUARD PREPARATION PLAN A. Target date for the Quality Enhancement Review (QER), at which time the PAD-stage ISDS would be prepared: N/A B. For simple projects that will not require a QER, the target date for preparing the PAD-stage ISDS: 01/15/2009 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. The medical waste management plan will be disclosed prior to Appraisal; the tentative date for disclosure is January 30, 2009. The SMU has agreed to accept transfer of the safeguard responsibilities. 1 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. Page 4 IV. APPROVALS Signed and submitted by: Task Team Leader: Mr Feng Zhao 01/08/2009 Approved by: Regional Safeguards Coordinator: Mr Warren Waters 01/08/2009 Comments: Sector Manager: Mr Christopher J. Thomas 01/08/2009 Comments: