The World Bank Report No: ISR12758 Implementation Status & Results Cambodia Avian and Human Influenza Control and Preparedness Emergency Project (P100084) Public Disclosure Copy Operation Name: Avian and Human Influenza Control and Preparedness Project Stage: Implementation Seq.No: 8 Status: ARCHIVED Archive Date: 27-Jan-2014 Emergency Project (P100084) Country: Cambodia Approval FY: 2008 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Emergency Recovery Loan Implementing Agency(ies): Ministry of Agriculture Forestry and Fisheries, Ministry of Health, National Committee for Disaster Management Key Dates Board Approval Date 24-Mar-2008 Original Closing Date 31-Dec-2011 Planned Mid Term Review Date 14-Feb-2011 Last Archived ISR Date 26-Jun-2013 Effectiveness Date 06-Aug-2008 Revised Closing Date 30-Apr-2014 Actual Mid Term Review Date 14-Feb-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project's overall development objective is to support the implementation of the Cambodia Comprehensive AHI National Plan contributing to minimize the threat posed to humans and the poultry sector by AHI infection in Cambodia, and to prepare for, control, and respond if necessary to a human influenza pandemic. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Animal Health Systems 5.80 Human Health Systems 3.50 Inter-ministerial Cooperation for Pandemic Preparedness and Project Coordination 1.70 Overall Ratings Public Disclosure Copy Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Moderate Implementation Status Overview The project is making moderately satisfactory progress toward the objective of contributing to minimizing the threat of avian flu. The number of villages that have adopted two or more disease prevention measures recommended by the project has reached the end-of-project target of 30 villages, representing over 1440 households. Evidence of improved effectiveness of participating animal and human health services in responding to the risk of avian flu include improved speed of response time to suspected outbreaks in poultry and humans. Still, poultry disease reporting at the local level is insufficient and possible flu cases in humans are not being identified quickly enough locally to save lives, although there Page 1 of 8 The World Bank Report No: ISR12758 was some improvement in 2013 in the human case fatality rate. Over 2000 trainees have been trained using a curriculum revised by the project (indicator a.1). Some 130 cases of disease suspected of being avian influenza were reported in the first three quarters of 2013 and all of them were investigated within 24 hours. Samples from all cases that were consistent with avian influenza after field investigations (91% of cases investigated) were collected and transported to the National Animal Veterinary Research Institute (NaVRI) for testing for avian influenza and Newcastle disease. Public Disclosure Copy To prepare for, control and respond to a human influenza pandemic, a pandemic preparedness plan was developed and a desk-top exercise was implemented. To foster inter- ministerial cooperation for pandemic preparedness, terms of reference for the National Committee for Disaster management (NCDM) have been modified to include inter-ministerial cooperation. A Pandemic Preparedness, Response and Recovery Program (PPRRP) has been prepared and tested. A NCDM emergency management information system and monitoring and evaluation systems have been designed, developed and established, and staff trained appropriately. Locations No Location data has been entered Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Number of villages adopting two or more Text Value No measures adopted 30 30 disease preventive measures recommended Date 03-Aug-2012 20-Dec-2013 30-Apr-2014 under the "Healthy Livestock, Healthy Village, Comments In all of the 30 villages more Farmer interviews and Better Life" scheme. than two measures were observations. being implemented. No case of H5N1 HPAI in periurban Text Value Limited number of cases. Not applicable Downward trend with almost commercial poultry flocks once control and zero number of cases. preventive measures are implemented. Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 Comments This indicator is irrelevant as all cases were in rural areas and has been replaced. Evidence of improved effectiveness of Text Value Low effectiveness of Evidence of improvement are High efficiency participating animal and human health services response preparation for mentioned in the comments in responding to the risk of avian influenza in identified risks. below. Public Disclosure Copy poultry and a human pandemic of influenza. Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 Comments Through data on reporting of Improved effectiveness is and response to disease measured by the speed of outbreaks, field studies on response to reported farms and villages before and outbreaks in poultry and after implementationof humans by both animal and preventive measures (earlier human health response access to treatment would be teams. Unfortunately, poultry disease reporting at the local Page 2 of 8 The World Bank Report No: ISR12758 a useful way of measuring level is still not sufficient, and this for all suspect cases). that possible H5N1 cases in humans are not all being identified at the local level Public Disclosure Copy quickly enough to save lives. Technologies demonstrated in the project Number Value 0.00 1.00 1.00 areas (number) Date 05-Oct-2012 20-Dec-2013 30-Apr-2014 Comments A technology package on the proper cleaning of villages, vaccination of poultry according to plan, and cage rearing of chicks has been demonstrated in the project villages. Clients who have adopted an improved agr. Number Value 0.00 1443.00 900.00 technology promoted by the project Date 05-Oct-2012 20-Dec-2013 30-Apr-2014 Comments 1443 households have 30 villages with 30 adopted improved poultry households adopting the raising technologies promoted measure per village. by the project. Clients who adopted an improved agr. Number Value 0.00 1101.00 500.00 technology promoted by project – female Sub Type Date 05-Oct-2012 20-Dec-2013 30-Apr-2014 Breakdown Comments 1101 women have attended training on Good Practice on Backyard Chicken Raising and they are raising poultry in their backyards. Intermediate Results Indicators Public Disclosure Copy Page 3 of 8 The World Bank Report No: ISR12758 Indicator Name Core Unit of Measure Baseline Current End Target a.1. Animal Health: Number of new VAHWs Text Value # New VAHWs being trained 2,122 with 83% of trainees 750 trained, and 80% of trained using the revised curriculum and using revised curriculum. providing disease reports. trainees providing disease Public Disclosure Copy percentage of these providing disease reports reports. at commune meetings. Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 Comments Achieved. Refresher courses also provided to existing VAHWs on avian and human influenza. New training materials printed. Kits containing basic equipment for VAHWs provided to all those trained and certified. a.2. Number of reports of suspected HPAI from Text Value Low level of reporting. 130 suspected cases reported 200 VAHWs. in first 3 quarters of 2013. Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 Comments 130 cases in Q1 to Q3 2013. All reports of suspected HPAI from VAHWs were investigated within 24 hours. (i) Percentage of suspect cases investigated Text Value Low number of investigation 100% (24 hours) 90% (24 hours) and time from report to investigation. Sub Type with longer period. Breakdown Date 03-Aug-2012 20-Dec-2013 30-Apr-2014 Comments 70% in 2011 Reports of suspected HPAI from VAHWs that were suspicious of AI. (ii) Percentage of investigated cases from Text Value Low number of sample 91% 80% which samples were collected. Sub Type collection. Breakdown Date 03-Aug-2012 20-Dec-2013 30-Apr-2014 Comments 60% in 2011 Sample was collected from 91% of 130 investigated Public Disclosure Copy cases in which suspicion of HPAI was high. (iii) Percentage of cases from which testing for Text Value Low testing on both diseases. 100% 100% Avian Influenza and Newcastle Disease are Sub Type Date 03-Aug-2012 20-Dec-2013 30-Apr-2014 done. Breakdown Comments 95% in 2011 All sample collected and transported to NaVRI for testing of H5N1 and ND. Page 4 of 8 The World Bank Report No: ISR12758 a.3. Target for training in emergency Text Value None trained Exceeded 100% 100% of target. vaccination met and government advised for Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 findings. Comments An additional 90 vets were Public Disclosure Copy trained under Healthy Livestock Healthy Village, Better Life program. a.4. Percentage of farms or markets on which Text Value Limited number of farms 84% 70% recommended risk mitigation measures to provided recommendations. prevent AI is fully implemented. Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 Comments 84% of farms had adopted the measures. Over 600 farmers and 200 traders trained in basic bio-security measures. Bio-security booklets printed. b.1. Human Health: Percentage of provincial Text Value 20% 100% 80% and district rapid response teams trained. Date 05-Aug-2008 30-Jun-2013 30-Jun-2013 Comments Exceeded as of this date. Refresher training courses also provided to all members of the Rapid Response Teams. b.2. Percentage of VHV trained in AI Text Value 10% 15% 70% monitoring, reporting and control measures. Date 05-Aug-2008 03-Aug-2012 30-Jun-2013 Comments HSSP2 program database. Dropped. This indicator was Component moved to HSSP2. Semiannual reported by dropped after the July/August The ICR will be assess up to HSSP2 2012. Mission determined that August 3, 2012. the target had been reached prior to the start of the project. b.3. Percentage of warning signals detection Text Value No outbreak 100% 70% of cluster of patients with clinical symptoms of Date 05-Aug-2008 30-Jun-2013 30-Jun-2013 influenza, closely related in time and place Public Disclosure Copy Comments Most of outbreak detections followed by field investigation within 24 hours. have been made from indicator based and event based surveillance, sentinel surveillance and zoonosis surveillance. b.4. Percentage of sentinel sites that generate Text Value 30% 100% 70% ILI surveillance reports on time. Date 05-Aug-2008 30-Jun-2013 30-Jun-2013 Comments Exceeded. MOH extended the ILI sites from 6 to 10 and Page 5 of 8 The World Bank Report No: ISR12758 also conducted Severe Acute Respiratory Infection detection at 4 sites to complement the ILI Public Disclosure Copy surveillance to get the most accurate data for seasonal influenza and new strains of pandemic influenza. b.5. Percent of targeted hospital staff trained Text Value 20% 80% 80% for infection control and case management. Date 05-Aug-2008 30-Jun-2013 30-Jun-2013 Comments HSSP2 program database. Achieved. Component moved to HSSP2, Semi-annual reported by but the ICR will be measured HSSP2 in 2012 till June 30, 2013. b.6. Percentage of suspected patients treated Text Value No outbreak 100% 70% according to infection control and case Date 05-Aug-2008 30-Jun-2013 30-Jun-2013 management guideline. Comments Exceeded original target This target to 100% in May (target was revised to 100% 2011. in May 2011, and this target was also achieved). A special technical survey would be needed to verify this self- reported data. b.7. Pandemic preparedness plan developed Text Value 0 Plan developed and Plan designed and tested. and desk-top exercise implemented. implemented. Date 05-Aug-2008 30-Jun-2013 30-Jun-2013 Comments Achieved. A rapid containment plan was also developed but will no longer be tested through a desk-top exercise (consistent with the recent shift of global health emphasis and WHO technical Public Disclosure Copy advice). c.1. Inter-ministerial Cooperation for Pandemic Text Value Not yet modified. TOR Modified TOR Modified. Preparedness: NCDM's TOR modified to Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 include inter-ministerial cooperation for Comments Achieved (in Year 5 instead of pandemic preparedness. Year 1 of the project). c.2. PPRRP prepared and tested. Text Value Not developed. Developed and Tested Developed and tested. Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 Comments Achieved. PPRRP developed and tested in targeted three Page 6 of 8 The World Bank Report No: ISR12758 high risk provinces (in Year 4 instead of Year 2 of the project). c.3. NCDM emergency MIS and M&E systems Text Value Not designed, developed or Designed, developed and MIS and M&E systems Public Disclosure Copy designed, developed and established. established. established designed, developed and established. Date 05-Aug-2008 20-Dec-2013 30-Apr-2014 Comments Achieved. Emergency MIS and M&E systems designed, developed and established (in Year 4 instead of Year 2 of the project). Data on Financial Performance (as of 21-Oct-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P100084 IDA-H3610 Effective 24-Mar-2008 08-May-2008 06-Aug-2008 31-Dec-2011 30-Apr-2014 P100084 TF-56832 Effective 08-May-2008 08-May-2008 08-May-2008 31-Dec-2011 30-Apr-2014 P100084 TF-58146 Effective 08-May-2008 08-May-2008 06-Aug-2008 31-Jul-2009 31-Mar-2014 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P100084 IDA-H3610 Effective USD 6.00 6.00 0.00 5.77 0.07 96.00 P100084 TF-56832 Effective USD 3.00 3.00 0.00 2.94 0.06 98.00 P100084 TF-58146 Effective USD 2.00 2.00 0.00 1.93 0.07 96.00 Disbursement Graph Public Disclosure Copy Page 7 of 8 The World Bank Report No: ISR12758 Public Disclosure Copy Key Decisions Regarding Implementation In the final four months of implementation the client should continue to consolidate activities, work to improve disease reporting and begin preparation of the government project completion report. The next mission and back to back completion mission is tentatively scheduled for June, 2014. Restructuring History Level two Approved on 27-Apr-2011, Level two Approved on 18-Oct-2012, Level 2 RVP Decision on 26-Jun-2013 Related Projects There are no related projects. Public Disclosure Copy Page 8 of 8