The World Bank Report No: ISR14148 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: 9 Status: ARCHIVED Archive Date: 24-Apr-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 27-Jan-2014 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 Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status Overview The project has satisfactorily achieved its PDOs as demonstrated by the following. The project supported the implementation of Cambodia’s Comprehensive AHI National Plan thereby by minimizing the threat posed to humans and the poultry sector through improved efficiency of reporting and response to disease outbreaks (both avian and human) as well as supporting implementation of appropriate preventive measures in poultry at the community and farm level. 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 Page 1 of 8 The World Bank Report No: ISR14148 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. Over 2000 trainees have been trained using a curriculum revised by the project (target 700). Some 180 cases of disease suspected of being avian influenza were reported by VAHW in 2013 and 96% were investigated within 24 hours (targets 200/annum and 90%). Samples from 100% of cases (target 100%) that was consistent with avian influenza after field investigations (82% of investigated cases, target 80%) were collected and transported to the National Animal Veterinary Research Institute (NaVRI) for testing for avian influenza and Public Disclosure Copy Newcastle disease. For the human health component the target was met for percentage of Provincial and District Rapid Response Teams trained; percentage of outbreak warning signals detected and investigated within 24 hours; and, percentage of suspected patients treated according to infection control and case management guidelines. The project helped Cambodia prepare for, control, and respond to human influenza pandemics 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) were 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 31-Mar-2014 30-Apr-2014 under the "Healthy Livestock, Healthy Village, Comments In all 30 villages more than Accomplished. Better Life" scheme. two measures were being implemented. 5885 households have benefited from this scheme. 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 31-Mar-2014 30-Apr-2014 Public Disclosure Copy Comments This indicator is irrelevant as all cases were in rural areas. Evidence of improved effectiveness of Text Value Low effectiveness of High efficiency reported High efficiency participating animal and human health services response preparation for in responding to the risk of avian influenza in identified risks. poultry and a human pandemic of influenza. Date 05-Aug-2008 31-Mar-2014 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 Page 2 of 8 The World Bank Report No: ISR14148 after implementationof humans by both animal and preventive measures (earlier human health response access to treatment would be teams. a useful way of measuring Public Disclosure Copy this for all suspect cases). 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 31-Mar-2014 30-Apr-2014 Comments 1443.00 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 4990.00 500.00 technology promoted by project – female Sub Type Date 05-Oct-2012 31-Mar-2014 30-Apr-2014 Breakdown Comments 4990 women have attended Exceeded the target training and they are raising poultry in their backyards following the training advice. Intermediate Results Indicators Public Disclosure Copy Page 3 of 8 The World Bank Report No: ISR14148 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 new VAHW were 750 trained, and 80% of trained using the revised curriculum and using revised curriculum. trained with 83% of trainees trainees providing disease Public Disclosure Copy percentage of these providing disease reports providing disease reports. reports. at commune meetings. Date 05-Aug-2008 31-Dec-2013 30-Apr-2014 Comments 2122 new VAHW were Exceeded the target trained, of which 83% provided disease reports. Refresher courses also provided to 3230 VAHW 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. 180 (180 in 2013, 141 in 200 VAHWs. 2012, 54 in 2011, 48 in 2010 and 42 in 2009) Date 05-Aug-2008 31-Dec-2013 30-Apr-2014 Comments 180 suspected cases were Exceeded the target reported during the project implementation period. 174 of suspected HPAI cases were investigated within 24hours. (i) Percentage of suspect cases investigated Text Value Low number of investigation 439 or 96% (24 hours) of all 90% (24 hours) and time from report to investigation. Sub Type with longer period. reported cases of project period. Breakdown Date 03-Aug-2012 31-Dec-2013 30-Apr-2014 Comments 70% in 2011 439 (96%) out of 465 Exceeded the target suspected HPAI cases were investigated within 24 hours. Public Disclosure Copy (ii) Percentage of investigated cases from Text Value Low number of sample 82% in 2013 80% which samples were collected. Sub Type collection. Breakdown Date 03-Aug-2012 31-Dec-2013 30-Apr-2014 Comments 60% in 2011 142 cases were typical of AI and had samples collected out of 174 investigated in 2013. Page 4 of 8 The World Bank Report No: ISR14148 (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 31-Dec-2013 30-Apr-2014 done. Breakdown Comments 95% in 2011 All samples collected were Public Disclosure Copy transported and tested in NaVRI. a.3. Target for training in emergency Text Value None trained Exceeded 100% of target 100% of target. vaccination met and government advised for Date 05-Aug-2008 31-Dec-2013 30-Apr-2014 findings. Comments An additional 90 vets were trained under Healthy Livestock Healthy Village, Better Life program. a.4. Percentage of farms or markets on which Text Value Limited number of farms 85% 70% recommended risk mitigation measures to provided recommendations. prevent AI is fully implemented. Date 05-Aug-2008 31-Mar-2014 30-Apr-2014 Comments 85% of farms provided with Exceeded the target recommendations had adopted the measures. 648 farmers and 211 traders trained in basic bio-security measures. 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. n/a Component moved to HSSP2. Public Disclosure Copy Semiannual reported by The ICR will be assessed only HSSP2 up to August 3, 2012. 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 Comments During the implementation followed by field investigation within 24 hours. period, most outbreak detections were made from indicators based and event based surveillance, sentinel Page 5 of 8 The World Bank Report No: ISR14148 surveillance and zoonosis surveillance. b.4. Percentage of sentinel sites that generate Text Value 30% 100% 70% ILI surveillance reports on time. Public Disclosure Copy Date 05-Aug-2008 30-Jun-2013 30-Jun-2013 Comments Exceeded. MOH extended the ILI sites from 6 to 10 and also conducted Severe Acute Respiratory Infection detection at 4 sites to complement the ILI 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 31-Dec-2013 30-Jun-2013 management guideline. Comments Exceeded original target This target to 100% in May based on self-reported data. 2011. As per the joint press release of MoH and WHO on 56th H5N1 cases). 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 31-Dec-2013 30-Jun-2013 Comments Achieved. A rapid containment plan was also Public Disclosure Copy developed but will no longer be tested through a desk-top exercise (consistent with the recent shift of global health emphasis and WHO technical advice). Page 6 of 8 The World Bank Report No: ISR14148 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 31-Dec-2013 30-Apr-2014 include inter-ministerial cooperation for Comments Achieved (in Year 5 instead of pandemic preparedness. Public Disclosure Copy 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 31-Dec-2013 30-Apr-2014 Comments Achieved. PPRRP developed and tested in targeted high risk provinces. c.3. NCDM emergency MIS and M&E systems Text Value Not designed, developed or Designed, developed and MIS and M&E systems designed, developed and established. established. established designed, developed and established. Date 05-Aug-2008 31-Mar-2014 30-Apr-2014 Comments Achieved. Emergency MIS and M&E systems designed, developed and established. Data on Financial Performance (as of 28-Mar-2014) 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 Closed 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 5.71 0.13 95.00 P100084 TF-56832 Effective USD 3.00 3.00 0.00 3.00 0.00 100.00 Public Disclosure Copy P100084 TF-58146 Closed USD 2.00 2.00 0.00 1.93 0.07 96.00 Disbursement Graph Page 7 of 8 The World Bank Report No: ISR14148 Public Disclosure Copy Key Decisions Regarding Implementation The client should consolidate project activities, and start drafting the government’s project completion report. The implementation completion mission is scheduled for June 2-13, 2014. The final implementation completion and results report will be delivered no later than October 31, 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