Indonesia: Emergency Response to COVID-19 Program - Additional Financing

OBJECTIVE

To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Indonesia (this is the same as the parent program).

DESCRIPTION

This additional financing seeks to support the costs of expanding activities of the Emergency Response to COVID-19 Program (parent program), under the COVID-19 Crisis Recovery Facility, as well as enable safe and effective deployment of COVID-19 vaccines. Following the parent program, the additional financing is to be co-financed with the World Bank (WB) and designed in accordance with the WB’s Policy on Program for Results (PforR).

The additional financing expands the three results areas under the parent program and focuses on the following:

• Results Area 1 - Improve hospital and health system readiness for COVID-19 response and vaccination and maintaining essential non-COVID-19 health services (US$245 million). The additional financing will expand service capacity to prevent, detect and respond to COVID-19; ensure preparedness for vaccine deployment; develop and implement infection control and safety measures in health care settings; support human resource capacity and skills at all levels for COVID-19 response including vaccination deployment and preservation of capacity for essential non-COVID-19 health services; and sustain essential non-COVID-19 services for women and vulnerable population groups.
• Results Area 2 - Strengthen public health laboratory, surveillance and supply chain capacity (US$136 million). The additional financing will strengthen COVID-19 testing capacity across the country; promote the development and implementation of laboratory quality assurance mechanisms; support strengthening of surveillance systems, including genomic surveillance; support implementation of a pharmacovigilance system for COVID-19 vaccines; and ensure quality assurance monitoring of cold chain, including storage and handling of the vaccines at the national and subnational level.
• Results Area 3 - Enable communication and coordination for emergency response and vaccine delivery (US$ 119 million). The additional financing will support multi-sectoral coordination and management, including strengthening of vaccine logistics and information management systems; improve efficiency and stewardship of the national and sub-national response, including institutional frameworks and plans for the prioritization and deployment of vaccines in an equitable manner; and expand strategic communication and tailored behavior change efforts at all levels including encouragement of vaccine acceptance and outreach to remote population.

ENVIRONMENTAL AND SOCIAL INFORMATION

This additional financing will be co-financed with the WB as lead co-financier, and its environmental and social (ES) risks and impacts have been assessed in accordance with the WB’s Policy on Program-for-Results Financing (PforR Policy). AIIB’s Environmental and Social Policy (ESP) was designed to apply to investment projects and has no provisions for its application to PforR operations. Therefore, as permitted by a decision of the AIIB’s Board of Directors, the WB’s PforR Policy will apply to this operation in lieu of AIIB’s ESP.

The WB has categorized the ES risks under this additional financing as “Substantial” (which is similar to Category B if AIIB’s ESP were applicable). As required under the WB’s PforR Policy, the program excludes activities that are likely to have significant adverse ES impacts that are sensitive, irreversible, or unprecedented (similar to Category A if AIIB’s ESP were applicable).

An Environmental and Social Systems Assessment (ESSA), which involves assessing the country’s systems for managing ES risks and impacts of the PforR, was conducted by the WB for the parent project in accordance with its PforR Policy. The ESSA is complemented by a Program Action Plan (PAP) at the operational level. The ESSA and PAP was updated for the current financing.

The anticipated overall environmental and social risks, as in the parent project remain substantial. There is a likelihood the project would lead to some E&S consequences, but the risks are predictable and can be managed through risk management measures. Risk areas of concern considered under the additional financing are aligned with the Vaccine Introduction Readiness Assessment Tool/ Vaccine Readiness Assessment Framework (VIRAT/VRAF) as recommended by the World Bank, WHO, and UNICEF. These include a) population targeting, social inclusion and equity; b) public health communication and stakeholder engagement; c) individual rights to vaccination and consent, particularly amongst population groups who are skeptical and/or refuse vaccination; d) handling of grievances, including pharmacovigilance measures to monitor adverse events; e) individual data privacy; e) environmental pollution and community health and safety issue related to the handling, transportation and disposal of COVID-19 vaccine wastes (i.e. syringes, vials, PPEs, etc.); f) vaccine safety related to end-to-end supply chain and logistics management systems for effective vaccine storage, handling, and stock management – including rigorous cold chain control; g) Occupational Health and Safety (OHS). Proposed environmental and social action plans under the additional financing are aimed to enhance existing systems and measures to correspond to these areas of concern. The focus will be on enhancing the capacity of MOH as the implementing agency to provide technical guidance, oversight, and capacity building for managing environmental and social risks.

The parent project incorporates a comprehensive project wide GRM which is functional and in compliance with World Bank requirements. The GRM enable a broad range of stakeholder to channel concerns, questions and complaints to the various implementation agencies and COVID-19 Call centers. The call centers are supported with call-free numbers and have been publicly disclosed throughout the country in the broadcast, digital and print media.

An Addendum to the Environmental and Social System Assessment (ESSA) has been prepared and disclosed in English and virtual consultations have been held with MOH and other stakeholders on the assessment and environmental and social action plans. Covid travel restrictions have limited these to virtual consultations. The final document includes all agreed actions and relevant time-bound achievement indicators.