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PROJECT INFORMATION DOCUMENT (PID)
APPRAISAL STAGE
Report No.: AB6209
Project Name
Region
Sector
Project ID
Borrower(s)
Implementing Agency
Environment Category
Date PID Prepared
Date of Appraisal
Authorization
Date of Board Approval
VN-VAHIP additional financing
EAST ASIA AND PACIFIC
Health (50%);General agriculture, fishing and forestry sector
(20%);Solid waste management (10%);General public
administration sector (10%);Other social services (10%)
P123783
THE SOCIALIST REPUBLIC OF VIETNAM
Ministry of Health
138A Giang Vo Street
Vietnam
Tel: (84-4) 6273-2273 Fax: (84-4) 3846-4051
[ ] A [X] B [ ] C [ ] FI [ ] TBD (to be determined)
January 9, 2011
January 20, 2011
June 30, 2011
1. Country and Sector Background
The Vietnam Avian and Human Influenza Control and Preparedness Project is co-financed by an
IDA Credit (SDR 13.5 million, US$20 million equivalent), an Avian and Human Influenza
Facility Grant (US$10 million), a Japan PHRD Grant (US$5 million), and the Vietnam
Government (US$3 million). The Credit and Grant were approved on March 13, 2007 and
became effective on August 23, 2007. The Project was restructured once in June 2010 to reallocate funds among the Disbursement Categories. The original Project’s Closing Date was
December 31, 2010. A second extension of six months from June 30, 2011 to December 31,
2011 was approved by the Bank management recently.
The Project Development Objective (PDO) is to increase the effectiveness of Government
services in reducing the health risk to poultry and humans from avian influenza in eleven high
priority provinces and thus contribute to addressing highly pathogenic avian influenza (HPAI) at
the national level by (i) controlling the disease at source in domestic poultry; (ii) early detection
and response to poultry and human cases; and (iii) preparing for the medical consequences of a
human pandemic. This is in line with and supports the implementation of Vietnam’s plans for the
medium to long-term control of avian and human influenza as outlined in the Integrated National
Operational Program for the Avian and Human Influenza 2006 – 2010 (The Green Book), and is
fully consistent with the approach envisaged under the Global Program for Avian Influenza and
Human Pandemic Preparedness and Response (GPAI).
The Project is being implemented jointly by the Ministry of Agriculture and Rural Development
(MARD) and the Ministry of Health (MOH), with MARD as the lead ministry for the overall
management of the Project, MARD for Component A activities and MOH for Component B
activities. Out of a total cost of US$38 million, US$21 million is under the management of
MARD and US$17 million is under the management of MOH. It consists of three components:
(a) HPAI Control and Eradication in the Agricultural Sector; (b) Influenza Prevention and
Pandemic Preparedness in the Health Sector; and (c) Integration and Operational Program Plan
(OPI) Coordination, Results Monitoring and Evaluation, and Project Management. Component
A, which is for animal health and managed by MARD, covers 11 selected Provinces. Component
B, which is for human health and managed by MOH, covers 8 out of the same 11 Provinces.
Component C is jointly managed by MARD and MOH.
The Project is being implemented jointly by MARD and MOH, with MARD as the lead ministry
for the overall management of the Project and for Component A activities and MOH managing
Component B activities. It consists of three components: (a) HPAI Control and Eradication in
the Agricultural Sector; (b) Influenza Prevention and Pandemic Preparedness in the Health
Sector; and (c) Integration and Operational Program Plan (OPI) Coordination, Results
Monitoring and Evaluation (M&E), and Project Management. Component A is managed by
MARD and covers 11 selected Provinces. Component B is managed by MOH and covers 8 out
of the same 11 Provinces. Component C is jointly managed by MARD and MOH.
2. Objectives
The Project Development Objective is to assist the Recipient to increase the effectiveness of
public services in reducing the health risk to poultry and to humans from avian influenza in
selected provinces, through measures to control the disease at source in domestic poultry, to
detect early and respond to human cases of infections, and to prepare for the medical
consequences of a potential human pandemic.
3. Rationale for Bank Involvement
The VAHIP is due to close on December 31, 2011. However, the threat from emerging infectious
diseases (EIDs), including influenza A (H5N1), has not been adequately reduced. The on-going
threat justifies additional investment into measures to reduce the risk posed by poultry and to
improve the capacity of health services and pandemic preparedness. A majority of high impact
infectious diseases that have recently affected humans have arisen at the animal-humanenvironment interface and significantly impact animal and human health, livelihoods and
development. More specifically, as predicted at the time VAHIP was prepared, HPAI viruses of
the H5N1 subtype are still entrenched in Vietnam, despite the improvements made. Although
the frequency and scale of H5N1 outbreaks has been reduced, they could flare up if close
attention to control and prevention is not maintained. The recent human influenza A (H1N1)
pandemic demonstrated the need for pandemic preparedness. By June 30, 2011, the original
VAHIP would have invested in strengthening of animal health systems in 135 Districts in 11
Provinces, and strengthening human health systems in 28 overlapping Districts in 8 of the 11
Provinces. The proposed AF is consistent with the draft National Strategic Plan for Avian and
Human Influenza for 2011- 2015. An extension of VAHIP will support the updated National
Strategic Plan by strengthening the human health system (Component B) in a larger number of
Districts while keeping the same "one-health" approach that underpinned the original VAHIP.
The AF also recognizes the importance of some key activities under Component A (HPAI
Control and Eradication in the Agricultural Sector) which will receive continued support in order
to consolidate and scale up the project impact on the ground. On the basis of the foregoing, the
Government has requested AF from the Bank to narrow the financing gap in order to achieve
these goals.
Description
The AF will keep the original components. Component A – HPAI Control and Eradication in the
Agricultural Sector ($2 million) will be managed by MARD Department of Animal Health to
supplement government support to the program. Component B Influenza Prevention and
Pandemic Preparedness in the Health Sector and Component C Project Management (total $18
million) will be managed by the CPMU of MOH.
Component A – HPAI Control and Eradication in the Agricultural Sector
Sub-component A1: Strengthening of Veterinary Services: Under the existing VAHIP, good
progress has been made in: (a) improving the quality management of the nine national and
regional veterinary laboratories to ensure that they have the necessary capacity and capability to
perform all necessary testing for avian influenza to international quality standards and in
improving their biosafety facilities, and (b) improving the commune-based early warning and
disease reporting in 90 districts in 11 project provinces through the provision of training for
commune animal health workers (CAHW) and supporting monthly meetings between district
veterinary stations and CAHW. To consolidate the impact on the ground, the AF will support the
operation of seven regional labs and two central labs, and costs associated with commune-based
early warning and disease reporting e.g. training, meetings between DVO and CAHWs.
Sub-component A2: Enhanced Disease control. Under the existing VAHIP, good progress has
been made in (a) upgrading Ha Vi live bird market in Hanoi and some selected live bird markets
and slaughterhouses in project provinces, (b) constructing a poultry destruction and disposal site
in Lang Son for smuggled poultry; and (c) developing bio security standards for smallholder- and
commercial farms. The achievements under VAHIP have provided a foundation for future
control and prevention of avian influenza along the production and market chains. The AF will
include continued support to strengthening operations of Ha Vi live bird market in Hanoi and
culling and disposal site in Lang Son for smuggled poultry for another 2 years (a testing period)
to ensure smooth operations of the facilities as they have just been completed.
Sub-component A3: Disease surveillance and epidemiological investigations: Under the
existing VAHIP, good progress has been made in (a) introducing a market-based and risk-based
surveillance approach; and (b) improving the quality of surveillance activities, including
sampling, laboratory analysis, data analysis, and reporting. As HPAI viruses are continuing to
circulate in the natural environment and poultry flocks, the AF will support risk-based disease
surveillance and epidemiological investigations at local levels.
Sub-component A5: Emergency Outbreak Containment Plan: The current VAHIP has
provided disinfectants, supplies, and basic equipment for effective outbreak containment in- and
outside the 11 project provinces. Provincial and district rapid response teams have been
established in all project provinces. Joint simulation exercises prove to be very useful for
improving coordination between animal health sector and human health sector in responding to
epidemics. These also helped improve responding capacity of commune, district, and provincial
levels to respond and control other emerging diseases such as H1N1, malaria, dengue fever, etc.
To consolidate experience and lessons, and deepen the impacts, the AF will finance stockpiles of
emergency supplies and simulation exercises.
Component B - Influenza Prevention and Pandemic Preparedness in the Health Sector
Sub-component B1: Improving Surveillance and Response System: Evidence in Vietnam
suggests that the weakest part of the response systems tend to be at the grass-root level, and
cross-sectoral collaboration at the district and commune levels is one of the critical factors to
strengthen the response systems. Under the existing VAHIP, good progress has been made in (a)
developing and piloting an improved surveillance system in Project Provinces; (b) establishing
and operating rapid response mechanisms; and (c) improving surveillance capacity. The AF will
focus on filling the gaps in human health sector in these areas while supporting the collaboration
of animal health and human health in surveillance and joint simulation. The AF will support
improvement of the quality of disease surveillance and expand the coverage of the internet-based
(infectious) disease reporting system in 54 additional project districts in the eleven Project
provinces. It will also support multi disciplinary Rapid Response Teams (RRTs) pilots in a few
selected districts to improve the linkage between the surveillance systems in animal and human
health sectors.
Sub-component B2: Improving Technical Quality and Efficiency of Curative Care
Preparedness: Under the existing VAHIP, good progress has been made in (a) reviewing and
updating technical guidelines and training materials on influenza clinical management (diagnosis
and treatment), infection control, management of patients with respiratory failure, and operation
of mechanical ventilation systems; and (b) improving capacities to control infection in hospitals
at central, Provincial and District levels. This component will scale up the pilot activities under
(a) and (b) in 54 additional project districts. It will also support development and implementation
of health sector pandemic preparedness plans at District level, piloting establishment of human
influenza (HI) surveillance in two to three Provinces, and upgrading isolation wards in three
Provinces. The new activities are aimed at improving hospital infection control and health sector
pandemic preparedness at District level.
Sub-component B3: Strengthening BCC and Risk Communication for Emerging Infectious
Diseases: Under the existing VAHIP, good progress has been made in (a) training for Provincial,
District, commune and village health workers in BBC skills and provision of equipment for
Provincial and District communications units; and (b) conducting community awareness,
information, education and communication campaigns. The AF will scale up training on BCC
and other campaigns at the community level in 54 additional districts. In addition, it will finance
the development and piloting of risk communications models through: (i) developing national
Risk Communication Plan (RCP); (ii) developing a toolkit for risk communication on EIDs; (iii)
training of spokespersons within health sector; and (iv) impact evaluation skills for preventive
medicine staff.
Sub-component B4: Strengthening the Preventive Health System at the Local Level:
Strengthening the capacity of District health systems would improve the country’s overall
capacity in early detection and early response to HAPI or similar infectious diseases.
Identification of a significant number of avian influenza outbreaks in Vietnam was promoted by
identification and reporting of human infection of HPAI (H5N1). Such a strategy is particularly
important when the country is running vaccination campaigns that may prevent large scale of
deaths among domestic poultry. Investments under VAHIP in the 28 pilot Districts have
improved the District preventive medicine system in selected Provinces and demonstrated good
impact on helping control H5N1, H1N1 and other emerging epidemic diseases. In the AF, the
pilot model developed under VAHIP will be replicated in 54 additional Districts in the eleven
Project Provinces to improve the emergency response capacity at District preventive medicine
centers, including provision of equipment and training of staff.
Component 3 - Coordination, Monitoring and Evaluation, and Project Management: This
component will support Project management, monitoring and evaluation, and coordination
between agriculture sector, human health sector and other concerned agencies implementing the
Integrated and Operational Program Plan (OPI). At the central level, MOH will be the lead
Ministry for the overall management and implementation of AF project. The Central Project
Management Unit (CPMU) in MARD will be replaced by the Department of Animal Health
(DAH) as implementer of AF funded activities under Component A. A Designated Account
(DA) will be opened at DAH. A Project Team including a Director, a Sr. Technical Expert, and
an Accountant will be appointed to manage and implement project activities. This team will also
provide technical guidance to project provinces through provincial animal health specialists
seconded to PPMUs to implement animal health related activities and coordinate with human
health sector. Results Monitoring and Evaluation, and incremental operating costs of DAH for
the AF implementation will be covered by the AF. The CPMU in MOH will be responsible for
the implementation of human health related activities and coordination with DAH in MARD. It
will manage the Project Designated Account in the CPMU, procurement of goods and consulting
services, Project monitoring and evaluation, Project reporting, and Project audit. At the
provincial level, the PPMUs under the on-going project will continue to implement the AF
project activities. The directors of the PPMUs will be directors of the Department of Health in
respective provinces. It will consist of project coordinator, procurement officer, accountant, and
project assistants. One staff from the agricultural sector will be seconded to the PPMU. This
arrangement is believed to be appropriate for better inter-sectoral cooperation. The AF will
finance the costs associated with project implementation and management including coordination
and M&E.
Financing
Source:
BORROWER/RECIPIENT
International Development Association (IDA)
AHI Facility (Grant)
Total
($m.)
2
10
13
25
Implementation
The project management structure at central and provincial levels will also remain unchanged.
The central Project Coordination Units (PCUs) of the Ministry of Agriculture and Rural
Development (MARD) and the Ministry of Health (MOH) will be responsible for the
implementation of the activities in animal health sector and human health sector under the AF
project respectively. The Ministry of Health will be the lead agency for implementation of the
AF project, instead of the Ministry of Agriculture and Rural Development. At the provincial
level, the joint Provincial Project Management Units (PPMUs) in 11 project provinces will be
responsible for implementation of the AF project. Provincial Department of Health will be the
lead agency for implementation of the AF project in respective provinces.
Safeguard Policies
Experiences from the Project show that the AF, with a continuation of existing activities, is not
expected to have any large-scale, significant and/or irreversible environmental and social impacts
as it is focused largely on capacity building and strengthening readiness for dealing with
outbreaks of avian influenza and preventing or reducing possible human infections by
strengthening emergency preparedness and response. In addition, the AF Project continues to
incorporate in its design other beneficial measures such as upgrading the regional/central
laboratories, improving bio-security in farms and hygiene in live bird markets and strengthening
the culling and disposal sites. With respect to the health sector, similar activities in additional
districts will continue to be supported, as well as equipment, and training to improve the
capacity, preparedness and readiness to respond, along with strengthening the curative care
systems in the Provinces and Districts. These will have positive impacts on human health and
the environment. Since the activities remain largely unchanged, the AF is still assigned an
Environmental Category of B.
Among the Bank’s safeguards policies, only OP 4.01 (Environmental Assessment) and OP 4.10
(Indigenous People) are triggered. The Bank’s policy on Pest Management is not triggered since
the Project: (a) will not procure any pesticides; and (b) will not promote an increase in the use of
pesticides increase. However, the chemicals to be used for the disinfection of farm
facilities/personal protection equipment will be evaluated on a case-by-case basis for conformity
with OP 4.09 for Pest Management. Similar to the parent Project, the AF will not trigger the
policies of OP 4.04, OP 4. 36, OP 4.11 on Natural Habitat, Forest and Physical Cultural
Resources respectively given that no activities affecting the natural habitat, forest and cultural
resources are proposed.
Contact point
Contact: Lingzhi Xu
Title: Senior Operations Officer
Tel: (202) 473-2803
Fax:
Email: [email protected]
For more information contact:
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