Document 6523991
Transcription
Document 6523991
Document of The World Bank FOR OFFICIAL USE ONLY Report No: T7676 TECHNICAL ANNEX ON A PROPOSED CREDIT IN THE AMOUNT OF SDR 3.3 MILLION (USD 5.0 MILLION EQUIVALENT) TO BOSNIA AND HERZEGOVINA FOR AN AVIAN INFLUENZA PREPAREDNESS PROJECT UNDER THE G OBAL PROGRAM FOR AVIAN INFLUENZA AND HUMAN PA JDEh C PREPAREDNESS AND RESPONSE (GPAI) FOR ELIGIBLE COUNTRIES UNDER THE HORIZONTAL APL May 29,2007 This document has a restricted distribution and may be used by recipients only in the performance o f their official duties. I t s contents may not otherwise be disclosed without World Bank authorization. CURRENCY EQUIVALENTS (Exchange Rate Effective, May 29,2007) Currency Unit = Konvertible Mark KM 1.46 = US$l US$1.51 = S D R l FISCAL YEAR January 1 - December 3 1 ABBREVIATIONS AND ACRONYMS AI AIPP APL BiH CQ CF CP EA EC EMP ERA ERL FA0 FBiH GDP GPAI H5N1 ICB ILI MAWMF MCA MoFTER MoE MoH M&E MoF NCB NGO National Competitive Bidding Non Governmental organization OIE PFD PHI PPE World Organization for Animal Health Program Framework Document Public Health Institute Personal Protective Equipment Contingency Plan Environmental Assessment European Commission Environmental Management Plan Emergency Recovery Assistance POM QCBS Project Operational Manual Quality and Cost Based Selection Emergency Recovery Loan Food and Agricultural Organization Federation o f Bosnia and Herzegovina Gross Domestic Product Global Program for Avian Influenza and Human Pandemic Preparedness and Response RS State svo Republika Srpska Bosnia and Herzegovina State Veterinary Office TF UNDP Trust Fund United Nations Development Program USAID WG U S Agency for International Development Inter-sectoral working group WP WB Work Program World Bank WHO World Health Organization Avian Influenza Avian Influenza Preparedness Project Adaptable Program Loan Bosnia and Herzegovina Selection based on consultants’ qualifications Counterpart Financing Influenza A virus o f H5N1 type International Competitive Bidding Influenza-like illness Ministry o f Agriculture, Water Management and Forestry Ministry o f Civil Affairs Ministry o f Foreign Trade and Economic Relations Ministry o f Environment Ministry o f Health Monitoring and Evaluation Ministry o f Finance Vice President: Country ManagerDirector: Sector Manager: Task Team Leader: Shigeo Katsu Orsalia Kalantzopoulos Marjory-Anne Bromhead David A. Bontemoo B O S N I A AND HERZEGOVINA Avian Influenza Preparedness Project FOR OFFICIAL USE ONLY CONTENTS Page . A ................................................................................. I. Countly and Sector Background and Global. Regional and National Dimensions ...................................... ii 2. Rationale for Bank involvement .................................................................................................................... 12 . ............................................................................................................................ 13 1. Lending Instrument ....................................................................................................................................... 13 2. Project Development Objectives ..... 3. Project Components...................................................................................................................................... 14 4. Lessons learned and rejected in the project design ..................................................................................... 17 B C D ............11 STRATEGIC CONTEXT AND RATIONALE PROJECT DESCRIPTION . ................ ............ ..................14 ..................................................................................................................................... 18 1. Partnership arrangements ............................................................................................................................ 18 2. Institutional and implementation arrangements .......................................... 19 3. Monitoring and evaluation of outcornes/results............................................................................................ 20 4. Sustainability........ 5. Critical risks andpossible controversial aspects ...................................................... 6. Credit Conditions .......................................................................................................................................... 22 IMPLEMENTATION . APPRAISAL SUMMARY ............ ....................................... 20 ......21 .............................................................................................................................. 23 1. Economic analysis......................................................................................................................................... 2. Technical 3. Social............................................................................................................................................................. 25 4. Fiduciary 5. Environment .................................................................................................................................................. 26 6. Safeguard Policies .................................... 27 7. Policy Exceptions & Readiness............................................................................................................ ..................................... 25 ................................................................................................. Appendix 2a: Detailed Project Description ............................................................................................................ Appendix 2b: Culling and Compensation Procedures.......................................................................................... Appendix 2c: Implementation Arrangements......................................................................................................... Appendix 3: Project Costs and Financing Arrangements .................................................................................... Appendix 4: Procurement Arrangements ............................................................................................................. Appendix 1: Results Framework and Monitoring 23 ..........24 29 39 49 53 57 59 This document has a restricted distribution and may be used by recipients only in the performance o f their official duties . I t s contents may not be otherwise disclosed without W o r l d Bank authorization . ............................................................................................ Appendix 6: Environmental and Social Issues....................................................................................................... Appendix 7: Organization of the Veterinary Services and the Health Care System in B I H ............................. Appendix 8: Project Preparation and Supervision................................................................................................ Appendix 9: Documents in the Project File............................................................................................................ Appendix 10: Statement of Loans and Credits ...................................................................................................... Appendix 11: Country at a Glance .......................................................................................................................... Annex 12: M a p IBRD 33375R ................................................................................................................................. Appendix 5: Financial Management Arrangements 63 71 73 77 79 83 85 87 BOSNIA AND HERZEGOVINA AVIAN INFLUENZA PREPAREDNESS PROJECT (AIPP) TECHNICAL ANNEX EUROPE AND CENTRAL ASIA ECSSD Date: M a y 29, 2007 Country Director: Orsalia Kalantzopoulos Sector Manager: Marjory-Anne Bromhead Team Leader: David A. Bontempo Sectors: General agriculture, fishing and forestry sector (50%); Health (50%) Themes: Natural disaster management (P); Other communicable diseases (P); Rural policies and institutions (S); Other environment and natural resources management ( S ) Environmental screening category: Partial Assessment Project ID: P 1004 15 Lending Instrument: Emergency Recovery Loan Project Financing D a t a [ ] Loan [x ] Credit [IGrant [ 3 Guarantee [ ] Other: For Loans/Credits/Others: Total Bank financing (US$m.): 5 .OO Proposed terms: Proposed terms (IDA): Standard Credit Modified Terms: 2 0 years to maturity; 10 years Source Local 1.2 1.1 2.3 BORROWER IDA Total: Foreign 0.2 3 -9 4.1 Borrower: Ministry o f Finance and Treasury Trg. BiHl, 7 1000 Sarajevo, Bosnia and Herzegovina Responsible Agency: Ministry o f Foreign Trade Federation Ministry o f Agriculture, Water Management and Forestry Sarajevo Bosnia and Herzegovina Federation Ministry o f Health Sarajevo Bosnia and Herzegovina and Economic Relations at state level; and: Ministry o f Agriculture, Water Resources and Forestry Republic o f Srpska Banja Luka Bosnia and Herzegovina Ministry o f Health and Social Welfare Banja Luka Republic o f Srpska Bosnia and Herzegovina Total 1.4 5 -0 6.4 Does the project depart from the CAS in content or other significant respects? Re$ PAD A.3 Does the project require any exceptions from Bank policies? Re$ PAD D. 7 Have these been approved by Bank management? - I s approval for any policy exception sought from the Board? Does the project include any critical risks rated “substantial” or “high”? Re$ PAD C.5 Does the project meet the Regional criteria for readiness for implementation? Re$ PAD D. 7 [ ]Yes [XINO [ ]Yes [XINO ]Yes [ IN0 [ ]Yes [XINO [XIYes [ ] N o [XIYes [ ] N o Project development objective The overall objective o f the Project i s to minimize the threat posed to humans and the poultry industry by the Highly Pathogenic Avian Influenza (HPAI) infection and other zoonoses, by enhancing both animal and human health infectious disease response and control capacities. To achieve this, three areas will be supported by the project: (i)prevention, (ii) preparedness and planning; and (iii)response and containment. Achieving these goals will contribute to diminishing the burden o f disease and loss o f productivity, limiting the regional spread o f HPAI, and enhancing economic and social prospects at the national, regional, and global levels. Project description [Details can be found in Appendices 2 and 2a] In addition to the Bank and government co-financing described below, various other international organizations-including the European Commission (EC), World Health Organization (WHO), United States Agency for International Development (USAID), United Nations Children’s Fund (UNICEF)-are active in assisting the Government o f Bosnia and Herzegovina to address the threat o f Avian Influenza. The Project has been designed in close cooperation with these organizations to leverage the maximum financing possible and to avoid duplication o f efforts. The complementary activities o f these organizations are briefly explained below. However, the exact levels o f financing o f these donor activities i s not presented, as this i s not considered direct cofinancing o f the Bank-funded project (in all descriptions, IDA total plus the Counterpart Financing (CF) is equal to total Componentjnancing). Component 1: Strategic Communications and Public Information - U S $0.20 million Financing IDA Credit: US$0.20 million IDA Credit Proceeds FBiH: US$O. 11 million RS US$0.09 million It i s o f critical importance that all sectors o f society are properly informed about the risks from HPAI, in order that proper protective measures can be taken, and, as importantly, to reduce the risk o f unwarranted fear about the disease (e.g., unnecessarily reducing consumption o f poultry products). This component would provide support for a broad range o f information and communication activities, to increase the attention and commitment o f government, private sector, and c i v i l society organizations, and to raise awareness, knowledge and understanding among the general population about the risk and potential impact o f the disease. Implementation o f the first phase o f the communications strategy has already been completed, through UNICEF’s Sarajevo office. Bank financing would implement subsequent phases. Component 2: Animal Health Protection and Disease Prevention and Control - U S $2.98 million Financing Gov’t. o f Bosnia and Herzegovina FBiH RS IDA Credit: US$0.25 million US$O. 17 million US$O. 10 million US$2.46 million IDA Credit Proceeds FBiH: US$1.62 million RS US$0.84 million The most effective way to reduce the threat from HPA, to both the economic sustainability o f domestic poultry production and human health i s to prevent the disease from establishing i t s e l f in domestic poultry. This component would support implementation o f disease prevention and control strategies at national and entity levels to address short, medium and long-term needs. Areas for support are based on detailed assessments o f (i)the epidemiological status o f H P A I in Bosnia-Herzegovina; (ii)the capacity o f the State Veterinary Office (SVO) to cope with a highly pathogenic avian influenza (HPAI) epidemic, including surveillance and diagnostic capacity at the national and entity levels; and (iii)the vulnerability o f the poultry industry to newly emerging infectious diseases. Implementation o f the Animal Health component will be assisted by the EC’s Twinning Arrangement (financed by the Government o f the Federal Republic o f Germany) with the S V O to provide technical assistance on institutional aspects o f the veterinary sector, particularly in food safety, inspections, and support to laboratories. The E C will also finance a feasibility study o n large-scale animal waste disposal Component 3: Human Health Protection, and Disease Prevention and Control - U S $1.98 million Financing Gov’t. o f Bosnia and Herzegovina FBiH RS IDA Credit: IDA Credit Proceeds US$0.22 million US$O.10 million US$O.lO million US$1.96 million PBiH: RS US$0.98 million US$0.98 million At present, there have been no human cases o f H P A I infection reported in BiH. However, it i s likely that at some point in the future, suspected or confirmed cases will occur, and rapid and coordinated interventions will be necessary. Under this component, the project will (a) help enhance the coordination and planning o f human health related activities, (b) strengthen the capacity o f investigation teams and virology laboratories in both entities, (c) help BiH rapidly j o i n the European Influenza Surveillance Network, (d) help develop the capacity o f hospitals to adequately and safely isolate and treat (suspected) human cases and, (e) finance the procurement o f seasonal flu vaccines and anti-viral drugs. Particular attention will be paid to capacity building and the training o f staff at the various levels o f the health system. This component contains support to the Ministry o f C i v i l Affairs at the State level, to enhance their capacity to fulfill their mandate to coordinate human health policy and response for all of BosniaHerzegovina. One o f the most crucial activities for preparedness in the Human Health sector i s the finalization o f a National Contingency Plan (CP), which integrates the CPs already prepared by each Entity. Most importantly the National CP will define a clear ‘Chain o f Command’ in the event o f a large-scale outbreak affecting human health. W H O i s leading this effort, through a series o f workshops undertaken in June 2006. The final CP, integrating the two Entity-level plans has been completed, and i s awaiting parliamentary ratification; the AIPP will provide financing for operationalization o f this plan. WHO has also recently completed an assessment o f laboratories throughout BiH, which will form the basis for the technical planning for the upgrade o f laboratories under the Project. In addition, WHO, with EC support, i s working to strengthen the overall surveillance system for seasonal flu, which will also help with faster identification o f any unusual flu strains which might arise. Component 4: Poultry Culling Compensation Scheme - U S $0.75 million Financing FBiH RS IDA Credit: US$O.lOmillion US$O.lO million US$0.55 million IDA Credit Proceeds FBiH US$0.3 1 million RS US$0.24 million Experience from world HPAI outbreaks has clearly shown that individuals are more likely to report sick animals if they have credible assurances from government that they will be compensated in the event that their animals must be killed to prevent further spread o f disease. Therefore, in order to provide sufficient incentive for early reporting by citizens o f sick animals, and hence timely response by government authorities, within this component funds for compensation will be provided. As evidenced by the experience from the culling campaign (that followed the A I occurrence in wild birds in February 2006), the compensation procedure prescribed and elaborated in the CP for A I ensures timely, efficient and transparent compensation payment to farmers. Component 5: Implementation Support, and Monitoring and Evaluation (M&E) - U S $0.45 million Fin an cing Gov’t. o f Bosnia and Herzegovina FBiH RS IDA Credit: US$O.12 million US$O. 15 million US$O.15 million US$0.03million One o f the key characteristics o f the HPAI threat i s the difficulty in predicting the course the pandemic will take. An important feature of the project, therefore, will be the flexibility to adapt to a changing situation with the ability to reallocate funds between components and categories, and possibly draw up new activities. The component would support costs associated with project management and coordination. I t would comprise two sub-components: (i)Implementation Support to the Technical Support Group in the Ministry o f Foreign Trade and Economic Relations; and (ii) Monitoring and Evaluation (M&E). Which safeguard policies are triggered, if any? Re$ PAD 0.6, Appendix 8 Only the Environmental Assessment safeguard i s triggered by the Project. Since the Project i s being processed under emergency procedures and i s assessed as a B-category project, a waiver was requested and granted to permit preparation o f the Environmental Management Plan (EMP) after Appraisal. The EMP has been finalized and disseminated. Formal adoption o f the EMP i s a condition for Effectiveness. Significant, non-standard conditions, if any, for: Re$ PAD C. 7 Board presentation: There are no Conditions for Board Presentation. Bosnia-Herzegovina(BiH) fulfills the eligibility criteria requirements for borrowing under the Global Program for Avian Influenza (GPAI). Specifically, BiH should be considered, according to the G P A I Program document, as one o f the “countries at risk, with no outbreak, o r that are at an early stage o f an outbreak”, government commitment and appropriate plan o f early detection and rapid response, including appropriate implementation and monitoring arrangements that the international agencies and donor community, including the Bank, could support.” (World Bank Report Number 34386 -Program Framework Documentfor the GPAI, December 5,2005, page 14) Loadcredit effectiveness: N o non-standard conditions. Covenants applicable to project implementation : Conditions of Effectiveness: Establishment by the Recipient o f the Technical Support Group in a manner and with the (i) composition and terms o f reference satisfactory to the Association; (ii) The Annual Work Program for the first year o f the implementation o f the Project, satisfactory to the Association, has been prepared and adopted by the Recipient and each Entity; (iii) The Project Operational Manual, EMP and the FM Manuals, each satisfactory to the Association, have been adopted by the Recipient and each Entity; A Project Agreement has been executed on behalf o f the Association and an Entity, on terms (iv) and conditions satisfactory to the Association; and A Subsidiary Agreement has been executed on behalf of the Recipient and the Entity (v) concerned, on terms and conditions satisfactory to the Association. Conditions o f Disbursement: a Project Agreement between the Association and the Entity responsible for implementing (i) Part 2 or Part 3 o f the Project, as the case may be, has been executed, on terms and conditions satisfactory to the Association; (ii) a Subsidiary Agreement between the Recipient and such Entity has been executed, on terms and conditions satisfactory to the Association; (iii) An opinion has been furnished to the Association stating that such Project Agreement and Subsidiary Agreement have been duly authorized or ratified by the parties thereto and are legally binding upon them in accordance with their respective terms; (iv) For expenditures under Component 4, adoption by the Recipient and each Entity of the Poultry Culling Compensation Scheme Manual, satisfactory to the Association; and (v) Retroactive Financing under Categories 2 and 4, up to an equivalent of SDR 100,000 (vi) The Federation o f Bosnia and Herzegovina has opened a Project Account with an initial deposit equivalent to US$0.02 million. (vii) The Republika Srpska has opened a Project Account with an initial deposit equivalent t o US $0.015 million A. STRATEGIC CONTEXT AND RATIONALE 1. Country and Sector Background and Global, Regional and National Dimensions (a) Country and Sector Background 1. Bosnia and Herzegovina has made remarkable progress in post-conflict reconstruction, social integration and state building since the end o f the 1992-95 war. However, the economy stands at only 70% o f i t s prewar level. The business environment i s not as investor-friendly as it needs to be to attract the levels o f investment required for sustained economic growth. Some 50% o f the 4.1 million population i s at or near the poverty level. The lack o f employment opportunities i s a major factor limiting the resettlement o f refugees and internally displaced persons. 2. The composition o f GDP appears to have changed markedly in the post-war period. According to official statistics, the share o f agriculture has declined significantly while the share o f services has increased. While the overall trends follow a similar direction in both entities, there are notable differences. The primary production sector (agriculture, fisheries and forestry) has remained an important sector in Republika Srpska (RS) at 20 percent o f GDP, but has dropped to less than 10 percent in the Federation o f Bosnia and Herzegovina (FBIH). Agricultural Gross Domestic Product (AGDP) makes up about 14% o f the country’s overall GDP. It i s estimated that 18% o f the population i s employed in agriculture. 3. The poultry industry represents one o f the main agriculture sub sectors, and production currently falls just short o f meeting the national market demand for i t s products. It i s estimated that BIH has around 32 million broilers (estimated annual production capacity), 1 million laying hens, and approximately 1 million animals raised in back yards. Annual production capacity for the industry i s 10 kg o f meat and 120 eggs per capita (annual consumption in BiH i s 14 kg o f poultry meat and 180 eggs per capita). The total annual production o f poultry meat for 2004 i s estimated at approximately 43,000 tons, and for the same year production o f eggs was around 450 million. Average market price for poultry meat i s US$2 per kg, and the price o f an egg i s US$O.O8. Commercial poultry farming i s largely organized as industrial production, primarily involved in the production o f eggs and fresh/frozen chicken meat and processed meat products. The commercial poultry plants are enclosed operations which use modern equipment and technologies. Other poultry are raised on small household farms limited to a few chickens and/or other domestic birds. (b) International Dimension 4. East Asia i s the region most affected by HPAI to date, with Cambodia, China, Indonesia, Thailand, and Vietnam all reporting human infections. The number o f countries affected by HPAI in East Asia has increased and now includes Cambodia, China, Indonesia, Japan, Lao PDR, Mongolia, South Korea, Thailand, and Vietnam. The geographical spread o f HPAI, the human dimension and the potential enormous social and economic impact are unprecedented. Despite control measures the disease continues to spread, causing further economic losses and threatening the livelihoods o f hundreds o f millions o f poor livestock farmers, jeopardizing smallholder entrepreneurship and commercial poultry production, and seriously impeding regional and international trade, and market opportunities. With outbreaks rapidly spreading in other regions such as Europe and Central Asia (ECA) and Africa, there i s a growing realization that the international community faces several transnational challenges that do not emanate directly from the policies o f individual states. Correspondingly, these challenges cannot be countered solely by the actions o f individual states, because they present a threat to the entire world. A n important emerging transnational threat i s the spread o f infectious diseases across national borders, which has the 11 potential to undermine countries’ stability, security, economic development, human capital accumulation, and not least, the welfare o f the population. (e) Regional and National Dimension 5. Until recently, avian flu outbreaks were limited to Southeast Asia. In July 2005, outbreaks were registered in domestic poultry and fowl in seven regions o f Russia. Four months later, outbreaks in poultry o f H P A I H5N1 were reported in four regions o f Kazakhstan. Since 2005, outbreaks o f avian flu have occurred in many countries outside East Asia. After crossing from China into Russia and Kazakhstan, outbreaks were reported in Albania, Azerbaijan, Austria, Bosnia and Herzegovina, Bulgaria, Cyprus, Croatia, France, Greece, Germany, Italy, India, Iran, Romania, Serbia, Slovenia, Switzerland, Turkey, and Ukraine. Seasonal migration o f birds contributes to transmission o f new strain variations to different geographical regions. In October 2005, H 5 N l was reported among migrating swans in Croatia, which lies on the northern border o f Bosnia and Herzegovina. 6. On February 16, 2006, four swans from Pliva Lake in Jajce Municipality were brought to the Reference Laboratory o f the BiH State Veterinary Office (Poultry Center o f Sarajevo Veterinarian Faculty) for testing. T w o o f the four swans tested positive in preliminary serologic tests; necropsy findings for these two swans indicated the presence o f AI. State authorities subsequently mounted a coordinated and thorough response to what was in essence a real-time emergency simulation. The preparation mission o f March/April2006 was presented with substantial detail on this response, and noted that implementation o f the veterinary control measures elaborated in the Contingency Plans (CP) appear to have successfully halted any further spread o f the infection. In particular, the CP’s clear “chain o f command” rules allowed local authorities to act with confidence. In addition, on March 9, 2006, a case o f A I was confirmed in a rooster in the municipality o f Bajina Basta (Serbia). As a consequence, the nearby community o f Bratunac in BiH was declared an endangered area, and measures were instituted as prescribed by the CP. The infection also appears to have been halted in this area. N o new cases have been reported since then. 7. The emergence o f outbreaks in neighboring countries has had a negative impact on both poultry production and consumption in BIH. Based on data from large-scale traders, poultry consumption appears to have fallen by about 30-40 percent after the recent cases emerged in Croatia and Romania. Official production fell by more than 50% in mid-2006, with some o f the major producers almost fully halting production’. The decline in production and consumption have been accompanied by a drop in market prices o f about 10 percent, while farm-gate prices o f chicken declined from 2.3 KM/kg to 1.4 1.5 KM/kg. (d) Organizational Structure of the Health Care and Veterinary Systems (please refer to Appendix 9 ) 2. Rationale for B a n k Involvement 8. HPAI control programs require a multi-disciplinary approach to integrate technical, social, economic, political, policy, and regulatory issues in addressing a complex problem. Working in a collaborative manner with other agencies (WHO, UNDP, UNICEF, EC, USAID), the Bank i s well-placed to apply the evidence and lessons learned from international best practice in the various regions to help ensure that BiH’s emergency preparedness plans and capacities are ready for the H P A I challenge. The Bank has a strong comparative advantage in providing integrator skills and multi-sectoral perspectives, I As poultry production needs to be planned in such a way that 36 days old chicken are available daily, the production chain cannot be stopped instantly. Therefore, the real extent o f the reduction can be seen only with a two-month delay, time required to complete the full production cycle. 12 and in addressing the institutional dimensions o f the response to such emergencies. I t can also bring extensive experience and skills in analyzing and addressing the social and economic impact. Importantly, the Bank has a long record in BiH in bringing together the relevant ministries, government agencies, and the donor community, and in helping ensure high level political coordination. 9. Given the Bank’s work with local and international partners in B i H and at the international level to address both preparedness and outbreaks and to assist with institutional assessments, the Bank can assist Bosnia and Herzegovina in leveraging additional resources from other international and bilateral agencies. In addition to its financial role, the technical assistance provided by the Bank has been important in similar global or regional emergency situations such as SARS, Tsunami relief, and HIV/AIDS. The Bank’s national and regional support will be closely linked with the activities o f FAO, WHO, OIE and the EU, and the proposed project i s fully consistent with, and draws heavily on the global strategies proposed by F A 0 and WHO. B. PROJECT DESCRIPTION 1. Lending Instrument 10. The project i s to be supported by a Credit from the International Development Association (IDA) o f US$5 million equivalent. In addition, the Bank i s working on helping to mobilize additional resources from bilateral and international agencies. Activities under the IDA-financed project will complement activities supported by other international partners and donor agencies (EC, UNDP, UNICEF, USAID, and WHO) and help ensure the availability o f adequate resources to fund the priority investments and technical assistance which BIH has identified as critical needs in implementing i t s response to HPAI. The Project i s supported by the Bank-financed Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI) approved by the Bank’s Board on February 9,2006. 11. As per the GPAI, a country will qualify for support under the GPAI when it demonstrates its commitment and readiness to implement early detection and rapid response measures appropriate to the specific country conditions. A country request for assistance would be eligible for financing under the GPAI when it meets the following eligibility criteria: (i) For countries in endemic situation where new human infections are being detected, it has prepared and i s implementing an HPAI Control Strategy; (ii)For newly infected countries with an active outbreak o f avian flu among poultry, but no human infections, the existence of an appropriate program o f rapid response, detection and containment measures, including appropriate implementation and monitoring arrangements that the international agencies and donor community, including the Bank, could support. (iii)For countries at risk, with no outbreak, o r that are at an early stage o f an outbreak, government commitment and appropriate plan o f early detection and rapid response, including appropriate implementation and monitoring arrangements that the international agencies and donor community, including the Bank, could support. (iv)For countries with very low income levels and very low capacity circumstances, including LICUS countries, special criteria and waivers would apply if a full-blown human pandemic were to materialize, to ensure that assistance would be available if and when needed, even ifthe country itself would hardly be able to generate or mobilize any effective A I response, to safeguard the globalpublic-goodnature o f the global avian influenza objective. 13 12. The joint BanWWHOAJNICEF pre-Appraisal mission o f MarcWApril 2006 made an assessment o f the readiness o f BiH to proceed with a program o f support under the GPAI. I t concluded that BiH meets the eligibility criteria as per (iii)above. The level o f commitment o f BIH i s high: (i)a letter requesting the Bank’s assistance was received on February 24, 2006; (ii)draft assessment plans and preparedness plans on the response to an avian influenza pandemic were prepared by the Government prior to the appraisal mission; and (iii)appropriate implementation and monitoring arrangements have been discussed and agreed. 13. Project Characteristics. The financial assistance under the project will be provided as a Credit. The Credit i s being processed as an emergency investment operation using procedures under OP 8.50 Emergency Recover Loan (ERL), and it meets all applicable Bank policies, practices and standards as discussed below. 2. Project Development Objectives 14. The overall development objective i s to minimize the threat posed to humans and the poultry industry by H P A I infection and other zoonoses, by enhancing both animal and human health infectious disease response and control capacities. T o achieve this, three areas will be supported by the project: (i) prevention, (ii)preparedness and planning; and (iii)response and containment. 3. Project Components 15. The project would finance activities under five components: (i)Strategic Communications and Public Information; (ii) Animal Health Protection, and Disease Prevention and Control; (iii)Human Health Protection, and Disease Prevention and Control; (iv) Poultry Culling Compensation Scheme; and (v) Implementation Support, and Monitoring and Evaluation (M&E). Even though the activities are organized by sectoral components, the project strongly endorses an integrated national plan that ensures common objectives across sectors for dealing with the avian flu issue. Component I: Strategic Communications and Public Information Financing IDA Credit: - U S $0.20 million IDA Credit Proceeds FBiH: US$O. 1 1 million RS US$0.09 million US$0.20 million 16. Building on the work initiated by the Entity Public Health Institutes with the support o f UNICEF, several communications interventions will be financed, chief among them the further development and implementation o f the already drafted communication strategy. The draft strategy includes, inter alia, improved communications strategies between and across government agencies (National Communication Plan); protocols for coordination o f the outbreak and crisis communication for professionals (veterinarians, human health medical personnel, inspections, c i v i l protection, state border service, etc); materials and targeted training for educators; capacity building in communication techniques for health workers, teachers and media professionals; and, at the community level, awareness raising and communication for behavior change activities through all appropriate communications channels. While it i s crucial that each sector involved in public awareness and communications work under an overall strategy and broader framework, the actual implementation o f communication and public information activities w i l l necessarily be carried out sectorally with a core set o f common objectives (more details are included in Annex 2A). U N I C E F took the lead role in implementation o f the first phase o f the communications strategy, with financing from U S A I D in the amount o f US$0.21 million. IDA financing would complement the planned UNICEFLJSAID interventions, especially after the first year o f implementation. Three sub-components are foreseen: 14 0 Developing basic communication materials; Developing and testing messages and materials to be used in the event o f a pandemic or emerging infectious disease outbreak; and Developing training courses in communications methodology for veterinary staff as well as for health workers at the local levels. - Component 2: Animal Health Protection, and Disease Prevention and Control U S $2.98 million Financing Gov't. o f Bosnia and Herzegovina FBiH RS IDA Credit: US$0.25 million US$O.17 million US$O. 10 million US$2.46 million I D A Credit Proceeds FBiH: US$1.62 million RS US$0.84 million 17. The most effective way to reduce the threat from HPAI to both economic sustainability o f domestic poultry production, and human health, i s to prevent the disease from establishing i t s e l f in domestic poultry. This component will provide support to the implementation o f disease prevention and control strategies established at national and entity levels to address short, medium and long-term needs. Areas for support are based on detailed assessments of: (i) the epidemiological status o f HPAI in BIH; (ii) the capacity o f the State Veterinary Office (SVO) to cope with highly pathogenic avian influenza (HPAI) epidemic, including surveillance and diagnostic capacity at the national and entity levels; and (iii)the vulnerability o f the poultry industry to new emerging infectious diseases. 18. The component would have four sub-components: 0 0 0 Enhancing HPAI prevention and preparedness capability; Strengthening o f Veterinary Services, disease surveillance, diagnostic capacity and applied research; Strengthening H P A I control programs and outbreak containment plans as well as capacities to implement those plans; and Improving bio-security in poultry production and trade, and isolating i t s potentially adverse effects on other aspects o f people's lives. 19. The European Commission i s actively providing support to animal health objectives through a twinning program with the SVO. This program i s under implementation, initially during 2007-2009 to support capacity building with the SVO in the areas o f legislative reform, food safety, phytosanitary regime, inspections, and laboratory upgrading. Component 3: Human Health Protection, and Disease Prevention and Control - U S $1.98 million Financing Gov't. o f Bosnia and Herzegovina FBiH RS IDA Credit: 20. US$0.22 million US$O. 10 million US$O.lO million US$1.96 million I D A Credit Proceeds FBiH: US$0.98 million RS US$0.98 million Both Entities have developed contingency plans. With the aim to further improve planning and coordination, the project w i l l (a) help conduct simulation exercises, (b) support the revision o f the plans and (c) support the preparation o f social distancing plans and clean-out plans for hospitals. The surveillance system w i l l be strengthened through: (i)the training and equipping o f investigation teams, ' 15 (ii) the equipping o f 1 virology laboratory in RS and two in the FBiH (one for virus typology in Sarajevo, and one for virus identification in Mostar); and (iii)the strengthening o f the communicable diseases monitoring and reporting system. It i s expected that all these efforts w i l l result in BiH joining the European Influenza Surveillance Network. To help reduce the risk o f a genetic recombination/ mutation o f the virus, the project will support the immunization against seasonal influenza o f populations at high risk. The capacity o f the health sector to adequately isolate and treat suspected or confirmed human cases o f avian flu will also be strengthened. Particular efforts will be made to train health staff at different levels o f the health system, improve their knowledge o f infection control measures and facilitate the adoption o f the most appropriate attitudes and behaviors so they can both protect themselves and effectively take care o f their patients. The interventions supported under the Project w i l l be based on BIH’s epidemiological and programmatic needs, and well-assessed options for meeting them. The interventions will be grouped in three sub-components: 0 0 0 Enhancing public health program planning and coordination; Strengthening o f the national public health surveillance system; and Strengthening health system response capacity. 2 1. The European Commission (EC) has allocated US$l80,000 equivalent from its ongoing project, being implemented with WHO support, to continue strengthening the surveillance systems in the human health sector. I n addition, for the period 2007-2009, the EC will contribute EUR 500,000 to strengthen the overall human health laboratory system. This support will be complementary to the laboratory upgrades provided under the AIPP. Component 4: Support to the B i H Poultry Culling Compensation Scheme - U S $0.75 million Financing FBiH RS IDA Credit: US$O. 10 million US$O.lO million US$0.55 million 22. IDA Credit Proceeds FBiH US$0.3 1 RS US$0.24 Experience from world HPAI outbreaks has clearly shown that individuals are more likely to report sick animals if they have credible assurances from government that they w i l l be compensated in the event that their animals must be killed to prevent further spread o f disease. As evidenced by the experience from the culling campaign that had followed A I occurrence in wild birds in February 2006, the compensation procedure prescribed and elaborated in the CP for A I ensures timely, efficient and transparent compensation payment to the farmers. The CP contains the necessary forms and instructions for personnel and institutions involved in culling, and ensures reimbursement o f the farmers within a timeframe o f 7-10 days post-animal depopulation. The only factor that can compromise the effectiveness o f the existing compensation procedure, and thereby decrease the incentive for farmers to participate in A I control efforts, i s the limited budget available for this purpose. Currently, compensation costs related to animal disease outbreaks are covered from the emergency fund (entity level budgets). Compensation costs on the scale o f that needed for the A I outbreak. experienced in February 2006 can be easily covered by the government. However, if AI would occur in an area close to large-scale poultry farms, the available budget under the current culling arrangements would not come even close to covering the resulting expenses. Therefore, in order to provide sufficient incentive for early reporting by owners o f sick animals, and hence enable a timely response by government authorities, funds for compensation will be provided within this component. A mechanism for the mobilization o f these funds w i l l need to be agreed as a condition of disbursement (under the Animal Health Component), as well as distribution o f the responsibility for repayment among national and entity governments. 16 Component 5: Implementation Support and Monitoring and Evaluation (M&E) - U S $0.45 million Financing Gov’t. o f Bosnia and Herzegovina FBiH RS IDA Credit: US$0.12 million US$O. 15 million US$O. 15 million US$0.03 million 23. One o f the key characteristics o f the HPAI threat i s the difficulty in predicting the course the pandemic will take. A n important feature o f the project, therefore, w i l l be the flexibility to adapt to a changing situation with the ability to reallocate funds between components and categories, and potentially to draw up new activities. The component would support costs associated with project management and coordination. It would comprise two sub-components: 0 4. Implementation Support to the Technical Support Group and PIU/PCU Monitoring and Evaluation (M&E). Lessons Learned and Reflected in the Project Design 24. Relevant lessons for the design o f the proposed project have been drawn from implementation o f projects in the agricultural and health sectors in Bosnia and Herzegovina. They have also been drawn from the design o f previous World BanWIDA and FAO-supported emergency recovery projects. These include the Vietnam Avian Influenza Emergency Recovery Project, which was the first Bank-financed project in response to the Avian Influenza. I n addition, lessons have been drawn from the design o f the Kyrgyz Republic A I project, which was the first country-specific project drawing from the GPAI, as well as projects currently under implementation in Turkey, Azerbaijan, Armenia, Georgia, and Albania. 25. Lessons learned indicate that project success depends to a large extent on the speed o f the response provided. Particularly when dealing with smallholders’ production systems, a speedy, efficient and transparent distribution o f suitable key inputs i s clearly a major factor in limiting the impact o f a crisis and hastening recovery. A performance audit o f some o f the emergency projects supported by the Bank in various regions drew the following general lessons: (i)emergency projects should avoid policy conditionality; (ii)project design must be simple and take into account a realistic assessment o f the existing Borrower’s capacity and other stakeholders capacity; (iii)a speedy project processing and approval are crucial to provide a prompt response and a substantial contribution to project success; (iv) procurement arrangements need to be flexible and should be finalized at an early stage; (v) mitigation and prevention measures should be included in the design to minimize impacts of a possible recurrence o f the disaster; and (vi) realistic assessments should be made o f counterparts’ absorption capacity, as well as o f the effective communications and coordination mechanisms among all relevant stakeholders. 26. The main recommendations arising from the first 18-month implementation period o f the Vietnam Avian Influenza Emergency Recovery Project are: (a) Preparedness i s a key factor. While Vietnam had a national strategy document to control avian influenza in the domestic poultry population, it was not clearly understood and shared by all relevant agencies and stakeholders, and some aspects o f the response were lagging behind. (b) A two-pronged strategy i s recommended. This should include: (i)the control o f avian influenza at the source in high-risk regions (through aggressive measures including culling, movement control and vaccination campaigns for poultry and ducks); and (ii)simultaneously 17 prepared short and medium-term measures to minimize the risks to humans and prepare for an eventual pandemic. High level government commitment i s o f the essence. For implementation arrangements, it i s important to have a coordination structure that i s empowered with multi-sectoral responsibilities, along with full-time project coordinators to implement activities in a “crisis situation”. Moreover, this level o f coordination would foster effective integrated national response, including all technical ministries in charge o f agriculture/animal health and human health, as well as other relevant sectors, at the national and sub-national level, in case o f a human epidemic. H P A I Control Strategy and Preparedness Plans need to be linked to the broader agenda of regulatory and institutional reforms. In particular, a revised “compensation framework” i s an essential element to obtain real cooperation from affected stakeholders (farmers/producers) and to ensure the efficacy o f the surveillance and diagnosis mechanisms. Other long-term reforms include the restructuring o f the poultry industry and the development o f food safety regulations. Technical, scientific and operational capacity o f the relevant participating agencies, and in particular National Veterinary Services, should be strengthened. The AI crisis highlighted several weaknesses in the animal health as well as public health services systems, including: poor surveillance at the local level, weak diagnostic capacity, lack o f epidemiological expertise and information system, and inadequate operating budget to bear the additional costs o f physical and human cost to contain the spread o f the disease. Control strategies must include awareness raising and public information campaigns. It i s extremely important to raise awareness in the public and private sectors from the initial moments, and to strengthen effective coordination mechanisms for the implementation o f the necessary technical responses, involving the Government, the donor community, the private sector and the civil society. Regional collaboration i s critical. Attention should be given t o support the integration o f each country to a regional and global framework for the control o f HPAI, and more broadly o f all trans-boundary animal diseases and other emerging infectious diseases, to increase costeffectiveness and ensure the harmonization o f activities and responses. Some important lessons learned from the response to the H I V / A I D S epidemic2 are incorporated in the design o f the proposed project. They include: I e 0 e e 0 The need for high level political commitment and leadership i s key. A comprehensive multi-sectoral approach i s needed. Monitoring and evaluation i s critical in the scaling-up o f a national response. Stakeholders at the country and international levels, are important in dealing with the A I threat. Building a strong fiduciary architecture i s essential. C. IMPLEMENTATION 1. Partnership Arrangements 28, The Bank and the international community can play a key role in the response to Avian Influenza, especially at the country level where there i s a need to develop an overall framework to guide national action plans that can be the basis for government and donor support. Such a framework should address 2 World Bank. 2005. Committing to Results: Improving the Effectiveness o f HIViAIDS Assistance. An OED Evaluation o f the World Bank’s Assistance for HIViAIDS Control. Washington, D.C. 18 both animal and public health aspects as well as economic impact. Many o f the investments needed to address this disease are core public health and animal health functions that are considered "global public goods", thus, necessitating a global and regional response with support from the international community. Such partnership arrangements have been developed in BIH with the technical agencies as well as with bilateral agencies. Several meetings were organized prior to and during appraisal to brief the international partners on the Bank's plans to work with the Government in the design of a country-specific project and to confirm their interest in participating in the financing o f the project. 29. BIH i s receiving support on the technical content o f an Avian Influenza response from key technical agencies. International agencies and donors have been active through a Task Force established in BIH for coordinated support o f AI. The European Commission (EC) has allocated US $180,000 equivalent from i t s ongoing project, being implemented with WHO support, to continue strengthening the surveillance systems in the human health sector. In addition, the E C has allocated EUR 500,000 for the 2007-2009, to assist with provision o f biosafety equipment for human health laboratories and hospitals. UNICEF has been working closely with the Inter-Sectoral Committee to design a draft communications strategy. As importantly, UNICEF support for A I communications was funded by U S A I D in the amount o f US $0.20 million. These activities are now nearly completed, and have delivered a wide range o f communications tools to enhance the overall government response. U N D P has expressed i t s interest to collaborate by making available US $100,000 to support A I activities. The aim o f the IDA-funded Project i s to support an integrated response to AI with all international partners contributing and supporting BIH's preparedness and control program. Further work in this regard will continue prior to effectiveness and during implementation to ensure complementarity o f all such grant financing from international partners. 2. Institutional and Implementation Arrangements 30. Because o f the inter-sectoral nature o f this project and potential for an A I outbreak or human pandemic that i s national in scope, it i s critical that both animal and human health experts, as well as communications specialists, work together closely at national and entity levels to perform the day-to-day tasks o f implementing the Project. Implementation o f the Project will be undertaken by a Technical Support Group (TSG) consisting o f technical advisors who are representatives o f the State Veterinary Office (SVO)3 in the Ministry o f Foreign Trade and Economic Relations, Ministry o f Civil Affairs, F B i H and RS Ministries o f Agriculture (Veterinarian Services), FBiH and RS Ministries o f Health, and consultants for communications and monitoring and evaluation. The representative o f SVO on the TSG will be a permanent civil servant and will serve as Project Coordinator, reporting to the Minister o f MoFTER. The TSG will report to the Council o f Ministers through MoFTER. The TSG government representatives will be responsible for coordinating with and reporting to their relevant government departments, to guide and monitor implementation o f activities in their respective areas. The TSG will be responsible for monitoring and evaluation, the preparation o f annual work programs and budgets, preparation o f TORSand specifications for goods and works bidding documents, and preparation o f quarterly and annual progress reports. 3 1. 32. Procurement, financial management and financial reporting services for the project will be provided by the P I U Forestry and Agriculture in Sarajevo, and by the Health Sector P C U in Banja Luka. More details on the implementation arrangements are provided in Appendix 2c. SVO has the mandate to coordinate veterinary services on behalf o f the Entity Ministries o f Agriculture, Water Management and Forestry. 19 33 . Overall responsibility for overseeing and coordinating institutional and implementation arrangements will be vested with the Minister o f Foreign Trade and Economic Relations (MoFTER) on behalf o f Council o f minister^.^ 34. At the cantonal and municipalities levels, implementation would be the direct responsibility of each cantonal/municipal veterinary/health authority. Small coordination units should be established at the local level comprising officials from healthheterinary services to work under the supervision and guidance o f the entity ministries. 35. T o facilitate the management and implementation o f the Project, a Project Operational Manual (POM) satisfactory to the Association i s to be prepared by the TSG as a Condition o f Effectiveness. 3. Monitoring and Evaluation of OutcornesDtesults 36. M&E activities related to the project will be the responsibility o f Technical Support Group (TSG) supported by the PIU/PCU. These activities could be carried out by the regular staff o f the agencies (with technical assistance from the project) or by contracting out these functions with specialized agenciedinstitutes when appropriate. Monitoring project progress and the achievement o f objectives will entail a process o f continuously and systematically reviewing the various project implementation activities. The objectives o f the M&E activities are to: (i)measure input, output and outcome indicators (see Appendix 1); (ii) provide information regularly on progress toward achieving results and facilitating reporting to the government and IDA; (iii) alert government authorities and the international partners to actual or potential problems in implementation so that adjustments can be made; (iv) determine whether the relevant stakeholders are responding as expected and intended by the project; (v) provide a process whereby the implementation agencies can reflect and improve on their performance; and (vi) enable the project to make necessary changes should the situation evolve. 37. 38. The results o f relevant M&E activities will be reflected in the quarterly and annual progress reports. A section o f the progress reports will be devoted to issues identified during project implementation and the strategies and actions to be taken to resolve such issues that affect progress. 4. Sustainability 39. Critical to the sustainability o f the Project will be the continuous ownership o f this initiative by the various stakeholders, coupled with strong political support and the availability o f an adequate flow o f financial resources to carry out project activities. In addition, institutional sustainability would be ensured by: (i)strengthening o f programs to maintain public awareness o f the threat o f avian influenza and other rapidly spreading infectious diseases; (ii)sustained surveillance and prevention and control activities, particularly in high risk regions; (iii)strengthened country capacity to manage at national and local levels the risk factors associated with the spread o f avian influenza and other infectious diseases; and (iv) effectiveness o f programs to control the spread o f avian influenza from birds to the general population. 4 An inter-sectoral Crisis Committee was established in November 2005 under the chairmanship o f the MoFTER to oversee the HPAI control and containment effort and to provide general policies and guidance for avian influenza control. An Inter-Sectoral Working Group (ISWG) was established by the MoFTERto provide technical response to the A I outbreak in February 2006, and led project preparation for the BiH. Both the Crisis Committee and the ISWG may continue to function as circumstances warrant. However, neither would have a role in implementation o f the Project. 20 5. Critical Risks and Possible ControversialAspects Risk From Outputs to Objective Decline in political commitment to addressing Avian Influenza and the threat o f a Global Influenza Pandemic. Rating Mitigation Measure S Continuing support for inter-sectoralcollaboration through information exchanges and dialogue and operationalization o f the Technical Support Group, which i s to provide liaison with the BiH and entity implementingagencies. Adequate implementation arrangements are being put in place as a pre-condition o f Bank financing; careful monitoring o f leadership and project management during project implementation; technical assistance and training. The TSG will inter alia, ensure coordination and linkages across relevant agencies and international partners. I n addition, an inter-sectoralworking group was established by the Chair o f the Committee as the counterpart team to work with the Bank and other donors in project design and will continue to play a role if needed during project implementation,. Implementationmechanisms explicitly address the link between the required centralized decision making (the principle o f ‘direct chain o f command’) with the needed local-level implementation, communication strategies will include local-level implementing actors as targets; capacity building includes periphery. Project implementing agencies do not have sufficient authority, leadership, and capacity to take leading role in Avian Influenza prevention and control. S Inadequate or lack o f multi-sectoraland intraEntity participation S Low cantonal/municipality level commitment means that strong central commitment does not translate into action on the ground. S From Components to Outputs Controlling the spread o f the pandemic may expose the government to criticism for the curtailment o f civil rights due to the adoption o f quarantines and other related measures. Inadequate institutional capacity to manage the project. Financial resources not accessible in a timely manner, weak procurement management M S M Lack o f timely and predictable access to expert advice and technical support M Low priority given to public accountability and transparency in program management Overall Risk Rating: M Project will support advocacy and coalition building to sensitize key groups including policy makers and the media. This will be complemented by carefully designed communication campaigns to build support for the project among the wider population. Capacity building and institutional development i s one o f the project’s key objectives. Procurement and financial management arrangements will be handled by experienced staff which will receive support from consultants. Project activities are being designed with assistance from leading multilateral agencies such as F A 0 and WHO. Arrangements in place for provision o f expert resources (OIEIWHOIFAO) during implementation. Publication o f audit results and achievements; transparency in decision and resource allocation. S Risk Rating - H (High Risk), S (Substantial Risk), M (Modest Risk), N (Negligible or Low Risk) 21 Possible ControversialAspects 40. The Project will support the implementation o f immediate t e r m responses to a global influenza pandemic -- the classic “social distancing measures”-- such as quarantine, bans on mass gatherings, and travel restrictions that may be politically and socially controversial. This means that dialogue and compromises are needed among different stakeholders, backed by a well-designed communication strategy. A high degree o f political commitment to preventing and controlling the spread o f infectious diseases such as a global influenza pandemic would be needed for managing controversies that will undoubtedly arise. 6. Credit Conditions 4 1. The key conditions needed to minimize the risks to the Project would be addressed by the country meeting the eligibility requirements for entering the Global APL. Specific provisions have been developed to meet the standard requirements covering organizational and staffing arrangements, as well management, procurement and financial management arrangements. These have been addressed during appraisal and were confirmed prior to Negotiations. Conditions of Effectiveness for the project would be: (a) Establishment by the Recipient o f the TSG in a manner and with the composition and terms o f reference satisfactory to the Association; (b) The Annual Work Program for the first year o f the implementation o f the Project, satisfactory to the Association, has been prepared and adopted by the Recipient and each Entity; (c) the Project Operational Manual, the EMP, and the FM Manuals, all satisfactory to the Association, have been adopted by the Recipient and each Entity (d) a Project Agreement has been executed on behalf o f the Association and each Entity, on terms and conditions satisfactory to the Association; (e) for each Entity, a Subsidiary Agreement has been executed on behalf o f the Recipient and the Entity concerned, on terms and conditions satisfactory to the Association. 42. Conditions of Disbursement comprise: (i)execution o f a Project Agreement between the Association and the Entity; (ii)execution o f a Subsidiary Agreement between the Recipient and the Entity; (iii)for expenditures under Component 4, adoption by the Recipient and each Entity o f the Poultry Culling Compensation Scheme Manual; (iv) provisions for Retroactive Financing under components 1, 2, 3, and 5; and (v) the opening o f Project Accounts (for the Federation o f Bosnia and Herzegovina, the initial deposit i s to be equivalent to US $0.02 million; for Republika Srpska, the initial deposit i s to be equivalent to U S $0.01 5 million). 43. Financial Covenants. The Federation P I U in the Ministry o f Agriculture and the RS PCU established in the Ministry o f Health will maintain financial management systems acceptable to the Bank. The project financial statements, summary reports and the designated account will be audited by independent auditors acceptable to the Bank on terms o f reference acceptable to the Bank. The annual audited statements and audit report will be provided to the Bank within six months o f the end o f each fiscal year. 44. The audits will be conducted in accordance with International Standards on Auditing (ISA) as issued by the I F A C and on terms of reference acceptable to the Bank. The P I U and P C U will appoint an acceptable firm o f auditors under terms o f reference acceptable 45. to the Bank to carry out operational review o f the compensation payment system as part o f the annual audit when compensation claims have been made. 22 D. APPRAISAL SUMMARY 1. Economic Analysis 46. The poultry industry in BH i s relatively small. Overall 2004 production amounted to 24.5 million kilograms. O f that, about half i s produced by large commercial poultry farmers and the rest by individuals, mainly subsistence farmers (Table 1). Exports have been negligible, largely because o f lack o f veterinary certification. 47. Poultry accounts for a relatively small part o f households’ consumption. In 2004, overall consumption o f poultry amounted to 38.2 million kilograms, domestic production meeting 64 percent o f consumption needs and imports accounting for the rest. One-half o f imports originated from Croatia. Overall poultry consumption amounted to about 1.3 percent o f GDP, 3 percent o f total food expenditures and slightly over 1 percent o f overall household consumption. Together with the consumption o f eggs and processed poultry products, consumption o f poultry and poultry-related products amounted to about K M 3 5 0 million in 2004, equivalent to 2.6 percent o f GDP and 2.1 percent the overall household consumption. Table 1. BH: Poultry Production and Consumption, 2004 Million o f chicken Production large farmers own-use informal sector Exports Imports officially registered informal sector Informal sector ConsumDtion 17.1 8.1 *’ 5.8 3.2 Million I’ kg 24.5 11.7 8.4 4.4 0.0 0.0 9.3 6.1 3.2 6.3 26.3 13.7 9.3 4.4 8.7 38.2 1/ Exports are negligible 21 Includes registered market-oriented production Economic Impact Analysis 48. The economic analysis considers the short-term financial benefits and costs o f the project and the associated program under a with-project and without-project scenarios. The analysis should be considered as setting only the lower bound on the potential economic benefits that would accrue. The analysis does not attempt to quantify the costs and benefits preventing the spread o f the virus to humans. The analysis considers two events. One i s sporadic outbreak o f disease, as occurred in early 49. 2006, and the other i s a catastrophic outbreak. Table 2 lists the key assumptions o f the analysis. The probability o f a sporadic outbreak i s assumed equal to 100 percent without a project, constant every year, while the probability o f a catastrophic outbreak i s assumed to increase from 40 percent to 50 percent over time. Both the probabilities o f sporadic and catastrophic outbreaks are assumed to be smaller and declining under the with-project scenario. Further, it i s assumed that a sporadic outbreak will cause 5 percent o f poultry to perish, while a catastrophic event will result in a 25 percent death rate. 23 Table 2. Assumptions for the Economic Analysis Year Year Year Without Project Sporadic contained outbreaks Widespread outbreak 100% 40% 100% 45% 100% 50% 90% 38% 85% 30% 80% 30% With Project Continued sporadic contained outbreaks Widespread outbreak Percent o f stock lost during sporadic contained outbreaks Percent o f stock lost during catastroDhic outbreaks 5 yo 25% 50. Under these assumptions, the N e t Present Value (NPV) o f the project using a discount rate o f 10 percent i s $0.3 million. The IRR for this project i s unique and equal to 25 percent. As indicated above, the project presents the lower bound o f benefits to society. The estimated 5 1, economic benefits would be substantially larger if the costs and benefits o f averting human hospitalization are taken into account. For example, were an outbreak o f avian flu to result in human infection, the cost o f hospitalization and possibly death would be substantial. 2. Technical 52. Animal Health. Successful implementation o f the project depends on a phased multidisciplinary strategy based on a sound epidemiological approach to control H P A I outbreaks. This strategy has to take into consideration the range o f epizootic and epidemiological scenarios that exist or may arise in BiH, as well as the different poultry production systems within the country, and different levels o f incidence (ranging from high incidence with variable flock outbreaks, through l o w frequency disease outbreaks with partial flock immunity, to sporadic outbreaks). A balanced combination o f appropriate disease control options, tailored to the specific characteristics and needs o f BiH, i s therefore essential for the achievement o f the project objectives. 53. K e y technical issues being addressed by the project include: (i) capacity o f the public and private veterinary services; (ii)adequate regulatory and incentive framework (including sub-laws); (iii) regulations and protocols in accordance with OIE standards and guidelines); (iv) adequate laboratory facilities and staff capabilities; (v) harmonization o f disease information systems to improve BiH’s capacity to participate in the World Animal Health Information System (WAHIS) o f the OIE; (vi) biosecurity measures; (vii) minimizing contact between potential infected wild birds and domestic poultry; and (viii) coordinating among public agencies and with the private sector to improve long-term planning for infectious disease control. 54. Human Health. So far, no human H P A I cases in humans have been reported in BiH. However, the existence o f free-ranging poultry in backyards and close contact between human and poultry put BiH at relatively high risk o f transmission o f the virus to humans. The assessments carried out show that the capacity o f the MOHs, Public Health Institutes (PHIS) and other stakeholders to: (i)rapidly and accurately detect H P A I cases in humans; (ii)adequately isolate and treat suspected or confirmed cases o f A I in humans; and (iii)protect from the A I virus and other communicable diseases both populations at high risks and the general population i s s t i l l relatively limited. 24 55. First, the chain o f command i s insufficiently defined, which could lead to many problems and delays, even in case o f a limited crisis. Second, while investigation teams do exist at the Entity level PHIs, and cantonal and regional PHIs, their capacity to quickly and effectively investigate and respond to local outbreaks appears too limited. Third, although efforts are being made by both Entities, the ability o f health services to effectively isolate and treat suspicious or confirmed A I human cases i s at present extremely limited. This i s even true at the level o f tertiary hospitals, where appropriately organized and equipped isolation rooms do not exist at present. Fourth, the investigation teams as well as laboratory and medical personnel lack protective equipment and clothing and the current stocks o f antiviral drugs appear too limited. Fifth, health services will rapidly become unable to cope with an explosive increase o f the number o f patients. In such a context, priority needs to be given to: (i)the strengthening o f the capacity o f Entity and local investigation teams through training and the provision o f necessary equipment, notably personal protective equipment; (ii)the creation o f isolation rooms in hospitals, for effective isolation o f the first cases o f HPAI in humans; (iii) the training o f health workers in infection control measures; and (iv) the preparation o f plans to "clean out" hospitals in case o f a severe outbreak and the identification o f culturally and socially appropriate social distancing measures in case o f a pandemic. In parallel, actions should be taken to help: (a) strengthen the system for the surveillance o f communicable diseases and help BIH become part o f the European Influenza Surveillance network; and (b) build-up adequate human microbiology and virology laboratory capacity in each Entity. 56. 3. , Social 57. Although there are several large and a number o f medium-size commercial poultry producers, about 25% o f poultry are kept by smallholders in their backyards and managed by women with the help o f children. Such families are disproportionately likely to be in the lower income quintiles. 58. The central roles o f women and children in managing backyard poultry have important implications for the project: 0 4. Given the involvement o f children managing domestic birds (feeding, egg collection, herding geese and ducks, etc.), awareness and educational efforts need to ensure that children are effectively targeted and reached with appropriately designed messages, through the schools. Reaching women with critical A I awareness messages and information will, similarly, require specific targeting and utilization o f suitable dissemination and outreach channels. School-age children can bring leaflets to their mothers. In the event o f culling, compensation will need to be provided to women owners, and the project will ensure that mechanisms are in place to ensure this. Fiduciary 59. The financial management arrangements o f the project are acceptable to the Bank. The overall F M risk for the project i s moderate except for the Poultry Culling Compensation Scheme that i s considered to be high risk. However adequate mitigation measures and internal controls are required prior to the disbursement o f funds and some o f the key controls are included below (appendix 5). The financial management arrangements o f the Federation PIU in Ministry o f Agriculture and the RS PCU established in the Ministry o f Health have been assessed and continuously monitored as part o f project supervision, and have been found to deliver high quality fiduciary services to the projects. They have both established and maintained good financial management system for the implementation of the Bank financed projects. The financial management systems will be expanded to support the proposed project and additional 25 expertise in financial management will be engaged and financed under this project. The internal control and fund flow arrangements are yet to be finalized for the cash grants/Poultry Culling Compensation Scheme component, but the basic control procedures for the existing compensation system for Avian Influenza described in 2005 i s a valuable basis for finalizing the procedures with the added complication with additional sources o f financing for the compensation from this project. The flow o f funds under the cash grantsPoultry Culling Compensation Scheme sub-component w i l l only begin after appropriate internal control and fund flow procedures have been documented in the financial manual that will be part o f the Project Operational Manual and after the Bank has assessed the internal control arrangements as satisfactory. Appropriate flow o f fund mechanisms i s a condition o f disbursement. Detailed financial management arrangements are described in Appendix 5 . 60. Procurement. The capacity o f the PIUPCU to conduct procurement under Bank guidelines has been assessed as satisfactory under the Forestry/Agriculture and Health Projects, respectively.. Procurement functions will be strengthened by the recruitment o f an additional procurement specialist to be responsible for procurement under this project in the PIU and PCU. Activities to be financed from the Credit shall be undertaken in accordance with the procedures set forth in the Bank "Guidelines Procurement under IBRD Loans and IDA Credits" dated May 2004 (the Procurement Guidelines). Similarly, the selection and employment o f consultants' services shall be governed by the "Guidelines: Selection and Employment o f Consultants by World Bank Borrowers" dated May 2004 (the Consultant Guidelines). Details on procurement arrangements are provided in Annex 4. The procurement plan will be finalized during Appraisal. 5. Environment Environmental assessment Environmental Category PI 61. The two safeguard issues which pertain to the Project are those o f environmental assessment for methods to be deployed for disposal o f culled poultry and o f mitigating the negative impacts o f mandated culling o f poultry on small scale backyard poultry producers. A delay in the completion and disclosure o f the Environmental Assessment from the normal appraisal stage has been approved, instead making this a condition o f disbursement for Component 2 - Animal Health, and Component 3 - Human Health. The draft EMP has been completed, with the public consultation held on July 20, 2006 in Sarajevo. Following this, the EMP was finalized in end-September 2006. Nevertheless, prior to Effectiveness, evidence of the adoption of the EMP by the Recipient and each Entity needs to be provided to the Association. Activities under the proposed project are not expected to generate any significant adverse environmental effect, as a large part o f the project i s geared to support prevention activities. Overall, the project would have positive environmental and social impacts. The primary potential environmental risks can be grouped into three categories: (a) Inadvertent human exposure and spread o f the virus due to: improper culling and disposal o f dead birds (wild birds, sick and dead birds from backyard and commercial poultries); lack of, or improper use o f personal protection equipment (PPE); improper disposal o f farm waste (i.e., bedding, manure, washings, etc. during and/or after an outbreak); and inadequate lab biosafety protocols. (b) Inadvertent release o f chemicals in the environment from unsatisfactory decontamination procedures (for personnel, poultry sheds, and transport vehicles, etc.). (c) Release o f chemicals and infectious agents into the environment from inadequate laboratory and medical facility waste management. 26 62. Building capacity for collection and testing o f Avian Influenza virus. The Project’s investments in facilities, equipment, and training for laboratories will improve the effectiveness and safety over existing avian influenza handling and testing procedures by meeting international standards established by OIE. Upgrading for laboratories will include provision o f appropriate facilities and training for waste management and for bio-safety level 2 and 3 operations. Medical waste generated in health care facilities will be managed using existing guidelines in BiH, which have been found satisfactory under previous projects. The Project would also support updating these guidelines, training o f health care workers to manage medical waste following these guidelines, and, as appropriate, purchase o f equipment for the proper handling and disposal o f medical waste in participating facilities. These provisions would be included in the Project Operational Manual to be prepared prior to effectiveness. 63. Overall, the Project w i l l assist the government to develop a strategy for managing future emerging and re-emerging zoonotic and infectious diseases outbreaks. As such, the project would improve environmental and social safeguards, in two areas: (i)mainstreaming environmental safeguards into protocols and procedures for the culling and disposal o f animals during an outbreak, in particular by adopting OIE standards in these areas, and improving bio-medical waste management systems in health facilities and laboratories; and (ii)development o f policies on compensation for poultry farmers affected by future outbreaks. 6. Safeguard Policies Safeguard Policies Triggered by the Project Environmental Assessment (OP/BP/GP 4.0 1) Natural Habitats (OP/BP 4.04) Pest Management (OP 4.09) Cultural Property (OPN 1 1.03, being revised as OP 4.1 1) Involuntary Resettlement (OP/BP 4.12) Indigenous Peoples (OD 4.20, being revised as OP 4.10) Forests (OP/BP 4.36) Safety o f Dams (OP/BP 4.37) Projects in Disputed Areas (OP/BP/GP 7.60) Projects on International Waterways (OP/BP/GP 7.50) Yes [XI [I [I [I [I [I [I [I [I [I No [I [XI [XI [XI [XI [XI [XI [XI [XI [XI 64. Since the Project i s assessed as a B-category project, an Environmental Management Plan (EMP) would be implemented with project support (see project components). The EMP addresses safe culling practices, and disposal o f carcasses, laboratory wastes, and medical waste. This EMP also covers the clean up o f animal wastes o f culled poultry by the local public veterinary services and minor civil works supported under the Project. 7. Policy Exceptions & Readiness 65. The only policy exception requested has been with regard to the waiver o f the completion of the E A and EMP per para. 12 o f OP 4.01. As noted above, evidence o f the adoption o f the EMP i s a condition for Effectiveness. The project meets the regional criteria for readiness for implementation. 27 28 Appendix 1: Results Framework and Monitoring BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project Project Development 0 bjective The overall objective o f the Project i s to minimize the threat posed to humans and the poultry industry by the HPAI infection and other zoonoses, by enhancing both animal and human health infectious disease response and control capacities. Outcome Indicators With regard to awareness o f HPAI threat and how to prevent it: Behavior changes among key veterinary and public health personnel Improved public awareness o f how to prevent spread increases, and behavior changes. Use o f Outcome Information YR1 - gauge effectiveness o f government HPAI strategy YR2 - determine if government HPAI strategy needs to be changed YR3 - mainstream lessons learned from HPAI strategy into animal health and public health systems. With regard to HPAI outbreaks among poultry: Government culls birds at the infection points following internationalbest practice Government provides timely compensation to farmers for culled birds With regard to HPAI outbreaks among humans: Infection diagnosed and contained Patients receive effective treatment for HPAI infection Use o f Intermediate Outcome Monitoring Intermediate Outcome (One per Component) Intermediate Outcome Indicator (*) Component 1: Target population informed about public health risks and procedures associated with HPAI. 50% percent o f at-risk population practicing safe handling procedures with respect to poultry and poultry meat. YR1-YR3. N o change in behavior indicates need to review media and messages. Component 2.A: National policy framework defined and national strategy developed to prevent, control, and eradicate HPAI among the animal population. Component 2.B: Animal disease surveillance and diagnostic capacities strengthened and training o f the veterinary services designed and completed. Relevant legislation - for registration o f poultry farms, biosafety, and surveillance and monitoring - including all necessary sub-laws, regulation, protocols and guidelines, prepared and adopted Laboratory equipment and materials are procured, distributed and installed; Staff i s trained in surveillance and diagnostic methods; Reporting and reaction time for suspected cases of A I i s reduced to the minimally acceptable levels; 75% average monitoring coverage in atrisk areas. Outbreak Containment Plan conforms with the guidelines o f FAO/OIE and GPAI; Chain o f command and coordination arrangements in place and functional. Emergency supplies procured and YRl-YR2: Identify gaps and needs for additional support. Determine if plans need to be changed. Component 2.C: Outbreak Containment Plan prepared and activated as needed in response to A I outbreaks 0 0 0 29 YR1-YR3: Verify compliance with procedure and identify needs for changes and training YR1-YR2: Identify gaps and needs for additional support. Determine if plans need to be changed. YRl-YR2: Identify gaps and needs for additional support. Determine if plans need to be changed. Intermediate Outcome (One per Component) Component 3.A: Better managed public health agencies through improved planning and coordination Component 3.B: Strengthened surveillance o f influenza-like illnesses Intermediate Outcome Indicator (*) available at strategic locations in the field; If appropriate, ring vaccination around infected areas completed;. Culling, disposal and disinfection activities completed as needed; Compensation provided to poultry owners rapidly and transparently. (in conjunction with Component 4) Chain o f command and coordination arrangements in place and functional Detailed response plan prepared, including a detailed implementation plan for social distancing Simulation exercise conducted each year and report produced and disseminated to all stakeholders. Notification o f Influenza like syndromes improved and early warning system functioning. X personnel trained in influenza surveillance and control Use o f Intermediate Outcome Monitoring YR1-YR2: Identify gaps and needs for additional support. Determine if plans need to be changed YR2-YR3: Review and evaluate plan and modify as necessary YW-YR3: Results o f simulation exercises and actual investigationo f outbreaks used to identify need for information, training and equipment YR1-YR2: identification o f gaps and needs for additional suppodtraining. Y E - Y R 3 : Assess need to revise the strategy for alert, investigationo f outbreaks and response. National Influenza Laboratory (NIL) safely collects, manipulates and tests HPAI specimens. At least one laboratory able to type and subtype influenza viruses and at least at bio-safety level 2 each entity. YRI-YR3 Inability to achieve biosafety levels indicates need to review investment, staffing, protocols and procedures Timely transmittal o f specimens to the UK reference laboratory Maximum5 days elapse between collection and transmittal o f specimens to reference laboratories for confirmation. Y R l -YR3: Verify compliance with procedure and identify needs for changes and training National and regional teams able influenza outbreaks At least one team in each Entity able to properly respond to outbreak within 24 hours after notification/alert. Component 3.C: Public health system responds to suspected or actual HPAI cases in humans Staff guidelines for immunization against both seasonal flu and HPAI completed and disseminated YR2-YR3: Assess guidelines to ensure sufficient immunization coverage o f populations at risk. 100 percent o f PHI, hospital, and PHC service personnel vaccinated against seasonal influenza. YRl-YR3: Review procedures and modify to meet targets 30 percent o f population at high risk vaccinated against seasonal influenza YR1-YR3: Review procedures and modify to meet targets to investigate and respond to 30 YRl-YR3: Verify capacity to respond to suspected outbreaks. Identify needs for training and additional support. Intermediate Outcome (One per Component) Intermediate Outcome Indicator (*) Use o f Intermediate Outcome Monitoring 2000 units o f anti-viral drugs stockpiled YR2-YR3: Review procurement and in each Entity and operational plan to storage procedures rapidly procure anti-viral drugs Y2: Review plan and modify as completed necessary Isolation rooms established and adequately equipped in at least 2 YR2-YR3: Assess progress in Hospitals in each Entity with staff trained establishing rooms and revise (andor re-trained). Safety measures well procedures if objectives not met know and PPE available. Prepare hospital clean out plans in cases o f serious YR2-YR3: Assess guidelines and dissemination methods outbreaks or pandemic. Guidelines on the use o f antiviral and on isolation and care produced and disseminated to staff. 50 percent o f staff in Entity, cantonal and RS hospitals knowing how to protect themselves and patients against the HPAI, use anti-viral drugs and adequately treat patient with HPAI. Y2-YR3 Assess capacity o f hospital staff to isolate and treat first cases o f patients. Identify alternative strategies Y2-YR3 Assess capacity o f hospital staff to isolate and treat first cases of patients. Identify alternative options to take care o f large numbers of patients in case of large outbreaks or a pandemic. Component 4: Poultry Culling Compensation Scheme operational, including agreed procedures for compensation o f both small-scale producers ("backyard"), and large-scale commercial producers In the event of outbreak, timely compensation provided to all farmers whose animals are culled Compensation procedures subject to regular updating, based on results o f each compensation event Component 5.A: Coordination and management o f project activities carried out as planned. Progress reports, financial monitoring, procurement and disbursement reports, audits, management and financial reports prepared and submitted periodically. Baseline developed for monitoring and evaluating Project impact six months after Credit effectiveness. Methodology defined and monitoring and evaluation periodically undertaken. Y 1 - Review comprehensiveness and timeliness o f reports and make adjustments as required Component 5.B: Coordination and management o f project M&E activities carried out in a professional manner, as planned. Y 1-Y2 Assess quality o f data collected through M&E activities and define what program adjustments are needed. NOTE: Should any disease outbreak occur (avian flu or another communicable disease), the response o f the health system will be examined, both for results monitoring and to ensure that lessons learned will inform further implementation o f this operation. 31 I / t- v) 5 C E 0 9 s 3 d m 4- ol M 1 m i- M M f U a, 5- x 0 +-' IA M Et a VJ I .a, a Y VJ .-c 0 d 0 0 I m I 00 M Appendix 2a: Detailed Project Description BOSNIA AND HERZEGOVINA: Avian Influenza PreparednessProject 1. The project would finance activities under five components: (i)Strategic communications and public information; (ii)animal health protection and disease prevention and control; (iii)human health protection and disease prevention and control; (iv) poultry culling compensation scheme; and (v) implementation support, monitoring and evaluation. It should be emphasized that even though the activities are organized by sectoral components, the Project calls for, and strongly endorses an integrated national plan that ensure common objectives across sectors for dealing with the threat o f HPAI. In addition to the Bank and government co-financing described below, various other international organizations -- including the European Commission (EC), World Health Organization (WHO), United States Agency for International Development (USAID), United Nations Children’s Fund (UNICEF) - are active in assisting the Government o f Bosnia-Herzegovina to address the threat o f Avian Influenza. The Project has been designed in close cooperation with these organizations, to leverage the maximum financing possible, and to avoid duplication o f efforts. With the exception o f UNICEF, the exact level o f financing o f these donor activities i s not presented, as this i s not considered direct cofinancing o f the Bank-funded Project, COMPONENT1: STRATEGIC COMMUNICATION AND PUBLICINFORMATION - U S $0.20 million Financing IDA Credit: IDA Credit Proceeds FBiH: US$O. 1 1 million RS US$0.09 million US$0.20 million 2. I t i s o f critical importance that all sectors o f society are properly informed about the risks from HPAI, in order that proper protective measures can be taken, and, as importantly, to reduce the risk o f unwarranted fear about the disease (e.g. unnecessarily reducing consumption o f poultry products). This component would provide support for a broad range o f information and communication activities, to increase the attention and commitment o f government, private sector, and civil society organizations, and to raise awareness, knowledge and understanding among the general population about the risk and potential impact o f the disease. 3. Building on the work initiated by the Entity Public Health Institutes with the support o f UNICEF, numerous communications interventions will be financed, chief among them the further development and implementation o f the already drafted communication strategy. The draft strategy includes, inter alia: improved communications strategies between and across government agencies (National Communication Plan); protocols for coordination o f the outbreak and crisis communication for professionals (veterinarians, human health doctors, inspections, civil protection, state border service, etc); materials and targeted training for educators; capacity building in communication techniques for health workers, teachers and media professionals; and, at the community level, awareness raising and communication for behavior change activities through all appropriate communications channels. A local Communications Specialist will be hired to work in the Technical Support Group to coordinate activities under this component. He/she will be assisted by short-term consultants to be engaged as needed t o address specific communications issues. In order to assist with the above tasks, three types o f activities are being considered for financing: 39 0 0 A. Developing basic communication materials, including developing and testing messages and materials to be used in the event o f a pandemic or emerging infectious disease outbreak; Developing training courses in communications methodology for veterinary staff as well as for health workers at the cantonal and municipal levels; and Collaboration among stakeholders, including state level authorities such as the Ministry o f Foreign Trade and Economic Relations, the Ministry o f Civil Affairs, the Ministry o f Security, as well as veterinary and public health authorities at the state, entity and municipality levels. Developing Basic Communication Materials 4. Activities to be supported would include developing and testing messages and materials to be used in the event o f a pandemic or emerging infectious disease outbreak, and further enhancing the infrastructure to disseminate information at the state and local levels and between the public and private sectors. Communication activities w i l l support cost effective and sustainable methods such as marketing o f “handwashing” through various channels through the delivery o f handwashing messages via mass media, counseling, schools, etc. Communication materials would be integrated into Avian Flu specific interventions as well as ongoing outreach activities o f ministries and sectors, especially ministries o f health, education, agriculture, security and transport. Specifically, support would be provided for: (i)the development and distribution o f basic communication materials (such as question and answer sheets and fact sheets) on influenza, influenza vaccine, antiviral agents, and other relevant topics; (ii)general preventive measures such as “do’s’’ and “don’t’s” for the general public. Support would also be provided for information and communication activities to increase the attention and commitment o f government, private sector, and civil society organizations, and to raise awareness, knowledge and understanding among the general population about the risk and potential impact o f the pandemic and to develop multisectoral strategies to address it. B. Developing Training Courses in CommunicationsMethodology 5. This sub-component would support the development and implementation o f training courses in communications methodology for veterinary staff as well as health workers at the State and local levels. I t will include the preparation and dissemination o f information materials, and the provision o f communications and information equipment for use at the state and local levels. Specifically, support would be provided for (i)information and guidelines for health care providers; (ii)training modules (webbased, printed, and video); (iii)presentations, slide sets, videos, and documentaries; (iv) and symposia on surveillance, treatment and prophylaxis. In addition, support would be provided to strengthen networks o f communication offices, as well as mechanisms to increase coordination and consistency o f messages among risk communication managers. Training would be provided under this sub-component for spokepersons from priority sectors in managing the media, partnering with the electronic and print media with a view to highlighting the national response, as well as accurately reporting on the monitoring, preparedness, containment and mitigation plans, as the case may be. The Ministry o f Education and relevant partners w i l l participate in the development o f educational materials to be used in schools. C. Collaboration with Stakeholders 6. The multi-dimensional problems associated with HPAI infection necessitate collaboration from a wide range o f stakeholders within each country, which has to be supported by broad communications and information campaigns to improve public awareness. The major stakeholders include various ministries (Finance, Agriculture, Health, Transport, veterinary services, national research institutions and diagnostic laboratories), NGOs and civil society organizations, private sector companies and associations (e.g. large poultry producers, farmers’ associations, veterinarians and farmer involvement at the grass roots level). 40 The sub-component would support activities designed to improve the effective coordination and collaboration among these stakeholders. - COMPONENT 2. ANIMAL HEALTH PROTECTION AND DISEASEPREVENTION AND CONTROL $2.98 million Financing Gov’t. o f Bosnia and Herzegovina FBiH RS IDA Credit: US$0.25 million USO.17 million US$O. 10 million US$2.46 million us IDA Credit Proceeds FBiH: US$1.62 million RS US$0.84 million 7. The project would support a program to develop and implement H P A I prevention, containment, control, and eradication activities in the livestock sector, specific to the needs o f BiH in the short, medium and longer term. These activities reflect an assessment o f the particular risks, conditions, constraints, needs and possibilities in the country, including a rapid assessment o f the veterinary services. Government contribution to this Component will consist primarily in o f consumables (e.g. personal protective equipment and supplies), minor goods, running costs o f various reporting systems, and in-kind staff costs. A. Enhancing H P A I Preparedness and Prevention Capability (US $0.31 million) 8. A l : Strengthening the National Policy and Regulatory Environment. The project w i l l support activities aimed at improving the policy, legal and regulatory framework that governs the national capability to implement the recommended disease detection, control, prevention, containment, and eradication measures in a uniform and effective way and in accordance with OIE standards and guidelines. The project includes support for a detailed review o f current policies and the existing legal and regulatory environment and for the drafting, as may be warranted, o f legal amendments, regulations and implementation guidelines and manuals. Staff o f the Ministries o f Agriculture, SVO, and other concerned agencies will, in topical working groups and with support by international experts on veterinary laws and regulations, review the relevant laws and regulations governing animal disease control and will draft the necessary legislative amendments, regulations and implementation guidelines. Particular emphasis w i l l be placed on regulations concerning the control o f notifiable diseases, the delineation o f the respective responsibilities o f the veterinary authorities, private veterinary service providers and farm owners. Specific areas o f emphasis are: 0 Development o f legislation establishing a national program for registration o f poultry farms. Data related to farm location, type o f production and capacity (number o f animals, production output) will be necessary for planning, implementation and evaluation o f AI preparedness and control activities. This information will also be necessary for efficient indemnification o f losses incurred from the destruction o f livestock. 0 Development o f legislation regarding biosafety requirements/conditions necessary for establishing and maintaining poultry farms. The capacity of relevant agencies should be increased to provide extension services/education to producers in support o f biosafety requirements. Development o f legislation mandating surveillance activities. This legislative framework w i l l need to incorporate equitable solutions for distributing costs and responsibilities for surveillance between government and producers. 41 Strengthening of Veterinary Services, Diagnostic Capacity, Applied Research, and Disease B. Surveillance (US $2.3 million) 9. B1: Strengthening Veterinary Services and Diagnostic and Applied Research Capacity. There are wide divergences in the capacities o f the individual animal health laboratories within the country. None o f the laboratories have an appropriate biosafety environment for handling A I agents. The short term goals for the system include developing appropriate capacities and biosafety levels (BSL) in regional laboratories involved in routine monitoringlscreening for AI. An evaluation o f capacities and procedures in existing laboratories, to include biosafety protocols, will precede the determination o f the specific steps that will be required to develop laboratory capacities. 10. The longer-term goal i s to upgrade all laboratories to at least Biosafety Level 2 and, depending on the overall financing that becomes available, to establish one B S L 3 lab, which could handle not only HPAI, but any other highly pathogenic organisms which need to be tested. Project financing w i l l provide, inter alia: civil works for rehabilitation and modernization o f the National Animal Health Laboratories network (likely to focus on 5-7 labs); crucial diagnostic equipment; waste decontamination and disposal equipment; refrigerators and microbiological cabinets; computers and software; and basic laboratory furnishings. Additional support for laboratories would be provided under the proposed IDA-financed Agriculture and Rural Development Project. 1 1. B2: Strengthening Animal Disease Information Systems. The effectiveness o f an AI control program will dependent upon the establishment o f a well functioning surveillance system, fed by valid data collected in the field. This surveillance system should permit rational allocation o f resources, creation o f alternative actions, and objective evaluation o f activities performed. Surveillance programs should be differentiated between wild and domestic birds and further delineated within the domestic population between free-range and commercial poultry. In order to achieve optimization o f surveillance efforts, risk areas (wild bird habitat) must be expanded and a scientifically based sampling scheme must be developed for domestic poultry. This will require assistance in obtaining sampling equipment, developing arrangements for sample transportation, obtaining personal protective equipment and training local staff. 12. Support will be provided for basic equipment, training, surveillance, and integrated reporting systems, for improved monitoring o f w i l d bird migration and “resting” points. This activity will be coordinated with technical professionals from the biological sciences, with training focused on disease recognition, safe handling o f potentially infected wild birds, and public communications. C. Strengthening H P A I Control and Outbreak Containment Capacity (US $0.30 million) 13. Project support will be made available for the implementation o f H P A I outbreak containment actions, as set forth in the draft national action plan and to be further specified in the final plan and associated implementation guidelines and manuals. The national action plan specifies the responsibilities and functions o f a National Disease Crisis Coordination Center (NDCCC). It also defines the composition and responsibilities o f Local Disease Crisis Coordination Committees (LDCCCs) that will be formed and trained now, and activated in any location where an outbreak i s suspected andor confirmed. 14. The project will finance and support activities related to the implementation o f the plan, including, inter alia, technical assistance and training for enhanced emergency response, outbreak control, data collection and interpretation, early warning systems, and basic epidemiology, as well as equipment such as personal protective equipment for field and laboratory epidemiological staff, culling equipment, and disinfection sprayers. In addition, a specific unit for epidemiological communications will be established. 42 D. Improving Biosecurity in Poultry Production and Trade (US $0.07 million) 15. Support will be provided for a training program on farm biosecurity practices. This training w i l l be primarily oriented towards smallholder operations, as larger commercial farms generally have quite good biosecurity. However, large operations will also be targeted, particularly where they are nearby to significant poultry populations in “backyards”. COMPONENT 3: HUMAN HEALTH PROTECTION AND DISEASEPREVENTION AND CONTROL $1.98 million Financing Gov’t. of Bosnia and Herzegovina FBiH RS IDA Credit: us IDA Credit Proceeds US$0.22 million US$O. 10 million US$O.lO million FBiH: RS US$0.98 million US$0.98 million US$1.96 million 16. This component would support a program to further plan and implement preparedness, and improve surveillance and prevention as well as response and containment activities in the human health sector in the short, medium and longer term. 17. On the basis o f the country’s epidemiological needs and assessment o f the particular conditions, constraints, needs and possibilities in BiH, initial support under the project will concentrate on a few essential areas. These will include the further refinement o f the contingency preparedness plans and the establishment o f a clear chain o f command and coordination mechanisms, the rapid strengthening o f capacities in intervention epidemiology (including simulation exercises), the expansion o f seasonal flu vaccinations, and the strengthening o f the health sector capacity to isolate and adequately treat a few suspected or confirmed cases o f A I in humans. In parallel, the project will help plan and support the strengthening o f the surveillance system for communicable diseases and o f laboratory capacity as well as o f the capacity o f the health sector to prevent the spread o f the A I virus among humans and to protect groups at high risk. Finally the project would also support efforts to prepare for social distancing and other interventions measures in case o f a pandemic. 18. Activities to be supported under the project would be grouped in three sub-components: (a) enhancing public health program planning and coordination; (b) strengthening o f public health surveillance system; and (c) strengthening health system response capacity. Government contribution to this Component would consist primarily o f laboratory and hospital consumables (e.g. personal protective equipment and supplies), minor goods, and in-kind staff costs. A. Enhancing Public Health Program Planning and Coordination (US $0.13 million) 19. Legal aspects regarding communicable diseases (including highly pathogenic infections) are covered by the Laws on the protection o f the population from infectious diseases, which were adopted in 1995 in RS and M a y 2005 in FBiH. Current institutional arrangements for addressing Avian Influenza in Humans in BiH parallel the organization o f the health system and responsibilities lie with the entities. 20. In the past year, both Entities have made significant efforts to plan and coordinate activities. The RS Preparedness Plan was adopted by the Government in October 2005. The FBiH “preparedness plan for expected emergence o f the Pandemic Influenza” has been revised in February 2006, and has now been approved by the Federation Government. In any case, these plans have now been superseded by the creation o f a National Contingency Plan, produced through a series o f multi-stakeholder workshops 43 sponsored by WHO. The National CP contains clear chain o f command and individual responsibilities and (b) the measures to ensure coordination between stakeholders working on animal and human health in M O H s and between MOHsAPHS and other actors within the health sector. The National CP i s not yet formally ratified by the full BiH Parliament; this i s expected to be completed by mid-2007. The subcomponent would support the following three activities: 22. A l : Refining Plans and Strengthening the Chain o f Command. As noted, the W H O has sponsored a series o f workshops which have led to an integrated National Contingency Plan (CP), which addresses the shortcomings noted above. T o help prepare all stakeholders t o better cope with outbreaks and ensure that individual responsibilities and procedures to be followed are well known, the project would finance the conducting o f simulation exercises at the State, Entity and local levels, once the new National CP i s approved. 23. A2: Review and Amendments o f Laws and Bylaws. The project would finance technical support to review and prepare necessary amendments to current laws and bylaws. More specifically, assistance will be given for the review and/or preparation of, inter alia: (i)statutory provisions regarding quarantine laws and how they apply in a public health emergency, (ii)laws and procedures for closing businesses and schools and suspending public meetings during a declared state o f emergency, (iii) medical volunteer licensure, liability and compensation for retired and non medical volunteers; and (iv) worker’s compensation laws as they apply to heath care and other essential workers. 24. A3: Social Distancing. The project would support the development o f a detailed implementation plan for so-called “social distancing” measures to be activated in case o f an epidemic. Social distancing measures will typically be activated on advice from health professionals and institutions, although they will not be the enforcing agencies. The implementation plan will have therefore to explicitly define institutional responsibilities for activation and enforcement o f social distancing measures and for inter-agency and inter-ministerial coordination. Training will also be provided to “enforcement agents” such as the police and military in safe, efficient implementation o f social distancing measures in ways that do not induce panic. Additional preventive actions that will complement social distancing (such as personal hygiene promotion through various communication channels, including hand-washing and proper cooking, and distribution and use o f masks) will also be supported. 25. A4: Clean Out Plans for Hospitals (Preparing for Coping with Severe Outbreaks and a Pandemic). The project will also support the preparation o f plans and measures to be implemented in case o f larger outbreaks or a pandemic. While a full-scale pandemic will rapidly overwhelm hospital capacity, there i s a need to prepare hospital “clean-out’’ plans to help create a buffer for localized outbreaks. Specifically, the project will support the preparation o f plans to reorganize and clean out infectious clinics and other departments in hospitals to make them able t o cope with an increase o f suspected or confirmed A I cases. The plans will necessarily include measures to evacuate hospitals o f non acute cases through, for instance, the canceling o f elective procedures or finding alternative accommodation for non-emergency admissions. B. Strengthening National Public Health Surveillance Systems (US $0.95 million) 26. At this point in time, there i s no national surveillance system for communicable diseases. The surveillance systems in place at the Entity level are based on routine health facilities reports for 62 diseases, which are compiled and analyzed by the hygiene and epidemiological departments o f the IPHs’. ’ See the WHO report titled “assessment o f the national surveillance system for communicable diseases” and dated September 2004. A new assessment o f the national laboratory capacity will be conducted by WHO in June 2006. 44 Except in the case o f suspected or confirmed outbreaks, reports are sent weekly t o the intermediary level (regional or cantonal PHIS) and monthly to the Entity level. N o specific surveillance system i s in place for influenza and influenza-like (ILI) illness and BiH i s not part o f the European Influenza Surveillance network. 27. Investigation and response teams exist at the Entity level (2 in RS in Banja Luka and Doboj and 1 in FBiH) and additional capacity can be mobilized at regional or cantonal level. These teams, however, lack protective personal equipment, spraying devices and disinfectant. Efforts to train staff in intervention epidemiology have already started and recently (2005), 24 epidemiologists attended the EPIET course organized by WHO with EU financial support. However, there i s an obvious need to further build-up capacity in intervention epidemiology and t o train and/or retrain investigation and response teams. 28. There i s no national or Entity Influenza Laboratory and or no capacity in the health sector for typing and sub-typing o f influenza virus strains. As indicated in the 2004 report on laboratory capacity in BiH6, the capacity o f existing microbiology and virology laboratories need to be significantly improved before the country can be considered to have an effective communicable diseases surveillance system. Basic facilities and good expertise exists in the country. However, the existing laboratory capacity i s highly fragmented and the lack o f training and investment in the past 15 years have left the laboratories operating at a level far below EU standards and the minimum bio-safety level 2 required for manipulating highly pathogenic viruses. Three interventions are planned. 29. B1: Improvement o f Capacity in Intervention Epidemiology. The project will first strengthen the capacity to investigate and respond to outbreaks, including: (a) investigation and collection o f specimens in areas where A I in birds or poultry are reported, (b) safely and rapidly transport o f specimens to laboratories (including to the UK reference laboratory) for diagnostic testing and virus sub-typing and confirmation o f results and, (c) outbreak investigation and containment measures in areas with suspected or confirmed human cases. T o this end and building on activities supported by WHO (with financing from EC), the project will support the Public Health Institute and regional/cantonal epidemiological investigation and response teams through: (a) the re-training o f staff, (b) the provision o f personal protective gears and other equipment and consumables (sprayers, disinfectants), the provision o f materials and bio-safety boxes for the collection and transport o f samples and, (c) communications equipment. 30. B2: Strengthening the Surveillance o f Influenza and Communicable Diseases. In parallel with activities listed in B 1 above, the project will complement the EU/WHO current efforts and pilot project aiming at the strengthening o f the communicable diseases surveillance system. In particular, the project will provide part o f the necessary I T equipment (computers, servers, software) and will contribute to the building o f capacity for reporting and analysis o f epidemiological data. In this framework, particular attention will have to be paid to the active surveillance o f influenza with a view to help BIH rapidly j o i n the European Influenza Surveillance network. B3: Strengthening the Laboratory Capacity. The project will contribute to building the laboratory capacity and network. More specifically, the project w i l l contribute to efforts towards upgrading two laboratories ( 1 in each Entity) to bio-safety level 2 and make them able to type and subtype influenza virus strains. In addition, the Project will assist with upgrading the laboratory in the P H I in Mostar, to enable it to provide virus identification capacity. T o this end, the project will finance part of the necessary studies, limited c i v i l works and equipment as well as kits, reagents and other consumables and personal protective equipment (PPE) for laboratory staff. The project will also finance training and 31. 6 Laboratory capacity in BiH- April 2004- (Ray Sanders and Bernardus Ganter) 45 retraining o f laboratory staff. If needed, the project would also finance appropriate sterilization equipment and incinerators for the management and disposal o f contaminated lab materials. C. Strengthening Health Care Response Capacity (US $0.9 million) 32. A t this point in time, the BIH health sy,stem appears relatively unprepared to immediately and adequately respond to even a limited outbreak, not talking o f coping with a pandemic. Seasonal influenza vaccination remains limited and MOHs have only very limited stocks o f anti-viral drugs (only 400 and 1000 antiviral treatments are available in respectively RS and the FBiH). 33. While the hospitals where the first A I suspected or confirmed human cases would be hospitalized have been identified, these facilities are not ready to appropriately and safely taking care o f highly infectious patients. Isolation rooms need to be established and properly equipped and health workers from these facilities need to be trained or re-trained in many areas and t o be provided with personal protective equipment. Three types o f intervention are proposed: 34. C1: Emergency Measures. Under the project, assistance will rapidly be provided to ensure that optimal medical care to A I suspected or confirmed human cases can be offered and to provide essential services to the community in case o f a pandemic. Towards this aim, the project will provide support for the: (a) establishment o f isolation capacity in the hospitals and infectious clinics that have been already identified (Banja Luka and Foca for RS; Sarajevo and Tuzla for the FBiH); (b) equipment o f the isolation rooms; (c) emergency stocks o f medicines and consumables, (d) protective equipment for health workers and; (e) training and retraining o f staff. In addition, an enhanced triage capacity will be supported for the Clinical Center in Mostar. 35. In case o f a declared influenza pandemic, this sub-component w i l l finance emergency imports identified as necessary under a well-defined preparedness and response program to be prepared as part o f project implementation. These imports are likely to include: (i) pharmaceuticals and vaccines, (ii) medical supplies and equipment, (iii)communication equipment, supplies and information campaigns, (iv) food and water containers, and (v) protective clothing. Particular attention will be paid to the definition o f measures towards the protection o f health care workers and t o ensure that they will be willing and can continue to be at work in a pandemic situation (including protection and compensation measures for the risks involved). 36. C2: Vaccination. This sub-component will help expand regular seasonal flu vaccination for targeted priority groups’ (as defined in the contingency plan). In view o f financial constraints as well as the anticipated limited quantities o f seasonal flu vaccines available on the international market, the project w i l l more specifically focus on the immunization o f the most at risk populations (poultry farmers and veterinarians) and o f health care workers. It would also finance the development o f a detailed logistical (procurement and distribution) plan for mass vaccination should an H P A I vaccine become available. 37. C3: Anti-Viral Drugs: Under this sub-component, the project will finance the stockpiling on anti-viral drugs (Oseltamivir or others). I t i s plan to help increase buffer stocks o f Tamiflu up to 3000 treatments for the Federation and to 1000 treatments for RS. 7 Including poultry farmers, veterinarians, health staff and persons with chronic disorders o f the pulmonary and cardio-vascular systems andor chronic metabolic and immunologic disorders. To a l l the extent possible, vaccines will also be provided for the immunization of children below 5 and persons over 65 years o f age 46 COMPONENT 4: POULTRY CULLING COMPENSATION SCHEME - U S $0.75 million Fin an cing FBiH RS IDA Credit: US$O. 10 million US$O. 10 million US$0.55 million IDA Credit Proceeds FBiH US$0.3 1 RS US$0.24 38. Early detection and reporting as well as rapid response depend critically on the incentives for poultry owners to report very quickly any sick and dead poultry to their veterinarians. Without adequate compensation arrangements in place, poultry owners have no incentive to do so, but must fear that their animals w i l l be destroyed and they lose this valuable capital. 39. The June 2002 Veterinary L a w in BiH confirms the right o f farmers to compensation for the elimination o f contagious animals, and determines the procedures for culling and compensation. The value o f culled animals i s determined by Entity Veterinary Services, according to the damage appraisal l i s t prepared by the appraisal commission. In the case o f Avian Influenza, the commission also confirms the number o f culled poultry. These procedures have been successfully employed for the recent outbreak o f H P A I in Jajce and Jezero. 40. In the event o f further HPAI outbreaks in BiH, the Project will provide support for culling and elimination o f infected and at-risk poultry, with compensation to farmers and commercial poultry producers based on the existing legal framework and the A I contingency plan. The order for culling and compensation will determine in advance the compensation value by type o f poultry (rather than requiring a commission to determine the value on a case-by-case basis). Accurate lists will be kept o f all poultry culled, so that the culling committee can calculate the compensation that will go to each poultry owner. Strict requirements will apply to recording, reporting and verification o f poultry culling, compensation claims and payments. 41. Bosnia-Herzegovina’s current capacity to compensate farmers for culled animals w i l l be enhanced by the provision o f US $0.55 million from the Project. This will be split evenly between the Entities, with each Entity provided matching funds o f US $0.1 million. Access to the Bank portion o f these funds will be conditional on the modalities for operating the Fund being approved by IDA. Key parameters guiding this effort are provided in Appendix 2b. COMPONENT 5: IMPLEMENTATION SUPPORT AND MONITORING AND EVALUATION U S $0.45 million Financing Gov’t. o f Bosnia and Herzegovina FBiH RS IDA Credit: A. US$O. 12 million US$O. 15 million US$O. 15 million US$0.03 million Implementation Support 42. This sub-component would support costs associated with project management and coordination, including costs associated with the Technical Support Group to be established to support project coordination and management, and costs associated with the PIU/PCU for procurement and financial management services. An inter-sectoral Crisis Committee was established in November 2005 under the chairmanship o f the Minister o f Foreign Trade and Economic Relations (MoFTER) to oversee the H P A I control and containment effort and to provide general policies and guidance for avian influenza control. This Committee will operate as needed in the event o f further A I outbreaks to ensure coordination and 47 linkages across relevant agencies and with international partners. Implementation arrangements are discussed in Annex 2c below. B. Monitoring and Evaluation (M&E) 43. B1: Training. This sub-component would support training in monitoring and evaluation at all administrative levels, mid-term evaluation workshop, and development o f an action plan for M&E and replication o f successful models. It would support the following activities: Training in M&E; 0 Implementation o f baseline studies; 0 Mid-Term evaluation o f the project; On-going part'icipatory monitoring and evaluation; and 0 Final project evaluation. 44. B2: Project Monitoring and Impact Evaluation. Support would be provided to develop project monitoring and impact evaluation assessments. Two types o f M&E are envisaged: 45. B2(i): Monitoring o f project implementation. This i s a function o f the TSG, which would collect relevant data from line ministries and other implementation agencies and then compile them into quarterly progress reports focusing on status o f physical implementation by component, use o f project funds (based on data provided by the PIUPCU) and monitoring indicators. Specific surveys can be conducted to obtain data for this purpose. Annual expenditure reviews would be conducted to assess government commitment to strengthen the public health functions as measured by budgetary allocations and their distribution by activity. 46. BZ(ii): Impact evaluation. The aim o f evaluation i s to find out whether the interventions are effective or the program i s having the desired impact. The evaluation will include both quantitative and qualitative aspects and be conducted on a yearly basis. The quantitative aspects w i l l rely on new information systems and surveys implemented as part o f the various components o f the project, currently existing data sources, and primary evaluative data collection efforts. The goal o f the qualitative aspect o f the evaluation will be to document perceptions o f program managers, staff, patients, and local and national leaders. Qualitative information will be collected using site-visit interviews, focus groups, and respondent surveys. 48 Appendix 2b: Culling and Compensation Procedures BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project Table 1: 2004 Production and Consumption o f poultry in BH/l Million o f c h i c k e n Million kg Production 13.9 20.1 offic iaV2 8.1 11.7 ow n - u s e 5.8 8.4 Imports 6.1 9.3 I n f o r m a l sector/3 6.3 8.7 Consumption 26.3 38.2 / 1 E x p o r t s are negligible /2 I n c l u d e s registered m a r k e t - o r i e n t e d p r o d u c t i o n 13 I n c l u d e s u n o f f i c i a l d o m e s t i c p r o d u c t i o n and unregistered i m p o r t s Poultry Culling Compensation Scheme 1. Early detection and reporting, as well as rapid response, depend critically on the incentives for poultry owners to report very quickly any sick or dead poultry to veterinarians. Without adequate compensation arrangements in place, poultry owners have no incentive to do this, and will fear that with the destruction o f their animals they will lose this valuable capital. 2. The June 2002 Veterinary Law in BiH confirms the right o f farmers to compensation for the elimination o f contagious animals, and determines the procedures for culling and compensation. The value o f culled animals i s determined by Entity Veterinary Services, according to the damage appraisal list prepared by the Appraisal Commission. In the case o f Avian Influenza, the Commission also confirms the number o f culled poultry. These procedures have been successfully employed for the February 2006 outbreak o f HPAI in Jajce and Jezero. 3. In the event o f further HPAI outbreaks in BiH, the Project will provide support for culling and elimination of infected and at-risk poultry, with compensation to farmers and commercial poultry producers based on the existing legal framework and the A I contingency plan. The order for culling and compensation will determine in advance the compensation value by type o f poultry (rather than requiring a commission to determine the value on a case-by-case basis). Accurate lists will be kept of all poultry culled, so that the culling committee can calculate the compensation that will go to each poultry owner. Strict requirements will apply to recording, reporting and verification o f poultry culling, compensation claims and payments. 4. The Poultry Culling Compensation Scheme will be financed by an IDA credit o f US$0.55 million, conditional on IDA’Sapproval of the modalities for operating the Fund.-In addition, each Entity would contribute US $0.10 million, as part o f the regular emergency fund allocation provided to the animal health sector. Village and Backyard Poultry Culling 5. Compensation for AI-infected poultry in Jajce and Jezero followed the procedures provided by the contingency plan. In future cases o f AI, the same approach should be taken. After official confirmation o f an outbreak, the State Veterinary Office authorizes the local veterinary stations to undertake necessary measures for control o f the disease. First an inventory o f all poultry i s done within a radius o f 3 km. Then, the actual culling i s undertaken. After the culling, the owner and assessor sign a 49 form defined in the Contingency Plan (Form 6 in Annex IV) in three copies. One copy i s kept by the owner, one copy i s submitted to the Entity Ministry o f Agriculture, and the third copy i s submitted to the Technical Support Group. Pre-numbered forms will be given to the Local Disease Crisis Coordination Committees (LDCCCs)' based on the inventory o f poultry in the at-risk region. The signed Form 6 will be the basis for payment o f farmers. The payments will be made with cash transfers through the municipal treasury systems. After culling, owners to be compensated in each municipality and the amounts to be paid will be announced in a public place. Commercial Poultry Culling 6. At commercial poultry enterprises and other large producers the culling will be conducted in the presence o f the owner by a team designated by the LDCCC. All will sign a form (in 3 copies) listing the culled birds. One copy o f the form will be kept by the owner o f the commercial enterprise; a second copy will be kept at the entity Ministry o f Agriculture and the third will be sent to the TSG. The compensation payments to commercial poultry enterprises will be made through bank wire transfers. The forms will be pre-numbered. Database and Forms 7. Forms will be printed, pre-numbered and kept with the Technical Support Group. The TSG will keep the database o f the forms sent to each municipality, owner and commercial producers. Compensation Payments 8. The parameters for payments will include the following: 0 0 Compensation to farmers will made be in cash through transfers to the respective municipalities; farmers will receive the compensation amounts from the municipality cashier. Appropriate procedures for supervising and verifying payments are specified by the Contingency Plan for A I and will be undertaken by the PIU/PCU at the direction o f the TSG. Full details regarding these procedures will be addressed in the Project Operational Manual. For small farmers, compensation per bird will be 100 percent o f the market price o f the laying hens as reported by the entity agriculture statistical directorate/or competent authority during the month preceding that in which the culling took place. For commercial producers, compensation will be provided by bank transfer. Compensation will be for reasonable replacement cost, Le., for birds less than 3 months old at the cost o f one-day-old chicks, and for birds older than 3 months at the cost o f 3-month-old birds, as reported by the entity agriculture statistical directorate/or competent authority during the month precedingthat in which the culling took place . 9. I f and when an HPAI outbreak occurs, the Entity Ministry of Agriculture will issue an ordinance for the use o f funds for compensation including the parameters o f compensation amounts. These amounts will be posted in a public place in the municipality. I t i s strongly recommended that the parameters for compensation are coordinated by both entities. 8 The project proposes using the exact same form defined in the BIh Contingency Plan - Annex I V : Form 6 50 Flow o f Funds 10. Procedures on flow o f funds should minimize delay but ensure maximum transparency. As stated above, compensation payments will be made through: (i) wire transfers to municipalities which will pay in cash for the compensation amounts to the farmers, and (ii) wire transfers to the accounts o f commercial poultry producers. 11. The State Veterinary Office, through the Technical Support Group, will verify that forms are complete, and on the basis o f Form 6 and the farmers paying lists, will direct the PIUPCU to prepare the withdrawal application with the necessary supporting documents for submission by the Ministry o f Agriculture to the State MoF to the Association for reimbursement, with instructions in the withdrawal application to transfer the payment directly to the Entity MOA. 12. The Entity MOA then transfers the funds to the municipality treasury, which processes the payments to the owners. On payment o f the compensation, the owner signs a payment receipt form, copies o f which are forwarded by the municipality to the Entity MOA,Entity MoF and the PIU/PCU. After the completion o f the payments, the municipality will submit payment lists to the TSG. 13. The PIU and PCU provide the TSG with reports on the payments on a quarterly basis, as part of the regular financial management reporting. A Poultry Culling Compensation Scheme database for each Entity will be maintained by the respective PIU/PCU to facilitate record keeping, claim verification, payment facilitation, monitoring and auditing. 14. Further detail regarding flow o f funds under the Poultry Culling Compensation Scheme can be found in Appendix 6 on Financial Management. These procedures will be fully elaborated in the Project Operational Manual. 15. Based on the law, the payment should be completed within 30 days. However, it would be highly desirable for compensation to be completed in a shorter time span, for example, no longer then seven days. After the HPAI outbreak in Jajce and Jezero, both Entities were able to compensate farmers within seven days o f culling. 16. Table 2 below illustrates the funds required to compensate farmers, both commercial and noncommercial (Le,, backyard or village, for personal consumption) if x percent o f all poultry in the state were lost to A I culling, given a price o f 10 KM per free range (backyard) chicken and 5 KM for commercial poultry and assuming a compensation scheme o f 100% reimbursement for non-commercial farmers and 50% reimbursement for commercial farmers. 51 Table 2: Funds required to secure percentage of State poultry stock, by type of farmer Total # of poultry (millions) Total Value ( I O Kh4 noncommercial; 5 commercial) Value O f 1% Value O f 2% Value O f 3% Value O f 4% Value O f 5% Non-commercial 5.8 58.0 0.580 1.160 1.740 2.320 2.900 Registered commercial 8.1 40.5 0.405 0.810 1.215 1.620 2.025 Total 13.9 98.5 0.985 1.970 2.955 3.940 4.925 0.360 0.719 1.079 1.438 1.798 0.611 1.221 1.832 2.443 3.054 Type of farmer Total Value in USD ($6.20 noncommercial) Non-commerciaL 5.8 36.0 Total 52 Appendix 2c: Implementation Arrangements BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project Technical Support Group 1. Implementation o f the Project will be undertaken by a Technical Support Group (TSG) consisting of technical advisors who are representatives o f the State Veterinary Office (SVO) in the Ministry o f Foreign Trade and Economic Relations’, Ministry o f Civil Affairs, FBiH and RS Ministries o f Agriculture (Veterinarian Services), FBiH and RS Ministries o f Health, a full-time consultant for communications and a part-time monitoring and evaluation consultant (see organizational chart below). SVO has the mandate to coordinate veterinary services on behalf o f the Entity Ministries o f Agriculture, Water Management and Forestry. The representative o f SVO on the TSG will be a permanent civil servant and will serve as Project Coordinator, reporting to the Minister o f MoFTER. The Project Coordinator will be supported by one full-time administrative assistant. The Administrative Assistant could be a civil servant, but would more likely be a short-term contracted position. The Terms o f Reference (TOR) would include assistance with office management, record-keeping, correspondence, drafting o f minutes o f meetings, translations and interpretation, and general organizational matters. The TSG will report on project implementation progress to the Council o f Ministers through MoFTER. The TSG government representatives will be responsible for coordinating with and reporting to their relevant government departments, to guide and monitor implementation o f activities in their respective areas. Except for the Project Coordinator and the communications specialist, the TSG members will serve on a part-time basis, retaining their regular civil service positions and responsibilities in their home agencies. 2. To facilitate the management and implementation o f the Project, a Project Operational Manual (POM) i s to be prepared by the TSG as a Condition o f Effectiveness. The TSG will operate as a virtual office, with daily communications via telephone, fax and e-mail, and will meet regularly on a schedule and in locations to be specified in the POM. The TSG will be responsible for preparation o f annual work programs and budgets, preparation o f TORSand specifications for goods and works bidding documents, monitoring and evaluation o f project activities, and preparing quarterly and annual progress reports to the Association. The TSG shall take decisions on the basis o f consensus. The detailed procedures governing the functioning o f the TSG will be described in the POM. Local Level Implementation 3. At the cantonal and municipalities levels, implementation would be the direct responsibility o f each cantonal/municipal veterinary/health authority. Small coordination units should be established at the local level comprising officials from healthheterinary services to work under the supervision and guidance o f the entity ministries. P I U and P C U 4. Procurement, financial management and financial reporting services for the project will be provided by the PIU Forestry and Agriculture in Sarajevo, and by the Health Sector PCU in Banja Luka. For procurement, the PIU and PCU will prepare bidding documents or requests for proposals based on technical specifications or TORSprovided by the TSG, conduct tenders, organize evaluation committees, and process payments to consultants and contractors after acceptance and approval o f the goods, works or services by the TSG. TSG members or specialists identified by the TSG will be invited by the PIU and 9 I t i s noted that when the planned state-level Ministry for Agriculture and Rural Development (exact legal name TBD) i s created, the SVO will move from MoFTER to this new ministry. 53 PCU to participate in proposal and bid evaluations. arrangements are found in Appendix 5 below. Further details regarding project procurement 5. The PIU and PCU will be responsible for financial management under the Project. They will be responsible for ensuring that each Entity establishes and maintains: (i)adequate accounting systems and procedures; (ii)flow-of-funds mechanisms facilitating timely disbursement o f funds and timely payments for goods, works and services; (iii)regular reporting on the use o f funds; and (iv) appropriate arrangements for regular financial audits. The PIU and PCU will prepare quarterly financial monitoring reports to the TSG and the Association. These responsibilities are described further in Appendix 6 (Financial Management Arrangements) below, and will be described in detail in the manuals o f financial procedures and summarized in the Financing Agreement. The PIU and PCU have experience with financial management under Bank-financed projects and have established sound internal control mechanisms on the application and use o f funds. Operating costs 6. Most o f the operating costs o f the TSG, PIU and PCU w i l l be provided by the Entities as part o f the counterpart contribution to project funding. Operating costs may include (i)maintenance and operation o f equipment and vehicles procured or used for the management o f the Project; (ii)staff salaries; (iii)travel costs and per diems; (iv) consumable office supplies; (v) communication, printing and publications; (vi) costs o f translation and interpretation; (vii) bank charges; and other miscellaneous costs as may be agreed. Poultry Culling Compensation Scheme 7. Both the TSG and the PIU/PCU as well as government at the municipal, entity and State levels will be involved in administration and reporting on payments under the Poultry Culling Compensation Scheme that are financed from the Credit proceeds. Access to proceeds from the IDA credit for eligible Compensation payments will operate under the following procedures: (a) In the event o f an A I outbreak and culling o f poultry, local veterinary services officials provide compensation application forms and instructions to owners (b) Copies o f the forms are provided by vet services to the owner, the Entity M O A and SVO (c) SVO through the TSG directs the PIU/PCU to prepare the withdrawal application with necessary supporting documents for submittal by the Entity MOAto the State MoF to the Association for reimbursement, with instructions in the withdrawal application to transfer the payment directly to the Entity M O A . (d) The Entity MOAtransfers the funds to the municipality treasury, which processes the payments to the owners (e) On payment o f the compensation, the owner signs a payment receipt form, copies o f which are forwarded by the municipality to the Entity MOA,Entity MoF and the PIU/PCU. The PIU and PCU provide the TSG with reports on the payments on a quarterly basis, as part o f the regular financial management reporting. (f) A Poultry Culling Compensation Scheme database for each Entity will be maintained by the respective PIU/PCU to facilitate record keeping, claim verification, payment facilitation, monitoring and auditing. (g) Operation o f the Poultry Culling Compensation Scheme w i l l be monitored and evaluated by the TSG as part o f the overall project M&E arrangements 54 8. Further details on the Poultry Culling Compensation Scheme are provided in Appendix 2b. In addition, the internal financial control procedures and flow-of-funds arrangements to be implemented by the PIU and PCU will be incorporated into the financial management section o f the POM. Project Implementation Arrangements Solid Lines indicate Reporting Responsibilities Dashed Lines indicated Functional Coordination Responsibilities Council of Ministers b MoFTER PT Tech Advisor Communications *For purposes of simplicity, organizational "boxes" are not presented for each governmental authority: this chart assumes that all members of the Technical Support Group continue to fulfill their normal reporting responsibilities to their relevant minist eriallgovernmental authorities In addition to the above implementation structures, the natiodl Crisis Committee (ad hoc body) will provide political leadership as necessary Compensation Fund activities will be coordinated through entlbyldget structures, as at present 55 56 Appendix 3: Project Costs and Financing Arrangements B O S N I A AND HERZEGOVINA: Avian Influenza Preparedness Project U S $6.4 m i l l i o n (Note: Component totals below f o r Components 2 and 3 do n o t precisely match the totals in the preceding text. Because o f their larger size, and the likelihood that i t i s under these components where contingencies will be required, this table subtracts a p o r t i o n o f the total component cost (approximately 15%), and places it in the Contingencies allocation.) COMPONENTS Local Foreign Total 1. Strategic Communications and Public Information 1. A Capacity Building 2.B Information and Communication Services Sub Total 0.06 0.23 0.29 0.03 0.09 0.12 0.09 0.32 0.4 1 2. A n i m a l H e a l t h Protection, and Disease Prevention and Control 2.A Enhancing HPAI Prevention and Preparedness 2.B Strengthening Disease Surveillance 2.C Strengthening H P A I Control Programs 2.D Improving Bio-security in Poultry Production Sub Total 0.06 0.42 0.09 0.05 0.62 0.40 1.27 0.16 0.01 1.84 0.46 1.69 0.25 0.06 2.46 3. H u m a n Health Protection and Disease Prevention and Control 3 .A Enhancing Public Health Program Planning 3 .B Strengthening o f Health Surveillance Systems 3 .C Strengthening Health System Response Capacity Sub Total 0.10 0.1 1 0.08 0.29 0.14 0.60 0.65 1.39 0.24 0.71 0.73 1.68 4. Poultry Culling Compensation Scheme 0.75 0.00 0.75 5. Implementation Support and M o n i t o r i n g & Evaluation 5.A Project Management 5 .B Monitoring and Evaluation Sub- Total 0.20 0.10 0.30 0.00 0.00 0.00 0.20 0.10 0.30 ~ Total Base Costs Physical Contingencies 0.30 0.10 5.6 0.4 Price Contingencies TOTAL PROJECT COSTS 0.20 2.75 0.20 3.65 0.4 6.4 57 Total project costs have been estimated at approximately US$6.4 million, o f which US $5.0 million (78.1 % o f total project costs) would be financed by an International Development Association (IDA) Credit. The Government would finance approximately US $1.4 million (21.9%). 58 Appendix 4: Procurement Arrangements BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project 1. As described in OP 8.50 for Emergency Recovery Assistance (ERA), in addition to emergency assistance, the Bank may support operations for prevention and mitigation in countries prone to specific types o f emergencies. Such operations could assist in: (a) developing a national strategy, (b) establishing an adequate institutional and regulatory framework, (c) carrying out studies o f vulnerability and risk assessment, (d) reinforcing vulnerable structures, and (e) acquiring hazard-reductiontechnology. 2. Given the threat that HPAI may pose to the economic and social fabric o f the country, as well as to the health o f the population because o f the risk o f an influenza pandemic, the proposed Project would be financed through a Credit to be approved following ERA procedures. A. Procurement 3. Procurement under the Project will be carried out in accordance with the Bank’s “Guidelines: Procurement under IBRD Loans and IDA Credits” dated May 2004, and “Guidelines: Selection and Employment o f Consultants by World Bank Borrowers” dated May 2004, and with the provisions stipulated in the Legal Agreement. Agreements covering procurement methods, thresholds, and other conditionality will be consistent with ERA assistance guidelines and determined for the Kyrgyz Republic according to its capacity and experience with Bank procurement. 4. The activities covered under the Project will be implemented on the basis o f annual work plans to allow for needed flexibility in adjusting activities to account for in-country experience and the lessons from implementation by other countries participating in the multi-country GPAI. Accordingly, the following approach to procurement will be adopted. 5. Implementing Agency Assessment. The Bank has carried out a procurement capacity assessment o f the PIU for the World Bank-funded Forest Development and Conservation Project (FBiH), and the PCU for the World Bank-funded Health Sector Enhancement Project (RS) which will be responsible for fiduciary tasks, including procurement, and found them satisfactory. Procurement staff in the PIU are experienced with procurement following World Bank guideless, including with all the procurement methods to be included under the Project. The same qualified staff will be responsible for procurement under this Project. However, given the country conditions, the Project has been classified in category “C”, signifying high risk (A low, B medium, and C high risk). The annual Procurement Plan (PP) would define thresholds for prior review appropriate to the category; these thresholds would be determined so as to minimize prior review as appropriate to the level o f risk. 6. Procurement Plan. A Procurement Plan (PP) covering the initial 12 month period o f Project implementation will be prepared by Negotiations. The updated PP for each subsequent year will be submitted to the Bank for approval before the end o f the previous year and would use a pre-defined standard format which would list as a minimum: (i) goods and services to be procured during the following calendar year, (ii) their value; (iii) the method o f procurement; and (iv) the timetable for carrying out the procurement. At the time o f approving the annual work program, the Bank would agree on the consistency with the application o f the Bank procurement guidelines to the specific procurement lots expected during the year and their methods o f procurement. If needed, the plan could be revised and re-submitted. A format for a typical PP would be agreed at Negotiations. 59 Procurement Methods and Thresholds. The Credit Agreement would define the appropriate methods and thresholds for International Competitive Bidding (ICB), National Competitive Bidding (NCB), Limited International Bidding (LIB), or Shopping in accordance with ERA guidelines. Thresholds for project procurement methods and prior review requirements have been indicated on the basis o f the Bank’s assessment o f the capacity o f the P I U which will be responsible for procurement, the estimated risks o f corruption in BiH, and the country’s capacity o f construction and manufacturing industries. 7. I I Quality and Cost Based Selection (QCBS) for Consultant Services Selection Based on Consultants’ Qualifications Individual Consultants I I >us$200,000 (International shortlist) <us$200,000 (National shortlist) <us$200,000 Services for assignments that meet the requirements set forth in the first sentence o f para 5.1 o f the Consultant Guidelines. Services for tasks in circumstances which meet the requirements o f para. 3.10 o f the Consultant Guidelines, with the Bank’s prior agreement. Single-Source Selection 8. Prior Review by the Bank. The Procurement Plan shall set forth those contracts which shall be subject to the Bank’s prior review process. All other contract shall be subject t o post review. 9. Advertisement. The General Procurement Notice (GPN) shall be published in the on-line edition o f Development Business following Project approval by the World Bank Board o f Directors. Special Procurement Notices (SPN) for all I C B goods contracts and Requests for Expression o f Interest for consulting assignments with firms exceeding the value o f US$lOO,OOO equivalent shall be published in the Public Procurement Bulletin, a local newspaper o f a wide circulation and the on-line edition o f the UNDB and posted on the websites o f the State Veterinary Office, the Ministries o f Agriculture and o f the Ministries o f Health. 10. These agencies will allocate a part o f their respective websites for posting information on contract awards, including the name o f each bidder who submitted a bid, bid prices as read out at public bid opening, name and evaluated prices o f each bid that was evaluated, name o f bidders who were rejected 60 and the reasons for rejection, the name o f the winning bidder and the price it offered. A l l contracts awarded through direct contracting (irrespective o f the amount) shall be listed on the websites. Information on the contracts awarded as a result o f an I C B and results o f selection o f consultant firms for contracts exceeding US$lOO,OOO will also be posted on the World Bank web-site by submitting the information to the World Bank Country Office in Sarajevo. 11. The P I U would follow the World Bank anti-corruption measures and would not engage services o f firms and individuals debarred by the Bank. The listing o f debarred firms and individuals i s located at: littp://www.worldbank.ora/html/o~r/~rocure/debarr.html 12. Procurement under Emergency Assistance Provisions. Following ERA procedures, the Project i s likely to include financing for items included on a positive list o f imports identified as necessary under a well-defined preparedness and response program to be prepared as part o f project implementation. In case o f a declared global influenza pandemic, which will trigger disbursement conditions for critical imports, support would be provided under the Project for the procurement o f a positive list o f critical imports. These may be procured under Modified International Competitive Bidding (MICB), according to paragraphs 2.66 and 2.67 o f the Procurement Guidelines. Also, commonly traded commodities may be procured through organized international commodity markets or other channels o f competitive procurement acceptable to the Bank, in accordance with the provision. 13. The positive l i s t o f critical inputs to be prepared by Bosnia-Herzegovina or to be purchased by the Borrower from the private sector, based on historical imports during national emergencies, would include: 0 0 0 0 0 Pharmaceuticals and vaccines Medical and veterinary supplies and equipment Communication equipments, supplies, and public awareness campaigns Food and water containers Protective clothing and gear 14. Disbursements for items procured under emergency assistance provisions can be made for up to 100 percent o f import costs. N o more than 20 percent o f the Credit proceeds may be used for retroactive financing o f expenditures, and the payments must have been made after the appraisal mission. 15. Procurement Audits. Because the Project would have a strong decentralized implementation element, and to help the Bank to carry out post-reviews o f procurement actions, consultants would be contracted as a cost to the Project to carry out annual procurement audits o f a sample o f contracts, under Terms o f Reference acceptable to the Bank. 61 62 Appendix 5: Financial Management Arrangements BOSNIA AND HERZEGOVINA: Avian Influenza PreDarednessProiect Country Issues 1. A Country Financial Accountability Assessment (CFAA) for BiH was carried out in 2001. An update o f the C F A A has recently been finalized. The C F A A identified systemic and structural weaknesses in public sector budgeting, accounting, reporting, and auditing. However, there have been several positive developments in the past four years, most notably, implementation o f a fully automated treasury system across all the Cantons in the Federation and all the regions in the RS. The introduction o f the on-line treasury system has brought about a major improvement in the accounting and reporting o f budget execution at the State, entity, and cantonal levels. The Bank’s Country Financial Management Strategy (CFMS) envisages mainstreaming o f project management into Ministries and Departments, and abstain from creating new stand-alone Project Implementation Units (PIUs) outside the ministries for implementation o f Bank-financed projects. This project accordingly will use the Federation P I U in the Ministry o f Agriculture and the RS P C U established in the Ministry o f Health for the purpose o f delivering fiduciary services to the project and securing the necessary reporting. Risk Analysis and Conditions The risk analysis from the Financial Management Questionnaire i s as presented below. (Note: The project’s financial management risks are not considered to be significant enough to warrant inclusion in section C5 o f the TA). 2. Risk . . Entity Level Project Level Control Risk Budgeting Risk Rating S M S Incorporated Mitigating Measures Risk financed projects As mentioned above The coordination made by the Technical Support Group need to rely fully on the two PIU/PCUs for fiduciary aspects Only issue would be if funds are not allocated by the entities for the Poultry Culling Compensation Scheme, as the funds are reimbursed by the bank. This 63 Conditions of Negotiations, Board or Effectiveness None None None Risk Risk Rating M H Accounting Internal Control 1 Financial IM M I I Incorporated Risk Mitigating Measures will be followed closely by the task team N o issues to mitigate Only the internal control risk for the Poultry Culling Compensation Scheme i s high. The Poultry Culling Compensation Scheme manual on the financial management parts needs to be finalized before disbursement starts. N o issues - following well established procedures N o issues - following well established procedures Following well established procedures. Adding an operational review o f the project. Conditions of Negotiations, Board or Effectiveness None Disbursement condition None None None Strengths 3. Both PIUs have extensive experience in implementing Bank-financedprojects. The two financial managers have been working in their capacity six and seven years respectively. Weaknesses and Action Plan 4. Financial management arrangements o f the AIPP are generally adequate, but a number o f actions are required to ensure that arrangements are fully satisfactory for the project, with i t s specific F M needs, especially with respect to the Poultry Culling Compensation Scheme. The following action plan was discussed with the Recipient during Negotiations. Satisfactory implementation o f the action plan will ensure the establishment o f a financial management system that fully meets requirements o f the Project and o f the Bank. 1 2 Action Implementation of appropriate internal control procedures and fundflow arrangements for the Poultry Culling Compensation Scheme component Responsibility Due Date PIU/PCUs with input Condition for the from TSG Poultry Culling Compensation Scheme component Staffing of the FM Units. Recruitment o f two Financial/Disbursement SDecialists. This i s onlv an action PIU/PCUs ~ 64 To be ready before project implementation I Remarks Compensation Scheme sub-component will be disbursed after the APIU has implemented appropriate internal control and fund flow procedures. Done for capacity building and not a F M condition. FM Procedures Manual. Revise existing manual to fully document the procedures for accounting and internal control, including disbursement and flow o f funds (including flow chart), financial reporting, including IFR, annual reports and audit. This i s only an action for capacity building and not a FM condition. Project Accounting and Financial Reporting System. Upgrade existing accounting software, to reflect requirements o f the new project, including capacity to generate FMRs without manual summarization in Excel; test the accounting and reporting system by producing sample FMRs for submission to the Bank for review and comments. This i s only an action for capacity building and not a F M condition. PIU/PCUs To be ready before project implementation PIUPCUS To be ready before project implementation A manual already exists and will require only minor updates to reflect the characteristics o f the project, including flow o f funds and accountability for cash grants/ Poultry Culling Compensation Scheme. I Done Implementing Entity 5. The main implementation responsibility o f the project i s with the Technical Support Group consisting o f broad technical participation from a l l involved institutions dealing with the activities o f this project. However, all financial management responsibilities as well as procurement responsibilities will be given to the Federation PIU in Ministry o f Agriculture and the RS PCU established in the Ministry o f Health. Budgeting 6. The two PIU/PCUs will prepare annual plans based on the implementation program, including the procurement plan. RS and FBiH will allocate budget funds to cater for the Poultry Culling Compensation Schemes according to already established procedures. Accounting 7. Both the PIUs have implemented computerized accounting systems using locally developed F M software, which i s used in several Bank-financed projects and have been found to be reliable and responsive to Bank-needs. The PIU/PCU will be using the same software for accounting for this project. 8. Accounting procedures for the two PIU/PCUs are set out in their respective Financial Management Manuals. The manual contains procedures for flow o f accounting information, invoice verification procedures, payment controls, and reporting formats. The manuals are satisfactory and the risk associated with the accounting policies and procedures i s negligible. The existing manuals will 65 , require only minor updates to reflect the characteristics o f this project. A separate manual on the Poultry Culling Compensation Scheme will be finalized before disbursement starts for this part o f the project, see further details below. 9. The staffing o f the existing Federation PIU in Ministry o f Agriculture and the RS PCU established in the Ministry o f Health are considered adequate to implement this new project at the initial phase, but additional staff might be needed to strengthen the existing capacity, to monitor the financial management o f the Poultry Culling Compensation Schemes, and to allow for periodic visits to the village level to review the Poultry Culling Compensation Schemes. The additional staff, if needed, would report to the PIUPCU’s financial managers and would be responsible for disbursement functions as well as project accounting-maintaining books o f accounts, reporting day-to-day transactions and preparing accounting reports and financial statements, as well as monitoring financial flows to project beneficiaries. The financial manager will have primary responsibility for the quarterly financial reports (Interim unaudited Financial Reports - IFRs) and will prepare the annual financial statements for audit. Internal Control & Internal Auditing 10. With the exception o f the Poultry Culling Compensation Scheme component, for which the AIPP does not have previous experience, the PIU/PCUs have maintained an effective internal control system to ensure that project expenditures are properly authorized, supporting documents are maintained; accounts are reconciled periodically; project assets, including cash, are safeguarded, and cash compensation grants are properly accounted for. Although project accounting will be on a cash basis, detailed assetiinventories register will be maintained as part o f the project internal control procedures. The AIPP will implement appropriate controls over inventories o f drugs, vaccines, medical equipment, and other sensitive and/or expensive assets will be especially important for the project. 1 1. Since the Federation PIU and the RS PCU are part o f the government set-up, they are subject to an audit by the respective Supreme Audit Institution o f the entities. Currently, neither entity has enacted law on internal audit in the public sector. However, establishment o f internal audit units within ministries i s a long term process and has not been factored into while assessing internal control environment for the project. 12. Poultry Culling Compensation Scheme. The Governments have established Poultry Culling Compensation Schemes from which the owners o f animals culled will be compensated (see Annex 2B). The Veterinary Law provides the legal basis to do so, but the required implementation arrangements still need to be refined and put in place, and the Project will provide technical support to do so. The necessary details will be developed and agreed upon during the first months o f project implementation and will be included in the Operational Manual. 13. As a condition of disbursement o f funds under the Poultry Culling Compensation Scheme component, the PIUiPCUs will implement appropriate internal control procedures and flow-of-funds arrangements acceptable to the Bank and documented in the Poultry Culling Compensation Scheme manual. The Project will provide US $0.55 million to finance and operate these Funds. 14. Internal Control Arrangements for the Poultry Culling Compensation Scheme. Annex 2B sets forth the procedures for recording poultry culled under government orders and for establishing and recording poultry owner’s claims for compensation payments. A number o f minimum internal control procedures and risk mitigation measures will be implemented with respect to recording and verifying poultry culling and claims for compensation payment before any flow o f funds i s initiated. 66 15. The financial and operational manuals will detail the mechanisms, as described in Annex 2B, for identifying those eligible for compensation payments, ensuring that there w i l l be no multiple claims. A Poultry Culling Compensation Scheme database will be maintained by the Project to facilitate record keeping, claim verification, payment facilitation, monitoring and auditing. 16. In the event o f government-ordered culling o f poultry, the culling and the preparation and processing o f culling records and compensation claims will be done in accordance with the procedures detailed in Annex 2B. 17. A l l forms to be used to record poultry cullings and compensation claims w i l l provided by the Project. They w i l l be pre-numbered and recorded in the database o f the Poultry Culling Compensation Scheme. A l l unused forms, as well as any invalid or incorrectly completed forms, must be returned to the Poultry Culling Compensation Scheme when the culling records are submitted. 18. Compensation payment to poultry owners will be by cash, bank transfer or postal transmission. There will be no vouchers or animal replacements. Payment will be made within four weeks from the date o f culling. 19. The owners o f village and backyard poultry will, at the time o f culling, receive a Culling Certificate noting the date and the type and number o f birds culled. Each certificate will be signed by all four members o f the Community Culling Supervision Committee (CCSC) or assessor and countersigned by the poultry owner. The certificate will be completed in three copies: one for the poultry owner, one for the local government administration, and one will be attached to the village summary culling record compiled by the CCSC and sent by the local government administration to the Poultry Culling Compensation Scheme through the TSG. Certificates not signed by all members o f the CCSC and the poultry owner are invalid. 20. Based on the individual poultry owner certificates, the CCSC w i l l compile a Village Summary Poultry Culling Record. All four CCSC members will sign and the poultry owners will countersign this l i s t o f birds culled and their owners. Forms not signed by all four members o f the CCSC are invalid, and all claims included on an invalid Village Summary Poultry Culling Record are rendered invalid as well. The village summary culling record i s the official record that establishes the poultry owners’ right to compensation from the Poultry Culling Compensation Scheme. I t will be completed in eight identical copies: one will be posted in a weather-protected public location in the village. Attached to the copies that are sent by the local government administration to the Poultry Culling Compensation Scheme and to the PIU/PCUs must be copies o f all individual owners’ culling certificates that form the basis for the compilation o f the village summary culling record. 21. The local government administration compiles a Summary Report on the basis o f all village summary poultry culling records, listing all villages and for each village the total number o f different poultry culled. This report i s made out in five copies and signed by the mayor o f the local government. Attached to the copies sent to the PIU/PCUs and to the Poultry Culling Compensation Scheme are the village summary poultry culling records and copies o f a l l individual owners’ culling certificates. 22. For medium- and large-scale poultry operations with more than 200 birds, the owner or manager will, at the time o f culling, receive an Enterprise Poultry Culling Record, signed by the veterinarian and an official from the local government administration, and certified by an audit firm acceptable to the Bank. The ownedmanager countersigns. There will be five identical copies. This document i s the official record that establishes the poultry owners’ right to compensation. Actual compensation payments will be based, however, on the lower o f (a) the number o f birds reported by the enterprise to the Poultry Culling Compensation Scheme at the end o f the quarter preceding the mandatory culling and for which 67 the required fee has been paid to the Poultry Culling Compensation Scheme or (b) the number o f birds reported and certified on the Enterprise Poultry Culling Record. If all or part o f the fee due to the Poultry Culling Compensation Scheme i s overdue by more than three months, no compensation will be paid. Flow-of Funds Arrangements for the Poultry Culling Compensation Scheme. Flow-of-funds arrangements for making compensation payments are designed to minimize the number o f stages through which funds will need to pass before reaching the intended beneficiaries, while ensuring maximum transparency. Once authorized by the PIU/PCUs, compensation payments w i l l be effected by the Poultry Culling Compensation Scheme through the banking system or through the Postal Service. 23. 24. Payment to the poultry owners will be made by the local government administration and supervised by the two community representatives on the CCSC, based on the village summary culling record kept by the local government and cross-checked against that kept in the village. To receive payment, each poultry owner will be required to present hidher culling certificate; the date and amount o f payment will be recorded on the certificate and countersigned by the poultry owner. 25. A l l payments made to individual poultry owners are recorded on both copies o f the village summary poultry culling record kept by the local government administration, and each poultry owner must sign for the payment received on both copies to confirm receipt o f payment. These two copies o f the village summary poultry culling record thus become the “village culling-and-payment record”. They must be signed by the local government representative and the two community representatives on the CCSC. The local government administration then completes the Summary Report by entering in the final column for each village the amounts paid, by village and by type o f poultry. The local government administration keeps one copy o f the completed Summary Report and submits the other to the Poultry Culling Compensation Scheme, with a copy o f each village’s culling-and-payment record attached. 26. For medium- and large-scale poultry enterprises the compensation payments w i l l be made through the banking system. The Poultry Culling Compensation Scheme w i l l transfer the funds to the credit o f the account(s) o f the eligible recipients. Banking fees associated with this service w i l l be financed by the Project. The Poultry Culling Compensation Scheme w i l l inform the PIU/PCUs o f the dates and amounts o f payments made, with appropriate documentary evidence. For enterprises that have no bank account or that failed to provide the necessary account details at the time o f culling, the payments will be made through the Postal Service. The Poultry Culling Compensation Scheme will provide the necessary information and instructions to the Postal Service, with the name and address o f the eligible recipient, and the amount o f payment. The Postal Service w i l l obtain confirmation from the recipient that the payment has been received and will submit this confirmation to the Poultry Culling Compensation Scheme. The Poultry Culling Compensation Scheme in turn will inform the PIU/PCUs o f the dates and amounts of payments made, with appropriate documentary evidence. 27. Funds Flow and Disbursement Arrangements. The Recipient w i l l establish two Designated Account (previously called Special Accounts), one for each Entity, in commercial banks, acceptable to IDA. Disbursements from the IDA Credit will follow the transaction-based method, Le., traditional Bank procedures: Advance documented with Statement o f Expenditures and other records, Direct Payments, and Special Commitments. For certain payments, above the Minimum Application Size as specified in the Disbursement Letter, the AIPP would submit withdrawal applications to the Bank for payments to suppliers and consultants directly from the Credit proceeds. Disbursement to the Poultry Culling Compensation Schemes w i l l be made on reimbursement basis. Withdrawal applications and documentation will be checked by the PIU/PCUs before submission to the Bank. In case o f declared emergency, following procedures agreed with IDA, additional funds may be deposited to the Designated Accounts A and B, the ceiling to which may be increased up 28. 68 to EUR 500,000. The declaration o f a national emergency would be a disbursement condition for this element o f the project. Upon declaration o f an emergency, the Recipient would submit to the Bank an initial recovery plan documenting the disaster declaration, the related budget appropriation and the proposed use o f the funds. The PIUs will keep the Bank informed o f updates in the recovery plan as the emergency response operations unfold. Allocation of Credit Proceeds Expenditure Category 1. Goods, Works, Services, and Operating Costs - FBiH Amount in US$ million 2. Goods, Works, Services, and Operating Costs - RS 3. Unallocated- FBiH 4. Unallocated- RS TOTAL AMOUNT Financing Percentage 2.55 100% 1.65 100% 0.4 0.4 5.00 29. Financial Reporting. For project monitoring purposes, quarterly interim un-audited financial reports (IFRs) will be required. The AIPP will be responsible for designing appropriate IFRs to include: (a) Project Sources and Uses o f Funds, (b) U s e s o f Funds by Project Activity, (c) Special Account/Local Bank Account Statements, (d) Physical progress report, and (e) Procurement report. These financial reports will be submitted to IDA within 45 days o f the end o f each quarter. The first quarterly IFR will be submitted after the end o f the first full quarter following the initial disbursement. Formats o f the annual financial statements and the IFRs are incorporated in the Financial Management Manual. The accounting software currently used by the PIU/PCUs will need to be upgraded to have the capacity to prepare IFRs incorporating all components, sub-components and expenditure categories, as may be appropriate. 30. Financial Audits. There will be annual audits o f the project financial statements, covering all aspects o f the project, including specific requirements for the Poultry Culling Compensation Scheme. The audits will be performed by independent auditors acceptable to the Bank, and in accordance with International Standards on Auditing (ISA), and the Bank's guidelines on auditing as stated in the guidelines: Annual Financial Reporting and Auditing for World Bank-financed Activities (June 2003). The auditors' TOR will be prepared by the PIU/PCUs and cleared by the Bank before the engagement o f the auditor. They will include both the audit o f financial transactions, an assessment o f the internal control, funds flow mechanisms, and the reasonableness o f the accounting, reporting and internal controls in respect o f the Poultry Culling Compensation Scheme, The annual audit reports will consist o f a single opinion on the financial statements o f the project, incorporating the project accounts, including Designated Account Reconciliation, and SR Withdrawal Schedule; as well as a Management Letter. The audit reports will be submitted to the Bank not later than six months after the end o f the fiscal year to which they relate. The cost o f the audits will be eligible for financing from the Credit. The AIPP will provide the auditor with full access to project-related documents and records, including the compensation claims database, and with the information required for the purpose of the audit. Sample TORSfor project audit will be included in the Financial Manual. 3 1. The PIU/PCU will carry out, or will arrange to have carried out, as part of the annual audit when compensation claims have been paid out, additional checks to ensure that the eligible poultry owners, and only they, are paid and are paid in full. This will include, but not be limited to, operational reviews to confirm the validity and legitimacy o f the compensation payments made. The reviewers would be required to verify compensation claims and payments made in randomly selected samples o f villages. 69 This verification w i l l include: checking against the database maintained by the Poultry Culling Compensation Scheme, collecting and verifying information available and obtained at the village level, checking with individual poultry owners, checking forms and reports, etc. Any significant weaknesses identified will be promptly rectified in close consultation with the Bank. In addition, the external independent auditors would be asked to provide an opinion on the reasonableness o f the accounting, reporting and internal controls in respect o f the operations o f the Poultry Culling Compensation Scheme, and the audit TORS(acceptable to IDA) would include these specific requirements. All ineligible claims would be refunded to the Poultry Culling Compensation Scheme and to IDA. 32. Supervision Plan. During project implementation, the Bank will supervise the project’s financial management arrangements in two main ways: (i)review the project’s quarterly interim un-audited financial reports as well as the project’s annual audited financial statements and auditor’s management letter; and (ii)during the Bank’s supervision missions, review the project’s financial management and disbursement arrangements (including a review o f a sample o f Statement o f Expenditures and movements on the Designated Account) to ensure compliance with the Bank’s minimum requirements. As required, a Bank-accredited Financial Management Specialist w i l l assist in the supervision process. 70 Appendix 6: Environmental and Social Issues BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project 1. The Bosnia and Herzegovina Avian Influenza Preparedness Project has been assigned World Bank environmental category B, since it involves moderate environmental impacts that can be mitigated during implementation o f the project. Although project activities supporting A I prevention, preparedness and planning, response and containment are not expected to generate significant adverse environmental effects, they do present a moderate environmental risk from inadvertent spread o f the A I virus and waste management. Overall the A I prevention and response-focused activities are expected to have a positive environmental impact, as the investments in facilities, equipment, and training for veterinary and public health service staff and laboratories w i l l improve the effectiveness and safety over existing avian influenza handling and testing procedures by meeting international standards established by OIE and WHO. This would be reinforced by the mainstreaming o f environmental safeguards into protocols and procedures for the culling and disposal o f animals during A I outbreaks. 2. This environmental management plan (EMP) will address the moderate adverse environmental effects of the Animal and Human Health Components. For the Animal component, the EMP will address zoonotic disease containment and waste management as pertain to disposal o f special waste, emissions and materials at laboratories, and training for veterinary services workers, to include procedures for safe handling o f A I materials, safe culling o f infected and at-risk poultry and disposal o f carcasses. For the Human Health component, the EMP will focus on equipment, refurbishing and training for laboratories and medical facilities to include key environmental issues in zoonotic disease containment and waste management. The EMP will provide mitigation plans and monitoring plans to ensure appropriate attention to environmental issues, and tracking progress or problems in their management. A delay in the completion and disclosure o f the Environmental Assessment from the normal appraisal stage has been approved, instead making this a condition o f disbursement for Component 2 - Animal Health, and Component 3 - Human Health. 3. The main areas o f environmental risk from project activities are the inadvertent spread o f the AI virus during culling, transport and disposal o f carcasses, animal waste, litter, and used protective gear; contamination o f surface and groundwater from use o f disinfectants; and laboratory bio-safety and waste management. In addition, minor environmental disturbances may occur during renovation o f laboratories. 4. Strategic Communications: N o environmental issues, but an important component for design and delivery o f communications tools for good hygiene, safe culling and disposal o f animal carcasses, animal waste management. 5. Animal Health: Equipment, refurbishing and training for regional laboratories and border inspection to include key environmental issues in zoonotic disease containment and waste management as pertain to special waste, emissions and materials; training for veterinary services and poultry sector workers to include procedures for safe handling o f A I materials; safe culling o f infected and at-risk poultry and disposal o f carcasses. Formal compensation for culled animals should target owners/primary beneficiaries (e.g., specifically including women where they are the primary backyard producers). Human Health: Equipment, upgrading, refurbishing and training for national reference and 6. regional diagnostic laboratories to include key environmental issues in zoonotic disease containment and waste management 71 72 Appendix 7: Organization o f the Veterinary Services and the Health Care System in B I H BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project A. Veterinary Care Veterinary Services 1. The veterinary service o f BiH, as it currently exists (see Figure, page 64), i s the combination o f a recently created system (incorporated in the country’s administrative structure as o f 1995) and remnants o f the former (Yugoslavian) legislative and institutional framework. Veterinary services at the state level in BiH fall primarily under the responsibility o f the senior veterinary agency in the country, the State Veterinary Office (SVO). SVO operates under the Ministry O f Foreign Trade and Economic Relations (MoFTER) o f the national government (Council o f Ministers (COM) o f B&H). 2. The state o f BiH consists o f two administrative units called entities, the Republika Srpska (RS) and the Federation o f BiH (FBiH). Each entity has i t s own Minister o f agriculture, forestry and water management (MAFW), under which the entity veterinary service operates. Both veterinary services are directly subordinated to the SVO BiH. 3. FBiH i s composed o f ten cantons, each with i t s own government, Ministry o f agriculture and veterinary service. Cantonal veterinary services are subordinated to the MAFW o f the FBiH. The smallest administrative units are municipalities. At that operative level, veterinary service i s established through municipality veterinary practices. 4. The ongoing evolution and development o f the BiH veterinary service i s primarily motivated by increased awareness o f the significance o f animal health and production issues for public heath and food safety. I t i s also driven by concern for economic development and food security. Further, the country’s overall developmental direction i s toward full accession to the EU, which will require updating o f veterinary services and harmonization o f related legislation with current EU requirements. 5. Current issues related to the global spread o f H P A I have emphasized the need for strengthening capacities and coordination within the veterinary service. Since institutional arrangements within this sector are complicated and heterogeneous, placement o f the managing authority for veterinary services (State Veterinary Office) at the national level (within MoFTER) clearly provides benefits towards a coordinated national response to AI threats. 6. At this point, the H 5 N 1 strain has only been confirmed in two wild birds in BiH. The resources that were required to address this discovery were, on an economic and human resources scale, relatively small, and the country’s veterinary services were able to provide a response that was adequate to prevent further spread. However, veterinary services in BiH are inadequately equipped and experienced to cope with a large scale H P A I outbreak. This i s evident across the entire range o f critical capacities, including: surveillance and diagnosis, implementation o f response and control measures and applied research capability necessary t o understand the etiology o f the disease. 7. Further strengthening and capacity building will require assistance to the BiH SVO, as the national competent authority, in developing animal health legislation related t o avian influenza (further addressed in separate section). This includes expanding human resources, developing competency, and providing necessary equipment to support SVO staff. 73 8. T o ensure efficient implementation o f plans and programs developed and adopted at a national level, regional (entity) and local (cantons/ municipalities) veterinary services must be strengthened as well. This w i l l require assistance in organizing training (possibly through SVO B&H) o f regional and local staff and assistance in equipping them with PPE and other required equipment. Figure: H i e r a r c h y o f the Veterinary Service o f Bosnia-Herzegovina B. Health Care System 9. Organization, financing and provision o f health care in BiH are the responsibilities o f the two Entities, and the ten autonomous Cantons in FBIH. Therefore, the health care system in BiH consists o f 13 heath sub-systems to cover approximately 3.9 million people. At the BiH level, the Ministry o f Civil Affairs (MCA) i s the only State body with responsibilities for coordinating the health sector. The legal basis for M C A i s provided by the BiH L a w on Ministries (March 2003) authorizing M C A to represent BiH at international level, to establish the basic principles for co-ordination and to co-ordinate plans of entities and other governmental bodies. Federation of Bosnia and Herzegovina (FBiH) 10. F B i H occupies approximately 51% o f the total territory o f BiH and has a population of approximately 2.3 million. Administratively, it i s divided into 10 cantons, each having i t s own Government and Assembly. The cantons are sub-divided into 79 municipalities. 74 11. The health care system in FBiH i s decentralized with most competencies (functions and responsibilities) allocated to the cantons. However, the Federation Ministry o f Health (FMOH) and the Health Insurance and Reinsurance Fund (HIF) have the function to define the health care network with a view to optimize i t s capacity for the provision o f medical services. While FMOH has the functions o f formulating health policy and drafting laws, these functions are doubled by the cantons. Determination o f health service needs and functions related to provision o f health care services (such as founding o f institutions) are assigned to the cantons but, in principle, the co-ordination function lies within the Government o f FBiH. Organization of the Health Sector in FBiH 12. The structure o f the health sector in FBIH consists o f 11 ministries o f health (10 Cantonal and 1 Federal), 11 health insurance funds (10 Cantonal, and 1 Federal Health Insurance and Reinsurance Fund) and 11 Public Health Institutions (10 cantonal P H I and 1 Federal). The Health care provider network consist o f 280 public and 333 private institutions (including pharmacies) employing altogether about 23,800 persons, out o f which 3.270 are medical doctors, 5 10 dentists, 260 pharmacists, 1 1,180 nurses, 286 health consultants and 7,606 non medical staff. Distribution of functions 13. The F M o H i s responsible for functions that cannot be executed at the Cantonal level: Borders’ sanitary inspections; Developing legislation at federal level; Developing health policy for the FBIH Planning o f the health care facilities network; Capacity building; Health inspections; Developing and regulating o f compulsory health insurance; and Monitoring and evaluating the health status o f the population. 14. The Cantonal Insurance Funds are responsible for financing the health service at the cantonal level. The Federal Health Insurance and Reinsurance Fund was established in January 2002 to address some o f the problems associated with a highly decentralized system related to an unequal economic basis and lack o f cross-canton health insurance coverage. The Federal Health Insurance and Reinsurance Fund i s entitled to receive 8% o f all contributions collected by the cantonal HIFs. 15. As noted earlier, the basic financial functions o f the health care system in FBIH i s placed within the cantons. Each o f the cantons has i t s o w n Health Insurance Fund responsible for the overall financing o f the health care services. The bulk o f the income for the Cantonal HIF comes from health contributions. Health insurance contributions are based on gross salary and amount to 17%. Cantons are authorized to define their own contribution rates within the upper ceiling o f 17%. The FPHI i s the leading research and educational institution in the field o f public health. I t s 16. functions also include health promotion and monitoring o f the health status o f the population. In the area o f monitoring and research, especially in the field o f health statistics and epidemiology research (also with respect to data collection o f the 25 indicators needed for W H O reporting), there i s collaboration between the federal P H I and the Cantonal PHIS. 75 17. Health ministries at the Cantonal level are in charge o f Cantonal health legislation, advising on technical matters, implementing regulations, organizing health care services and health policy planning mostly related to the Cantonal hospitals, the health centers ( D o m Zdravlja -DZ), ambulantas (health posts), pharmacies and other Cantonal health institutions. 18. Import, procurement, distribution and control o f pharmaceutical products are under control o f the Department for Drugs within the FMOH. This department i s also responsible for drug registration, control o f drugs and herbal products, the issuing o f work permits for pharmacies, controlling and issuing import permits for drugs and herbal products in FBiH. Republika Srpska 19. The Republika Srpska (RS) with approximately 1.4 million inhabitants occupies approximately 49% o f the total BiH territory. RS consists o f four regions: Banja Luka (630,000 citizens), DobojBijeljina (420,000 citizens), Sarajevo-Zvornik (230,000 citizens) and Trebinje/Foca/Srbinje (120,000 citizens) and 54 municipalities. 20. The health care system in RS in centralized with the overall power concentrated within the Ministry o f Health and Social Welfare (MOH), the Public Health Institute (PHI), and the Health Insurance Fund (HIF). In addition, the Drug Agency o f RS, and the Agency for Accreditation and Quality Improvement were established in the past 2-3 years. Organization of the Health Sector in RS 2 1. Health care services are provided by a network consisting o f 63 D o m Zdravlja (DZ), (including spas and emergency centers), 16 secondary level health institutions (including psychiatry hospitals and rehabilitation centers) and 2 tertiary level clinical centers. Altogether, 1 1,2 10 people are employed in the health care sector out o f which 7,177 are medical staff (1,783 medical doctors) and 4,034 are non-medical staff. Distribution of Functions 22. The M O H i s responsible for the health sector in RS and has the following functions: Policy making, strategy development, health care facilities, network planning, sanitary inspections, health inspections and co-coordinating health issues in RS. 23. The P H I i s responsible for functions such as research and education in the field o f public health, health promotion and monitoring o f the health status o f the population. The P H I also collects data for the 25 indicators needed for WHO reporting. 24. The Health Insurance Fund (HIF) has as main functions the collection o f health insurance contribution (however this does not include contribution payment) and financing and contracting health care services. The organizational structure consists o f eight regional offices and the head office o f the HIF in Banja Luka with four departments: Economy, Legal, Medical and Information Technology (IT) department. Health insurance contribution amounts to 15% o f the net salary. 76 Appendix 8: Project Preparation and Supervision BOSNIA AND HERZEGOVINA: Avian Influenza PreDaredness Proiect Preparation Appraisal Negotiations Board Planned date o f effectiveness Planned date o f mid-term review Planned closing date Planned March 27,2006 M a y 17,2006 September 2006 October 2006 December 2006 June 2008 April 3 0 20 10 Actual March 27, 2006 M a y 18,2006 M a y 9,2007 June 19,2007 October 3 1, 2007 June 2009 December 3 1,20 10 K e y institutions responsible for preparation 'of the project: Inter-sectoral Working Group Bank staff, consultants, and other international partners who worked on the Project included: Name David A. Bontempo Mirjana Karahasanovic Samra Bajramovic Francois Decaillet Betty Hanan Bekim Imeri Ivailo Izvorski k i n a Smirnov Srecko Lata1 Danielle Malek Nikola Kerleta Olav Rex Christensen Jose-Manual Bassat Nicholay Chistyakov Amy Evans Tanja Bijev Leigh Hammill Sabina Seric Helena Eversole Caroline Brown Boris Rebac Haris Hajrulahovic Nela Kacmarcik Selena Bajraktarevic Title Team Leader Operations Analyst Program Assistant Lead Health Specialist Implementation Specialist - Consultant Social Scientist - Compensation Issues Sr. Economist Research Analyst Public Relations Specialist Lead Counsel Procurement Analyst Senior Financial Management Specialist Senior Communications Officer Senior Finance Officer Environmental Consultant Interpretor/Translator Sr. Program Assistant Veterinary (Consultant) UNICEF Resident Representative Communicable Diseases Specialist Health Specialist Liaison Officer Communications Officer Health Officer Bank funds expended to date on project preparation: 1. Bank resources: $80,000 2. Trust funds: $0 3. Total: $80,000 4. Estimated annual supervision cost: $100,000 77 Unit ECSSD ECSSD ECCBA ECSHD ECSSD ECSSD ECSPE ECSPE ECCBA LEGEC ECSPS ECSPS EXTCD LOAGl ECSSD Consultant ECSSD ECSSD UNICEF WHO WHO WHO UNICEF UNICEF 78 Appendix 9: Documents in the Project File BOSNIA AND HERZEGOVINNA: Avian Influenza Preparedness Project BANK Guidance notes to country teams on responding to A I Rapid assessment o f the economic impact o f public health emergencies o f international concern the example o f SARS - Milan Brahmhatt Vietnam Avian Influenza Emergency Recovery Project - Memorandum of the President and Technical Annex Minutes o f the meeting on the Emerging zoonoses and pathogens: A Global public goods concern - implication for the World Bank, April 19, 2005 Issues Note on Avian Influenza in Africa, September 27, 2005. - Franqois L e Gall and Ok Pannenborg Minutes o f the Review Meeting to discuss the horizontal APL. Project Framework Document for the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI) Avian and Human Influenza Financing Needs and Gaps Aide Memoire o f preparation mission GOVERNMENT Avian Influenza Assessment for Bosnia and Herzegovina, November 2005 - Seric and Cavaljuga Avian Influenza, Plan of Measures in Case o f Appearance o f Avian flu in Bosnia and Herzegovina The National Readiness Plan for Pandemic Flu in Republika Srpska, October 2005 Preparedness Plan for Expected Emergence o f the Pandemic Influenza for the Federation o f BiH, March, 2006 FBiH Law on Protection o f Population from Communicable Diseases, (dated May 18, 2005) RS Law on Protection o f Population from Communicable Diseases (dated June 22, 1995) A Draft Outline o f National Communications Plan for Prevention o f Human Avian Influenza in Bosnia and Herzegovina OTHER DONORS A global strategy for the progressive control o f HPAI - FAO/OIE in collaboration with WHO May 2005 FAO’s response to the avian influenza crisis - September 19,2005 Technical Cooperation Program - Project descriptions for East Africa, West Africa, Europe and Central Asia, North Africa, and the Middle East - WHO 2005 Assessment o f the National Surveillance System for Communicable Diseases - WHO September 2004 WHO/EU Project Support to Health Care reform in BiH (focus on Communicable Disease Surveillance) Summary o f an ongoing and planned assistance o f the European Commission in BiH on prevention and combating o f Avian Influenza (Veterinarian and Health Sector) UNICEF in Bosnia and Herzegovina and Avian Influenza - Concept Paper UNICEF Timeline - Avian Influenza Communications 79 D. PUBLIC H E A L T H RELATED Global avian influenza information from WHO Web site at www.who,int/csr/disease/avian-influenza Information on U.S. influenza preparedness available at: www.hhs.gov/nvpo/pandemics/dhhs.htmland www.cdc.gov/flu/avian WHO. 2005. Responding to the avian influenza pandemic threat. Recommended strategic actions. Geneva. WHO. 2005. WHO global influenza preparedness plan. The role o f WHO and recommendations for national measures before and during pandemics. Geneva. United States Department o f Health and Human Services. 2005. Pandemic Flu Fact Sheet. United States Department o f Health and Human Services. 2004. Pandemic Influenza Preparedness and Response Plan. Draft. Browner, J., and Chalk, P. 2003. The Global Threat o f New and Reemerging Infectious Diseases. Reconciling US. National Security and Public Health Policy. Santa Monica, CA: RAND. Dowdle, W.R. 1997. The 1976 Experience. J. Infect Dis 1997; 176 (suppl. 1): S69-72. Garcia-Abreu, A., Halperin, W., Dane1 I.2002. Public Health Surveillance Toolkit. A guide for busy task managers. Washington, D.C.: World Bank. Huffman, S., on the basis o f report by Daniel Miller and Asel Ryskulova. 2005. Epidemiologic Surveillance Systems in Eastern Europe and Central Asia: An Overview. Washington, D.C.: World Bank. Neustadt, R.E., Fineberg H.V. 1982. The Epidemic That Never Was. Policy Making and the Swine Flue Scare. Vintage Books. E. ANIMAL H E A L T H RELATED OIE website on Avian Flu Official reporting, scientific information, Standards, Guidelines, and Recommendations (www.oie.int) F A 0 website on Avian Flu General information, Communication, Publications, Projects proposals and reports (www.fao.org) FAOIOIE. February 2005. Second FAO/OIE Regional Meeting on Avian Influenza Control in Asia. Ho Chi Minh City. FAO/OIE. February, 2004. Recommendations o f the Joint FAOIOIE Emergency Regional Meeting on Avian Influenza Control in Animals in Asia. Bangkok. FAO/OIE. March 2005. Summary Report o f the First Regional Steering Committee o f GF-TADS (Global Framework for the Progressive Control o f Transboundary Animal Diseases) in Asia and the Pacific. Tokyo. FAOIOIEIWHO. February, 2004. FAO/OIE/WHO Technical Consultation on the Control o f Avian Influenza, 3-4 February, 2004: Conclusions and Recommendations. OIE. May, 2005. OIE Report o f the First Meeting o f the Steering Committee o f the Joint OIE/FAO Network o f Expertise on Avian Influenza (OFFLU). OIE. Paris. OIEIASEAN. August 2005. The Southeast Asia Foot and Mouth Disease Campaign: Business Plan for Phase I11 (2006-2008). OIEIFAO. Network o f Expertise on Avian Influenza (OFFLU). Paris. OIEIFAO. April, 2005. International Scientific Conference on Avian Influenza, OIE Paris, France 7-8 April 2005: Recommendations. Paris. 80 F. Bibliography o f Recent Reports & Other Documents 8 8 8 8 8 8 8 8 Bell, Clive and Maureen Lewis. October 2004. The Economic Implications o f Epidemics Old and New. Working Paper Number 54, Center for Global Development. Washington, DC. (See also powerpoint presentation, “Economic Implications o f Epidemics Old and New”). OIE. 2004. Emerging Zoonoses and Pathogens o f Public Health Concern. Rev. sci. tech. Off. int. Epiz., 2004, 23 (2). FAOIOIE. February 2005. Second FAO/OIE Regional Meeting on Avian Influenza Control in Asia. Ho Chi Minh City. FAO/OIE. February, 2004. Recommendations o f the Joint FAO/OIE Emergency Regional Meeting on Avian Influenza Control in Animals in Asia. Bangkok. FAOIOIE. March 2005. Summary Report o f the First Regional Steering Committee o f GF-TADS (Global Framework for the Progressive Control o f Transboundary Animal Diseases) in Asia and the Pacific. Tokyo. FAOIOIEIWHO. February, 2004. FAO/OIE/WHO Technical Consultation on the Control o f Avian Influenza, 3-4 February, 2004: Conclusions and Recommendations. Ferguson, N e i l et al. 2005. Strategies for Containing an Emerging Influenza Pandemic in Southeast Asia. Nature. OIE. May, 2005. OIE Report o f the First Meeting o f the Steering Committee o f the Joint OIE/FAO Network o f Expertise on Avian Influenza (OFFLU). OIE. Paris. OIE/ASEAN. August 2005. The Southeast Asia Foot and Mouth Disease Campaign: Business Plan for Phase 111(2006-2008). OIEIFAO. Network o f Expertise on Avian Influenza (OFFLU). Paris. OIE/FAO. April, 2005. International Scientific Conference on Avian Influenza, OIE Paris, France 7-8 April 2005: Recommendations. Paris. Sandman, Peter and Jody Lanand.2005. Bird Flu: Communicating. Perspectives in Health, Vol. 10, No. 2. Pan American Health Organization. Washington, DC. Schudel, A. August 2005. Tackling Avian Influenza at Source. Avian Influenza Technical Discussion & Coordination Meeting (powerpoint presentation). Washington, DC. Smolinski, Mark, Margaret A. Hamburg, and Joshua Lederburg (Editors). 2005. Microbial Threats to Pandemic Influenza. National Academies Press. Washington, DC. WHO. 2005. WHO Global Influenza Preparedness Plan: The Role o f WHO and Recommendations for National Measures Before and During Pandemics. Department o f Communicable Disease Surveillance and Response, Global Influenza Program. Geneva. WHO. January 2005. Influenza Pandemic Preparedness and Response: Report by the Secretariat. Executive Board, 1 15th Session, Agenda Item 4.17. Geneva. World Bank. July 2, 2004. Technical Annex for a Proposed Credit o f SDR3.5 million to the Socialist Republic o f Vietnam for an Avian Influenza Project. Washington, DC. 81 82 Appendix 10: Statement of Loans and Credits BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Proiect ~~~ ~ Difference between expected and actual disbursements Original Amount in US$ Millions Project ID FY PO88663 2005 PO83353 PO79226 PO84596 Purpose IBRD IDA Orig Frm Rev’d Cancel Undisb 000 000 1634 223 0 00 0.00 0.00 0.00 18.89 -0.87 0 00 0.00 0.00 0.00 9.78 0.00 0.00 12.00 0.00 0.00 0.00 10.64 0.74 -0.68 0.00 34.00 0.00 0.00 0.00 23.93 4.45 0.00 0.00 51.00 0.00 0.00 0.00 50.63 24.00 0.00 1.44 0.00 SF HLT SEC ENHANC 000 1700 000 2005 URB INFRA & SERV DEL 0.00 20.00 2005 EDUC RESTRUCTURING 0.00 10.00 2004 EMPLYMT 2 0.00 PO71039 2004 ECON MGMT SACiIBTA PO70992 2004 SOSAC 2 GEF 7.00 0.00 0.00 0.00 8.01 0.00 3.75 0.00 0.00 0.00 3.40 1.50 0.00 0.00 12.00 0.00 0.00 0.00 9.04 -1.86 0.00 BUS ENABLG ENV SAC 0.00 44.00 0.00 0.00 0.00 29.33 -20.02 0.00 2002 ROAD MGMT SAFETY 0.00 30.00 0.00 0.00 0.00 11.86 -2.32 0.00 2002 SOLID WASTE MGMT 0.00 18.00 0.00 0.00 0.00 25.87 -2.93 0.00 4.59 4.23 PO7 1004 2003 SOC I N S TA 0.00 PO7916 1 2003 FOREST DEVTKNSRV TA PO55434 2003 SM SC COM AGRIC PO71001 2002 PO71347 PO57950 PO70995 2001 COMM DEVT 0.00 15.00 0.00 0.00 0.00 6.71 PO709 17 200 1 PRIV TA 0.00 19.80 0.00 0.00 0.00 19.39 16.37 0.00 PO70079 2001 TRADE & TRANS FACIL IN SE EUR 0.00 11.00 0.00 0.00 0.00 0.07 1.60 0.00 PO58521 200 1 ELEC PWR 3 RECN 0.00 35.00 0.00 0.00 0.00 8.15 4.22 0.00 0.00 339.55 0.00 0.00 0.00 252.04 33.14 3.55 Total: 83 STATEMENT OF IFC’s Held and Disbursed Portfolio I n Millions of US Dollars Disbursed Committed IFC IFC FY Approval Company Loan Equity Quasi Partic. Loan Equity Quasi Partic. 1985 Energoinvest 9.49 0.00 0.00 0.00 9.49 0.00 0.00 0.00 1997 Enterprise Fund 0.00 1.52 0.00 0.00 0.00 0.94 0.00 0.00 2002 FCL 12.11 0.00 0.00 2.48 12.11 0.00 0.00 2.48 2004105 H V B CPB 0.00 4.06 0.00 0.00 0.00 4.06 0.00 0.00 2001 PBS-SPV 0.00 0.00 0.71 0.00 0.00 0.00 0.00 0.00 1997/99/01102 Procredit Bosnia 3.63 0.00 0.00 0.00 3.63 0.00 0.00 0.00 2002105 Raiffeisen-BOS 14.53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1998 SEF Akova 0.59 0.00 0.00 0.00 0.59 0.00 0.00 0.00 1999/01/05 SEF Bosnalijek 9.08 0.00 0.00 0.00 3.63 0.00 0.00 0.00 2.23 0.00 0.00 0.00 0.00 1998 SEF Lignosper 2.57 0.00 0.00 0.00 1999 SEF Lijanovici 0.85 0.00 0.00 0.00 0.85 0.00 0.00 1977 T K A Cazin 4.12 0.00 0.00 0.00 4.12 0.00 0.00 0.00 1998 Wood Agency-AL 5.53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Wood Konjuh 2.16 0.00 0.00 0.00 1.85 0.00 0.00 0.00 Wood Kozara 1.95 0.00 0.00 0.00 1.64 0.00 0.00 0.00 Wood Podgradci 1.34 0.00 0.00 0.00 1.09 0.00 0.00 0.00 Wood Vrbas 1.95 0.00 0.00 0.00 0.39 0.00 0.00 0.00 5.58 0.71 2.48 41.62 5.00 0.00 2.48 Total portfolio: 69.90 Approvals Pending Commitment F Y Approval Company 2002 Lukavac Loan 0.01 Total pending commitment: 84 0.01 Equity Quasi Partic. 0.00 0.00 0.00 0.00 0.00 0.00 Appendix 11: Country at a Glance BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project Bosnia Europe 8 and Central Asia Herzegovina POVERTY and SOCIAL 2003 Population, mid-year (millions) GNI per capita (Atlas method, US$) GNI (Atlasmethod, US$ billions) Lowermiddleincome 4.1 1,540 6.4 473 2,570 1,2l7 2,655 1,480 3,934 2.1 2.3 0.0 0.2 0.9 1.2 20 44 74 t5 4 63 69 31 50 69 32 11 81 Development dlamond' Life expectancy ? -- A v e r a g e annual g r o w t h , 1997-03 Population (%) Laborforce (%) M o s t recent e s t i m a t e ( l a t e s t year available, 1997-03) Poverty (%of population belo wnational po verfyline) Urban population (%of to tal populatio n) Life expectancyat birth (years) infant mortality (per I000 live births) Child malnutrition (%of children under5) Access to an improvedwatersource (%ofpopulation) Illiteracy (%ofpopulation age 15+) Gross primary enro llment (% o f school-age populatlo n) Male Female 5 91 3 x)3 x)4 x)2 GNI per capita Gross primary enrollment 1 1 Access to improved water source 0 112 113 111 ----Bosnia andHerzegovina ____ Lo uer-mlddle-income group KEY ECONOMIC R A T I O S and LONG-TERM T R E N D S 1983 1993 2002 2003 E c o n o m i c ratios' GD P (US$ billions) Gross domestic investment/GDP Ekports o f goods and services/GDP Gross domestic savings/GDP Gross national savings/GDP Current account balance1GDP Interest payments/GDP Total debt/GDP Total debt service/ekports Present value of debtlGDP Present value o f debtlekports 1983-93 1993-03 (average annualgrowth) GDP GDP percapita - - .. .. 17.8 15.4 5.6 19.6 24.5 -17.1 -2.5 7 .O 19.9 25.2 -14.0 0.9 -22.2 1.0 45.8 7.1 29.2 PO.8 -19,0 2002 2003 5.5 4.4 2.7 2.4 0.8 41.3 7.1 23.8 ,093 1 Indebtedness 2003-07 4.2 3.6 -Bosnia and Herzegovina Lo uer-middle-income a m u ~ P STRUCTURE o f the ECONOMY 1983 1993 2002 2003 (%of GDP) Agriculture Industry M anufactunng Services 14.9 32.1 15.2 52.9 14.9 31.9 15.1 52.8 Private consumption General government consumption Imports of goods and services 92.3 24.8 61.2 91.8 22.3 59.2 1 9 8 3 - 9 3 1993.03 2002 (average annualgrowth) Agriculture industry Manufacturing Services Private consumption General government consumption Gross domestic investment imports of goods and services Trade 2003 2.5 2.5 2.5 2.2 .. 35.6 11.1 17.9 85 20.2 Bosnia and Herzegovina ~ PRICES and GOVERNMENT FINANCE 1983 1993 Domestic prices (%change) Consumer prices Implicit GDP deflator Government finance (%of GDP, includes current grants) Current revenue Current budget baiance Overall suwlusideficit 2002 2003 0.3 1.0 02 09 50.7 6.5 -2.5 49 3 65 03 2002 2003 Inflation I (Oh) I /lo 5 0 sa , x ~ 00 99 15' ~ - 02 01 GDPdeflator 03 =-+-.CPI TRADE 1983 1993 (US$ millions) Total exports (fob) n.a n.a. Manufactures Total imports (cif) Food Fuel and energy Capital goods 1 Export and i m p o r t l e v e l s ( U S $ mill.) I 952 3,233 1272 3 890 T l5 Oo0 ,4 000 f '3 000 t 12 000 c 11 000 I 0 -b 97 E,~pottpnce index (1995=WO) Import pnce index (?S95=WO) Terms o f trade (995=100) I 9a 99 00 oExports 01 02 03 mlmports BALANCE o f PAYMENTS 1983 1993 (US$ millions) Exports o f goods and services Imports o f goods and services Resource balance 2002 2003 1,374 3,428 -2,054 1759 4 121 -2 362 248 565 327 7 11 Current account balance -1,241 1325 Financing items (net) Changes in net reserves 1,282 -41 1806 -481 0 2.1 1785 17 Memo: Reserves including goid (US$ millions) Conversion rate (DEC, local/US$j Total debt service IERD IDA Composition o f net resource flows Official grants Official creditors Pnvate creditors Foreign direct investment Portfolio equity Worid Bank program Commitments Disbursements Principal repayments t o G D P (%) 1 Net income Net current transfers EXTERNAL DEBT a n d RESOURCE FLOWS 1983 (US$ millions) Total debt outstanding and disbursed IB RD IDA I C u r r e n t a c c o u n t balance 1993 2002 2003 C o m p o s i t i o n o f 2 0 0 3 debt (US$ mill.) 424 0 2,563 538 726 2 880 540 803 0 0 125 45 5 151 43 6 G 65 32 D 71 0 0 0 102 97 23 86 23 35 A - IBRD B - IDA 23 C-IMF C 92 D - Other multilateral E - Bilateral F - Private G - Short-term IBRD 33375R B O S N I A A N D H E R Z E GO V I N A SELECTED TOWNS MAIN ROADS NATIONAL CAPITAL RAILROADS MAIN RIVERS DAYTON AGREEMENT LINES MUNICIPAL BOUNDARIES INTERNATIONAL BOUNDARIES This map was produced by the Map Design Unit of The World Bank. The boundaries, colors, denominations and any other information shown on this map do not imply, on the part of The World Bank Group, any judgment on the legal status of any territory, or any endorsement or acceptance of such boundaries. To Zagreb 16°E 17°E 18°E To Bjelovar 19°E To Osijek CROATIA Un a To Karlovac Bosanski Brod (Srp.Brod) va Dervent De rventa a Derventa Bo Cazin Sa Vbr as Bihac´ Bosanska Krupa a an na Varoˇs Kotor Varos Bosanski Petrovac Kljucˇ Vlasic´ Mts Mts.. Kri Jajce Travnik Travnik D To Obrovac Zenica Kladanj Vareˇs Vares Vlasenica ba Vr Srebrenica a Bugojno r REPUBLIKA SRPSKA Visoko Visoko FEDERATION OF BOSNIA AND HERZEGOVINA i c Livno To Valjevo Bosna s n To Zadar Spreca va ja i 44°N SERBIA Tuzla Tuzla Maglaj REPUBLIKA SRPSKA Drvar Drva rvarr To Belgrade Teslic Teslic´ ˆ To Medak Bijeljina Gracanica ˇ S U CROATIA 45°N Sava ˇ Brcko Banja Luka Sanski Most To Sveti Rok To Belgrade sna Drin a 45°N ˇ Bosanska Gradiska ˇ (Srp. Gradiska) Bosanska Novi (Novi Grad) Prijedor Pale Visegrad Visegrad ˆ l im L A ˇ Gorazde Konjic 44°N To Kraljevo SARAJEVO Jablanicko jezero Jablanica D ri na a retv Ne p To Sjenica s Foca ˇ (Srbinje) Mostar Ta ra Gacko a Piv Stolac 43°N 43°N Bileca ´ MONTENEGRO Trebinje Trebinje To Podgorica BOSNIA and HERZEGOVINA Ad r iat i c Sea To Shkodër 0 10 20 30 40 50 Kilometers ALBANIA 0 16°E 17°E 10 20 30 Miles 18°E 19°E JULY 2006