Health System Enhancement Project - Additional Financing (ADB-51107-003)

  • South Asia
Geographic location where the impacts of the investment may be experienced.
  • Sri Lanka
Geographic location where the impacts of the investment may be experienced.
Financial Institutions
  • Asian Development Bank (ADB)
International, regional and national development finance institutions. Many of these banks have a public interest mission, such as poverty reduction.
Project Status
Stage of the project cycle. Stages vary by development bank and can include: pending, approval, implementation, and closed or completed.
Bank Risk Rating
Environmental and social categorization assessed by the development bank as a measure of the planned project’s environmental and social impacts. A higher risk rating may require more due diligence to limit or avoid harm to people and the environment. For example, "A" or "B" are risk categories where "A" represents the highest amount of risk. Results will include projects that specifically recorded a rating, all other projects are marked ‘U’ for "Undisclosed."
Voting Date
Sep 30, 2021
Date when project documentation and funding is reviewed by the Board for consideration and approval. Some development banks will state a "board date" or "decision date." When funding approval is obtained, the legal documents are accepted and signed, the implementation phase begins.
Democratic Socialist Republic of Sri Lanka
A public entity (government or state-owned) provided with funds or financial support to manage and/or implement a project.
  • Education and Health
The service or industry focus of the investment. A project can have several sectors.
Investment Amount (USD)
$ 113.00 million
Value listed on project documents at time of disclosure. If necessary, this amount is converted to USD ($) on the date of disclosure. Please review updated project documents for more information.
Primary Source

Original disclosure @ ADB website

Updated in EWS Apr 9, 2022

Disclosed by Bank Sep 30, 2021

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Project Description
If provided by the financial institution, the Early Warning System Team writes a short summary describing the purported development objective of the project and project components. Review the complete project documentation for a detailed description.

The Health System Enhancement Project (the original project), for $60 million (comprising $37.5 million in concessionary loan and $12.5 million grant, and $10 million equivalent from the Government of Sri Lanka in counterpart funds), was approved in October 2018, effective since February 2019 and is due to close on 30 November 2023. The original project aims to improve efficiency, equity, and responsiveness of the primary health care (PHC) system based on the concept of providing universal access and continuum of care to provide high quality package of essential health services. The original project pursues an equity perspective by targeting underserved populations access to PHC. 

Due to the coronavirus disease (COVID-19) pandemic affecting Sri Lanka in March 2020, $15 million was reallocated from the original project ($10 million from the concessionary loan and $5 million from the grant) via memos dated 25 March and 10 April 2020 to meet the urgent financing requirements on curtailing the COVID-19 pandemic. The government made this reallocation request from the original project as COVID-19 related interventions are coming under the scope of the project which included interventions to improve communicable disease surveillance and strengthen IHR (output 2). The reallocated resources were requested for meeting the emergency activities related to scaling up of molecular biology laboratory capacity, increasing the accessibility to emergency medical equipment at hospitals, expanding high dependency and intensive care units, expanding oxygen accessibility, and increasing the availability of consumables like surgical masks, personal protection equipment and reagents and other consumables for polymerase chain reaction (PCR) testing and screening of COVID-19.

The exponential increase of COVID-19 cases in all provinces since April 2021 has created an emergency need to scale up services across the entire country to better respond to COVID-19 patients without compromising care of patients due to other illnesses. A comprehensive assessment has been undertaken by PMU, PIUs and the ADB consultation mission in November 2020 in addition to follow-on consultations with the government in May 2021, which confirmed the requirement of $110 million additional financing to immediately address the emergency needs due to increasing COVID-19 burden while also ensuring the overall project (original project plus additional financing) successfully completes its targets on-time and on-budget. Furthermore, under HSEP many contracts for the second round of civil works are ready to be awarded by Q4 2021. More funds are required to make the payments for the first round of ongoing civil works as many of those are near completion. The additional financing should be ready by September 2021 to continue the ongoing project progress.

The additional financing provided by the proposed investment is the most appropriate and efficient modality to finance the scale up of the outputs of a well performing ongoing project, addressing the government’s urgent financing requirements to support and manage the third wave of COVID- 19 pandemic, and the replenishment of reallocated funds approved in 2020 to complete the originally planned activities mainly related to PHC development.


Investment Description
Here you can find a list of individual development financial institutions that finance the project.

Contact Information
This section aims to support the local communities and local CSO to get to know which stakeholders are involved in a project with their roles and responsibilities. If available, there may be a complaint office for the respective bank which operates independently to receive and determine violations in policy and practice. Independent Accountability Mechanisms receive and respond to complaints. Most Independent Accountability Mechanisms offer two functions for addressing complaints: dispute resolution and compliance review.
Responsible ADB Officer Jayasundara, Herathbanda
Responsible ADB Department South Asia Department
Responsible ADB Division Sri Lanka Resident Mission
Executing Agencies
Ministry of Health
Dr. Nihal G. Wijesooriya
Inland Revenue Bldg.
Sir Chittamplam A. Gardiner Mawatha
P.O. Box 513, Colombo 2, Sri Lanka
Ministry of Health
Mr. W.M. Piyasena
Suwasiripaya, No.385, Rev.Baddegama
Wimalawansa Thero Mawatha


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