As stated by the ADB, the proposed project will respond to above-mentioned challenges by supporting the implementation of key components of Tajikistan's national plan for health systems integration in the National Health Strategic Plan (2020 2030). The project will enable Tajikistan to better respond to cross-border health threats, improve regional health security in Central Asia, improving the efficiency and capacity of public health laboratory system, and transforming PHC system to better respond to emerging climate-related health risks and expand women's access to services. It prioritizes digital health transformation and institutional integration of epidemiological and public health laboratory stakeholders to improve the efficiency, effectiveness, and capacity of overall disease surveillance system. It will upgrade health infrastructure and strengthen the capability of the health workforce to delivery more efficient and patient-centered services.

The project will also empower women in rural and border communities to design and deliver initiatives on increasing the awareness of emerging notifiable diseases, climate change-related health risk, and risk factors that affects women's and girl's SRHR. The project will focus on 18 border and rural districts, including their respective 18 jamoats and 36 villages, where underserved and hard-to-reach groups face the most severe gaps in public health service access. The project is an integral part of development partners' efforts to strengthen the resilience of Tajikistan's health system. The improved disease surveillance and public health laboratory testing capacity of Tajikistan to be supported through the ensuing project enables timely and effective detection and response to emerging infectious diseases, which is considered a regional public good, as it contributes to improved health security in Central Asia and beyond.

The proposed project financing is $37 million, which includes $10 million from Tajikistan's ADF country allocation, $7 million from ADF thematic window, $9 million from the Pandemic Fund cofinancing, $5 million from the Green Climate Fund cofinancing, and $6 million from the government's counterpart financing for taxes and duties and operation and maintenance costs occurred during the project implementation period.

The impacts that the proposed project is aligning with are:

• Equitable access to essential health services improved with rural-urban and gender-related health disparities addressed (National Health Strategy 2021-2030), and
• Public health threats in Central Asia Regional Economic Cooperation Program (CAREC) region addressed comprehensively, efficiently, and sustainably while safeguarding the needs of the most vulnerable segments of the population in Tajikistan (CAREC Strategy 2030).

The project's proposed outcome is 'Health security and service delivery of Tajikistan improved with enhanced gender responsiveness and climate resilience. The project has below 4 proposed outputs:

• Output 1: Disease prevention and public health emergency response capacity at points of entry improved;
• Output 2: Pandemic preparedness, prevention, and response capacity improved;
• Output 3: Capacity and efficiency of sanitary and epidemiology service improved; and
• Output 4: Resilience of primary health care system to manage emerging infectious disease, climate-related health risk and SRHR improved

The ADB categorized the project risks as follows:

Environment - B
Involuntary Resettlement - C
Indigenous Peoples - C

ADB Team Leader:

Dai-Ling Chen
Email: dchen@adb.org 

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ACCOUNTABILITY MECHANISM OF ADB

The Accountability Mechanism is an independent complaint mechanism and fact-finding body for people who believe they are likely to be, or have been, adversely affected by an Asian Development Bank-financed project. If you submit a complaint to the Accountability Mechanism, they may investigate to assess whether the Asian Development Bank is following its own policies and procedures for preventing harm to people or the environment. You can learn more about the Accountability Mechanism and how to file a complaint at: http://www.adb.org/site/accountability-mechanism/main.