Additional Financing to Support to COVID-19 vaccine purchase and health system strengthening (WB-P178279)

Countries
  • Madagascar
Geographic location where the impacts of the investment may be experienced.
Financial Institutions
  • World Bank (WB)
International, regional and national development finance institutions. Many of these banks have a public interest mission, such as poverty reduction.
Project Status
Proposed
Stage of the project cycle. Stages vary by development bank and can include: pending, approval, implementation, and closed or completed.
Bank Risk Rating
A
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
Dec 30, 2022
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.
Borrower
Government of Madagascar
A public entity (government or state-owned) provided with funds or financial support to manage and/or implement a project.
Sectors
  • Education and Health
The service or industry focus of the investment. A project can have several sectors.
Investment Type(s)
Grant
The categories of the bank investment: loan, grant, guarantee, technical assistance, advisory services, equity and fund.
Investment Amount (USD)
$ 41.00 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 @ WB website

Updated in EWS Nov 16, 2022

Disclosed by Bank Nov 14, 2022


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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.

According to bank documents, the project objective is to support the Government of Madagascar to acquire and deploy COVID-19 vaccines, and to strengthen its immunization services.

The proposed additional financing (AF) of a US$41 million equivalent International Development Association (IDA) grant will support the costs of expanding activities of the Madagascar Support to COVID-19 Vaccine Purchase and Health System Strengthening (P176841) with a primary objective to enable affordable and equitable access to COVID19 vaccines and help ensure effective vaccine deployment in Madagascar through vaccination system strengthening, and to further strengthen preparedness and response activities under the parent project. The increase in scale will be reflected in an increase in the overall project financing from US$100 million to US$141 million with the amount of the AF being distributed under the two components included in the parent project.

Component 1: Acquisition of Vaccines and Medical Supplies [originally US$71 million; with proposed AF, US$80 million]. The implementation of the activities under the parent project will continue without any changes. The project will continue to finance: (i) acquisition of vaccines for priority groups defined in NVDP; and (ii) acquisition of vaccination supplies needed for activities outlined in the Vaccine Delivery and Distribution Manual, including diluents, syringes, and medical supplies associated with the vaccination response.

Changes: Under this component, the parent project will be able to procure more doses with the allocated budget than initially planned under the parent project as the country opted for single dose Johnson and Johnson/Janssen vaccine which costs less. That will represent 8 million vaccines to cover 27% of the population. The AF will finance: (i) acquisition of COVID-19 vaccine doses to cover an additional 3 percent of the population, thusthe total of 9 million doses purchased by the project will contribute to the government’s plan to reach 50.5 percent COVID-19 vaccination coverage by June 2023; and (ii) acquisition of vaccination supplies needed to vaccinate the additional proportion of the population such as diluents, syringes, and all medical supplies associated with vaccination. The country is considering vaccine purchase via COVAX, as the Janssen vaccine is now available through the cost-sharing mechanism. The cost-sharing framework agreement was signed on November 26, 2021. World Bank procurement arrangements for vaccines through COVAX are still being finalized.

Component 2: Strengthening Health System for the Effective Deployment of Vaccines [originally US$29 million; with proposed AF, US$61 million]. The implementation of the activities under the parent project will continue without any changes. The project will continue to finance: (i) strengthening of vaccine logistics system, cold chain and vaccination sites (storage and transportation); (ii) strengthening surveillance and information systems including vaccine safety and AEFI monitoring; (iii) strengthening planning and coordination capacity including training of health workers/vaccinators
and waste management; (iv) communication campaign to address vaccine hesitancy; and (v) operating costs.

Changes: Under this component, the AF will finance activities to scale up: (i) deployment of health professionals to deliver the additional doses procured through this AF; (ii) purchase of additional equipment for vaccines distribution (cold chain equipment, vehicles and motorbikes) and data reporting (tablets and computers); (iii) additional technical assistance for the deployment of vaccines, including for communication and demand creation based on a geographic mapping of pockets of hesitancy and for the utilization of drones for vaccines transportation in remote areas (this
will be contracted with private operators specialized in drones utilization); and (iv) incentives for community health workers and mobilizers (incentives to be received by community health workers would be linked to the number of people referred to vaccination sites. An independent organization will be contracted for payments which will be based on properly validated statements).

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

Contact Information
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World Bank:
Maud Juquois
Senior Economist, Health

Borrower:
Government of Madagascar

Implementing Agency:
Ministry of Public Health
Zely Arivelo Randriamanantany
Minister of Public Health
zrandriamanantany@yahoo.fr 

ACCESS TO INFORMATION

To submit an information request for project information, you will have to create an account to access the Access to Information request form. You can learn more about this process at: https://www.worldbank.org/en/access-to-information/request-submission 

ACCOUNTABILITY MECHANISM OF THE WORLD BANK

The World Bank Inspection Panel is the independent complaint mechanism and fact-finding body for people who believe they are likely to be, or have been, adversely affected by a World Bank-financed project. If you submit a complaint to the Inspection Panel, they may investigate to assess whether the World Bank is following its own policies and procedures for preventing harm to people or the environment. You can contact the Inspection Panel or submit a complaint by emailing ipanel@worldbank.org. Information on how to file a complaint and a complaint request form are available at: https://www.inspectionpanel.org/how-to-file-complaint 

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How it works