Laos COVID-19 ISM Aide Memoire – October 2020

Lao PDR COVID-19 Response Project (Credit No. 6606-LA) The Frist Virtual Implementation Support Mission October 12-19, 2020

Aide Memoire Public Disclosure Authorized I. INTRODUCTION

1. The first virtual implementation support mission (ISM) for the Lao PDR COVID-19 Response Project (Laos COVID-19) from October 12-19, 2020. The mission was led by Ms. Emiko Masaki (Senior Health Economist and Task Team Leader) and Ms. Keiko Saito (co-TTL, Senior Disaster Risk Management Specialist). A list of the officials met, and the team members is provided in Annex 1. The objectives of the mission are to: (i) review the progress made since the Project became Effective (April 7, 2020) which covers Project Components, procurement, financial management, environmental and social framework, and the Results Framework in terms of progress toward achieving the Project Development Objective (PDO); (ii) review implementation progress of the US$1 million grant from the Pandemic Emergency Financing Facility (PEF) implemented by UNICEF and WHO; and (iii) discuss and assess the need for additional financing for the COVID-19 vaccines.

Public Disclosure Authorized 2. The team would like to thank Dr. Founkham Rattanavong, Director General of the Department of Planning and Cooperation (DPC), and Dr. Chansaly Phommavong, Deputy Director of DPC and representatives from other departments of the Ministry of Health (MOH) for their close cooperation and support during the virtual ISM and continued commitment in implementing the Laos COVID-19. The team also thanks the development partners for their valuable inputs and contributions to the technical discussions during the mission. The Aide-Memoire was discussed at the wrap-up meeting on October 19, 2020 chaired by Dr. Founkham Rattanavong, Director General of DPC, and this final version incorporates MOH’s comments and was endorsed by the World Bank (WB) management. As part of the WB Access to Information Policy, and with the agreement of the MOH, the Aide-Memoire will be publicly disclosed.

II. PROJECT DATA AND RATINGS Public Disclosure Authorized Table 1: Key Project Data and Ratings

Project Data US$ (millions) Original Project Amount 18 Total Disbursement 6.36 (35%) Disbursement in FY 0.83 Closing Date December 31, 2022

Project Ratings: Previous Current Project Development Objective Satisfactory Satisfactory Implementation Progress Satisfactory Satisfactory Component 1: Emergency COVID-19 Response Satisfactory Satisfactory Component 2: Strengthening System for Emergency Response Satisfactory Satisfactory Public Disclosure Authorized Component 3: Project Management and Monitoring and Evaluation Satisfactory Satisfactory Project Management Satisfactory Satisfactory Moderately Procurement Satisfactory Satisfactory Financial Management Satisfactory Satisfactory Monitoring and Evaluation Satisfactory Satisfactory Moderately Environmental and Social Compliance Satisfactory Satisfactory

1 Laos COVID-19 ISM Aide Memoire – October 2020

III. IMPLEMENTATION PROGRESS AND KEY FINDINGS

3. Since Project Effectiveness, there has been significant progress in implementing activities for the COVID-19 emergency response under Component 1. Overall progress towards achievement of PDO indicators is progressing well (see Annex 3) and is Satisfactory.

Component 1: Emergency COVID-19 Response

4. The mission team noted that significant progress has been made under this Component, which has disbursed US$4.13 million or 32% of the total Component budget mostly for the procurement of laboratory and medical equipment. Key achievements include (a) all procured items have been distributed to health facilities at central and provincial level; (b) training on medical equipment and molecular polymerase chain reaction diagnostics has been provided in 17 Provinces; (c) surveillance training on the use of the District Health Information System version 2.0 (DHIS2) modules (data entry, data processing, use of system to monitor indicators for COVID-19) has been completed at central and provincial levels; (d) training of staff and volunteers on contact tracing, contact monitoring for COVID- 19 in 18 Provinces; (e) supported key activities of National Center Laboratory and Epidemic (NCLE) for surveillance, report, contact tracing and follow-up, sample collection; (f) provided funds for warehouse management and vehicle maintenance; (g) completed the procurement of IT equipment and furniture for the Emergency Operating Center (EOC) to sustain 165-166 hotlines for access by communities; and (h) completed procurement documents for the second round of the procurement of the medical equipment.

5. While most of the activities under sub-components are progressing well, some activities under sub-components: 1.6. Quarantines; 1.8. Essential Health Service Delivery; and 1.9. Contingencies require immediate adjustment and further clarifications on activity scope, roles and responsibilities across implementing Departments, and close monitoring from the Project Coordination Office (PCO) to ensure activities are fully aligned with the National COVID-19 Preparedness and Response Plan and implemented in a timely manner. Key findings and recommendations are summarized below:

• Sub-component 1.6. Quarantines. Some activities under this sub-component were not clearly defined in terms of the roles and responsibilities of Departments and Provinces to implement activities for quarantine facilities, including quarantine at boarder check points, government designated facilities (establishment of quarantine facilities, providing food and other necessary supplies to the quarantined population as well as health workers). No clear mechanism is in place for Departments and Provinces to submit their activity plans and funding requests. There is a large financing gap for quarantine activities, especially at sub-national level. The mission team suggested that DPC, through PCO and Department of Communicable Disease Control (DCDC), summarize implementation procedures to clarify the approval process and required documentation, including evidence needed to prove that payments have been made. Once these processes are clearly defined, the PCO should then communicate them to Departments and Provinces and provide training on the processes.

• Sub-component 1.8. Essential Health Service Delivery. Procurement of laboratory equipment is currently included under this sub-component; however, this does not correspond to the priority activities included under the Essential Health Services Pillar of the National COVID-19 Preparedness and Response Plan. The mission recommends MOH to revise and update the activities under this sub-component to ensure that funds are prioritized for activities with the largest funding gaps under the Essential Health Service Pillar (7.10-7.12) of the National COVID-19 Preparedness and Response Plan to support the continuation of the maternal and child health services delivery in the COVID-19 era.

2 Laos COVID-19 ISM Aide Memoire – October 2020 • Sub-component 1.9. Contingencies. While it was agreed to allocate contingency funds to pay for healthcare workers' overtime, there has been no progress under this sub-component. The mission recommends that MOH/PCO develop and approve a template and regulation for overtime payment for healthcare workers engaged in COVID-19 response activities, referring to the Ministry of Finance (MOF) instruction of COVID-19 Financial Management no. 0991/MOF. The mission also recommends changing the Department responsible for this activity from the Department of Healthcare and Rehabilitation (DHR) to the Department of Finance (DOF) (or it can be joint) since DOF is directly involved in the overtime payment activity using Government funds.

Component 2: Strengthening System for Emergency Response

6. This Component aims to strengthen capacity and provide support for emergency response including training and development of guidelines. A total amount of US$78,543 (2.1%) of the budget has been disbursed as of October 15, 2020. Continued consultative meetings on guidelines development and delivery of medical equipment to health facilities are in progress. The priority activity for Fiscal Year 2020 is the construction of treatment and isolation facilities in the existing hospitals in Champasak, Sekong and Attapue Provinces. The National Procurement Committee for COVID 19 has authorized MOH to procure consultant services for the design and supervision of the planned civil work, and to construct a laboratory at Phonthong District in Champasak Province. The mission discussed and agreed that the construction at the existing hospitals would include intensive care unit, isolation and laboratory rooms. To expedite the procurement process, concerned technical departments are requested to work closely with PCO to review the plan for the new civil works to ensure necessary preparatory activities are completed without delay.

7. The mission discussed the capacity of the current warehouse and acknowledged the immediate need for improving/expanding warehouse capacity and strengthening the logistic and supply chain system. The mission agreed that the PCO and concerned departments such as the Department of Food and Drug (FDD) and Medical Project and Supplies Center should identify the gaps and needs which could be considered by additional financing or restructuring.

Component 3: Project Management and Monitoring and Evaluation (M&E)

8. The Project is managed by the PCO under the DPC of MOH. Currently, the Project has three key consultants on board including the Project Manager, Accountant, and Environmental and Social (ES) Officer Given the need to closely monitor the construction of the isolation facilities in the three southern Provinces, and to coordinate and support each technical Department to expedite implementation, the mission team recommends that the PCO assesses the need for additional consultants and fill the capacity gaps as soon as possible. The mission discussed and agreed with the PCO to procure consultancy services for the detailed construction design, supervision, satisfaction survey firm, and an ES consultant for the planned civil work for isolation facilities in the 3 Provinces. This is reflected in the revised Procurement Plan to be submitted to the World Bank.

Implementation Progress of Pandemic Emergency Financing Facility (PEF)

9. The PEF grant of US$1 million was approved and transferred to UNICEF and WHO, on July 2, 2020, for the procurement of vaccines for the immunization program and health facility training respectively. Procurement of vaccines is already complete. The health facility training commenced in July 2020 and has been completed at the national level. Training at Provincial and District levels are scheduled for the next three months and will be completed by January 31, 2021 (see Annex 2 for details of the implementation progress of the PEF grant).

Coordination with Development Partners (DPs)

3 Laos COVID-19 ISM Aide Memoire – October 2020 10. The COVID-19 coordination meeting with DPs, chaired by Dr. Founkham Lattanavong, Director General of DPC, MOH, was held to update partners’ support to the national COVID-19 response, improve coordination across DPs, and ensure DPs’ supported activities are fully aligned with the National COVID-19 Preparedness and Response Plan for 2020-2024, as its implementation requires the coordinated efforts from DPs and a platform for effective coordination. The meeting was attended by WHO, UNICEF, ADB, CHAI, JICA, USAID, PSI, USCDC, LuxDev, Embassy of Russia, KOICA, Global Fund, and Swiss Red Cross1. Overall, the meeting confirmed that further improvement is needed for coordination across partners and MOH Departments to ensure effective implementation of the Response Plan and monitoring of the implementation progress. The mission agreed to hire a M&E consultant to support MOH through DPC to coordinate and monitor implementation of the Response Plan.

Additional Financing for COVID-19 Vaccine and its Deployment

11. Additional Financing (AF) from the WB can be made available for the financing of COVID- 19 vaccine and deployment as soon as the Government of Lao PDR (GOL) expresses the need to the WB. It was agreed that there is a need to conduct a vaccine introduction readiness assessment in order to identify the capacity and financing gaps and to inform the design of the AF. Therefore, the mission team proposes a vaccine readiness assessment to commence as soon as possible.

12. Following the COVID-19 coordination meeting, a technical meeting was organized with Gavi, WHO, UNICEF, CHAI and USCDC to discuss collaboration and coordination in supporting COVID- 19 vaccine deployment. The National Immunization Technical Advisory Group (NITAG) provides overall technical guidance and recommendations on introduction of any vaccines into the country, while the MOH is responsible for approval of the vaccine being imported to the country. The types of vaccines and sources of funding support have not yet been identified. The COVID-19 vaccine readiness assessment tools (VRAF and VIRAT)2 were introduced to MOH and partners. It was agreed that the partners will jointly support MOH to conduct the COVID-19 vaccine readiness assessment to identify capacity and financing gaps as well as investment needs to effectively deploy COVID-19 vaccines to target beneficiaries. The vaccine readiness assessment will inform the need for AF, the application to the COVAX facility, and the development of the COVID-19 vaccine deployment plan. The existing draft national deployment and vaccination plan for Pandemic Influenza Vaccines will also be used to guide the vaccine deployment plan development. The mission team recommends that the PCO continue the coordination mechanism and use the assessment results to inform MOF for the scope and need for AF for COVID-19 vaccine deployment.

13. The meeting with MOF confirmed that COVID-19 vaccine is a critical public health measure and is a priority for the Government. The GOL is in discussion with bilateral partners for possible vaccine financing and is eligible for the COVAX facility. The MOF is willing to consider AF to the ongoing COVID-19 Project for the COVID-19 vaccine deployment and additional investment in the logistic mechanism and delivery system; however, the scope and financing gaps need to be first assessed and confirmed by MOH. Given the tight fiscal situation at present, MOF is interested in grant financing to cover the immediate needs before a Credit to be considered. The mission confirmed that the team will work closely with MOH and other DPs to conduct the vaccine readiness assessment to confirm the capacity and funding gaps in vaccine deployment.

Procurement

1The meeting was attended by World Health Organization (WHO), United Nations Children's Fund (UNICEF), Asia Development Bank (ADB), Clinton Health Access Initiative (CHAI), Japan International Cooperation Agency (JICA); United States Agency for International Development (USAID), Population Services International (PSI), United States Centers for Disease Control and Prevention (USCDC), Lux-Development, Embassy of Russia, Cooperation Agency (KOICA); Global Fund, and Swiss Red Cross Korea International. 2 The COVID-19 Vaccine Readiness Assessment Framework (VRAF) is a tool developed by the WB, while the Vaccine Introduction Readiness Assessment Tool (VIRAT) is developed by WHO for the COVAX facility.

4 Laos COVID-19 ISM Aide Memoire – October 2020

14. Overall, procurement performance of the Project is considered as Moderately Satisfactory. Contractual commitments at US$4.526 million (35.6% of total amount specified in the Procurement Plan) 7 months since Project Effectiveness. The Project implementing agency has completed procurement of 4 packages (23.5%) out of a total of 17 packages. The mission reviewed the progress of implementing the procurement activities, including reviewing delivery and the use of procured medical equipment under first round (batch 1), the progress of items under second round (batch 2), and the procurement arrangement for the construction of isolation facilities in the three southern Provinces. The mission team noted that activities in the Procurement Plan are being implemented, although at a slow pace, especially the delay in procurement of batch 2 and the hiring of an additional procurement consultant to support the current team; the team is already mobilized to its full capacity in managing two other ongoing WB financing health projects - Health Governance and Nutrition Development Project and Health and Nutrition Services Access Project. The team also noted that although procurement of batch 1 has been completed, no effective system is in place to monitor and track the distributed medical equipment. The mission strongly encouraged MOH to expedite creating this system, along with procuring the medical equipment in batch 2, and hiring the necessary consultants for the detailed design and supervision of the planned civil works, the survey for beneficiary satisfaction, and the ES for Project implementation. Annex 3 provide detail of the status of the procurement packages for works, goods and consulting services under the project.

Financial Management (FM)

15. The FM performance of the Project is Satisfactory. Project FM arrangements are largely in place and working. The first Interim Unaudited Financial Report was submitted in a timely manner. However, the team would like to bring to the PCO’s attention the following three FM issues: (a) recruitment of Project auditors: it was agreed that PCO will submit the terms of reference (TOR) in systematic tracking of exchanges in procurement (STEP) for review and no objection, and it is expected that the contract will be signed in November; (b) it was observed that there have been a few items of long unliquidated advance (currently two items remain unliquidated since March and April this year), and it was agreed that PCO will follow up with DCDC and agree on the date for liquidation, and the policy that no further advances shall be provided until the old advances are liquidated has been put in place; and (c) the revised FM Manual was not submitted to the WB prior to the mission, while the PCO submitted the translated Manual to the WB on October 16, 2020. The PCO was also advised to complete the physical count and attach asset identification numbers on the medical equipment distributed to Provinces by the end of October and update the Project Asset Register accordingly. Disbursement has been relatively high at 35% to date and is largely due to direct payments. There has been no documentation of expenditures since the advance was provided due to the small amount of expenditure. The mission advised PCO to prepare relevant paperwork for the documentation of expenditures and submit the application to MOF for signature; the PCO confirmed that the action had been completed by the wrap-up meeting.

16. The transaction review revealed that improvement is needed for the transaction coversheet. The PCO finance team should ensure the correctness of description, consistency between amount in numbers and amount in words and complete review and sign-off by authorized officials. Moreover, we recommend the transaction coversheet to include details of journal entries, e.g., Component, sub- component, activity and account codes to which the expenditure should be charged. This was discussed with the PCO finance team during the mission.

Environmental and Social Framework (ESF)

17. The ESF performance is rated as Moderately Satisfactory. One of the two ES consultants which were agreed to be recruited is on board to support PCO to implement and monitor ESF instruments applied under the Project; these include the Environmental and Social Management Framework (ESMF) and Stakeholder Engagement Plan (SEP) governed by Environmental and Social Commitment Plan

5 Laos COVID-19 ISM Aide Memoire – October 2020 (ESCP). However, progress in ESF implementation was slow with training planned to be provided for Project staff and health workers while Project activities have been already initiated on the ground. The WB’s ESF team met, on October 13, 2020, with the PCO and other Departments’ representatives from MOH to discuss (a) the status of ESF implementation under the Project; and (b) ESF application by the new proposed activity for construction of isolation buildings in Champasack, Sekong and Attapeu Provinces. Main points discussed and next steps agreed are summarized below.

18. The Project has prepared and submitted a plan for training on Infection Prevention and Control (IPC) and supplying waste management equipment to the Provinces. The implementation of ESF instruments is relatively slow with no action taken to identify risks and measures to be applied by Project activities to provide health services which have been already initiated by the Project health workers on the ground. No major ESF issues and grievance related to the Project have been reported or received through the hotline established. However, a report on the status ESF compliance by the Project is required to be prepared as part of the semi-annual Progress Report and sent to the WB for review. For higher risk activities such as the new sub-project for construction of isolation buildings, the mission suggests that an ESF report should be prepared and provided to the WB on a quarterly basis as per the ESCP.

19. The MOH is preparing TORs for a firm to provide the detailed design and supervision of the construction of isolation facilities to be supported under the project. The mission suggested that the ESF requirements should be integrated into the draft TOR and shared with the WB team for review. The mission recommends that (a) one additional ES consultant needs to be recruited to support the implementation of ESF related plans, particularly to support the ESF implementation of the new Project activity; (b) the ESF monitoring report should be prepared as part of Project Progress Report and submitted to the WB; and (c) all plans/actions specified in the ESCP and ESMF need to be implemented starting from training for Project personnel by the ES consultants. In parallel, the WB team suggested that PCO should conduct an environmental and social screening for the proposed construction works to identify potential risks and management measures once the additional ES consultant is recruited. Monitoring and Evaluation including citizen engagement indicators

20. The mission team discuss the achievement of the result indicators which mostly overachieved in the very short implementation period. The Project was prepared as an emergency; many of the targets for the indicators appear to have been too low (see Annex 4). It was agreed that the end targets will be revised through restructuring during the upcoming AF process or should the GOL not proceed with AF for COVID-19 Vaccines, a level 2 restructuring will be conducted specifically to update the end targets. It was also agreed with the PCO and MOH to add a new citizen engagement indicator under Component 3 in the Result Framework, which is “Percentage of beneficiaries who expressed satisfaction with the Project interventions, including on delivery and communication modalities (Percentage)”. This will require a survey firm to conduct a rapid survey twice a year over a two year period.

IV. NEXT STEPS AND AGREED ACTIONS

21. It has been tentatively agreed that the next implementation support mission of Laos COVID-19 will be a Mid-Term Review mission and take place in 6 months’ time (in May 2021, with a date to be confirmed); in the interim the WB team will take the opportunity to conduct field visits once the travel ban is lifted. The PCO will be required to produce a Mid Term Review report well in advance of the mission. The Task team will provide a template and list of headings that should be included in the report.

Table 2: Summary of Agreed Actions

Actions Responsible Due Date I Component 1: Emergency COVID-19 Response

6 Laos COVID-19 ISM Aide Memoire – October 2020 Actions Responsible Due Date Summarize implementation and approval procedures for 1 DCDC November 30, 2020 activities under 1.6. Quarantines Update the sub-activities 1.8. Essential Health Services to fully align with the National Covid-19 Preparedness and DHR/DHHP3/ 2 November 30, 2020 Response Plan; and submit the revised budget plan for DPC (PCO) WB’s No Objection. Develop a template and regulation for overtime payment 3 DOF/DHR November 30, 2020 for healthcare workers (sub-component 1.9) MOH/DOF/ 4 Approve overtime payment for health workers November 30, 2020 DHR II Component 2: Strengthening System for Emergency Response Complete TOR of the detailed design and supervision 5 DPC (PCO) November 30, 2020 firm for constructing isolation facilities in 3 Provinces Complete identification of the gaps and needs for 6 improvement of the warehouse capacity, logistic and FDD/MPSC November 30, 2020 supply chain system III Component 3: Project Management and M&E Review the consultancy need for project implementation 7 DPC (PCO) October 30, 2020 and reflect in the revised Procurement Plan Finalize and submit a revised Results Framework to the 8 WB, updating the end targets and include the citizen DPC (PCO) October 30, 2020 engagement indicator under Component 3 Assign a coordinator for the COVID-19 Vaccine 9 DPC/EOC October 23, 2020 Readiness Assessment IV Additional Financing Conduct a technical meeting on a joint vaccine readiness DPC/EOC/ 10 October 30, 2020 assessment MCHC4 11 Send request letter to MOF to inform the AF need MOH/DPC November 30, 2020 V Procurement 12 Upload procurement information into STEP DPC (PCO) Regularly 13 Complete procurement of medical equipment batch 2 DPC (PCO) November 20 , 2020 Submit TOR of the construction detailed design and 14 DPC (PCO) November 15, 2020 supervision firm in STEP Complete and submit TOR of a satisfaction survey firm 15 DPC (PCO) November 15, 2020 in STEP VI Financial Management 16 Submit audit TOR in STEP for no objection DPC (PCO) October 30, 2020 DPC (PCO) 17 Agree with DCDC on advance liquidation date October 30, 2020 and DCDC Complete verification, affixing asset number and update 18 project asset register for equipment distributed to DPC (PCO) November 15, 2020 Provinces and other locations 19 Review and correct details of transaction coversheets DPC (PCO) October 30, 2020 20 Complete signing of audit contract DPC (PCO) November 30, 2020 VII Environmental and Social Framework 21 Recruit the additional ES consultant DPC (PCO) November 15, 2020 Include progress of ESF implementation in a Progress 22 DPC (PCO) February 15, 2021 Report and share with the WB team 23 Draft action plan for ESF’s implementation DPC (PCO) October 28, 2020

3 Department of Hygiene and Health Promotion 4 Mother and Child Health Center

7 Laos COVID-19 ISM Aide Memoire – October 2020 Actions Responsible Due Date Include ESF requirement in the draft TOR for the 24 detailed design of the isolation buildings and send it to DPC (PCO) October 30, 2020 WB Carry out the risk screening and share the report for the 25 DPC (PCO) December 10, 2020 proposed construction in three Provinces with the WB Include a summary of grievance or feedbacks received 26 DPC (PCO) February 15, 2020 from the beneficiaries in the project progress report

Annexes: Annex 1: List of Officials and Development Partners Met Annex 2: Pandemic Emergency Financing Facility Grant Annex 3: Status of Procurement Packages for Works, Goods and Consulting Services Annex 4: Results Framework

8 Laos COVID-19 ISM Aide Memoire – October 2020 Annex 1: List of Officials Met and Composition of the WB team

Name Position Organization Government Dr. Founkham Rattanavong Director General, DPC MOH Dr. Chansaly Phommavong Deputy Director of DPC MOH Dr. Onchanh Keosavanh Deputy Director of FDD MOH Dr. Bounsou Keohavong Deputy Director of FDD MOH Dr. Buathep Phoumin Deputy Director, DHR MOH Dr. Khamsay Dethluexay Deputy Director Mahosot Hospital Dr. Phaivunh Keopaseth Director Setthathirath Hospital Dr. Viengsavanh Head of Division, DCDC MOH Dr. Inpong Thongphachan Head of Center CCEH Ms. Vilakone Phaengkhamhuk Head of Division CCEH Mr. Bounsathienh Phimmasen Head of Division, DoF MOH Ms. Manisone Sayyasen Head of Procurement Unit, MPSC MOH Dr. Somchanh Thounsavath Head of Division, DHR MOH Dr. Haikham Keokenechanh Acting Head of Admin Division, DCDC MOH Dr. Bounthanome Saengkeopaseth Head of Epidemiology Unit NCLE Dr. Maiphone Soukvixay Head of M&E Division, DPC MOH Dr. Pasumphon Thongmalongsath Head of Planning Division, DPC MOH Dr. Phonethavy Khodsymueang Head of Admin Division, DHHP MOH Mr. Khamtik Phunthalarmexay Deputy Head of Maintenance Unit of MOH MPSC, FDD Dr. Vixayyang Chaivungmun Deputy Head of Division, DHR MOH Ms. Saengmontha Oupaengvong Deputy Head of Division, DoF MOH Dr. Dasavanh Manivong Deputy Head of Division National Health Security Officer Mr. Somsamai Bounchaleun Officer, DHHP MOH Ms. Sinchay Luanglath Finance Officer NCLE Ms. Deaunpheng Inthavong Officer, FDD MOH Mr. Oulaisith Phunyavong Officer, FDD MOH Dr. Vongkham Inthavong Officer TB Control Center Dr. Phangchoiy Punyalath Officer NIP Dr. Founkham Rattanavong Director General, DPC MOH Dr. Chansaly Phommavong Deputy Director of DPC MOH Dr. Onchanh Keosavanh Deputy Director of FDD MOH Dr. Bounsou Keohavong Deputy Director of FDD MOH Dr. Buathep Phoumin Deputy Director, DHR MOH Dr. Khamsay Dethluexay Deputy Director Mahosot Hospital Ministry of Finance Mr.Soulivath Souvannachoumkham Director General of External Finance and MOF Debt Management Department Mr. Phimpha Phommavong Deputy Head Division, State Asset MOF Management Department Mr. Souksavanh Keosouvunh Officer, National Treasury MOF Mr. Vannasone Thammavong Officer, Budget Department MOF Mr. Venephet Basysom Officer, Tax Department MOF Mr. Viphasouk Saysanavongphet Technical Officer, External Finance and MOF Debt Management Department PCO Ms. Khaikham Xaynhaphoun Project Manager MOH

9 Laos COVID-19 ISM Aide Memoire – October 2020 Name Position Organization Mr. Viengthong Chongwaxiong IT Office MOH Mr. Xiongyang Boonmar IT MOH Mr. Phanthanou Louangsay Procurement, MOH Mr. Amphone Keoudom ES Officer MOH Mr. Phisith Xaysomphou FM MOH Ms. Oulayvanh Chanthavong Project Coordinator and Admin MOH Ms. Viengphin Boulommavong Administrative MOH Ms. Vilaylath Sengsavang Administrative MOH Dr. Pasongsith Boupha Senior Advisor MOH Development Partners Ms. Yu Lee Park Technical Officer WHO Dr. Lauren Franzel Team Lead – Vaccine Preventable Diseases WHO & Immunization Mr. Hironori Okabayashi Policy Advisor JICA Dr. Viengphone Khanthamaly Influenza Program Lead USCDC Dr. Josh Mott Program Director USCDC Dr. Mikeston Deputy Country Representative USAID Dr. Phonepaseuth Khampanisong Technical Officer LuxDev Mr. Alexander Artamonov Minister Councilor Russian Embassy Mr. Jean-Marc Country Coordinator Swiss Red Cross Ms.Chanthasone Phonnasane M&E Officer Swiss Red Cross Ms. Hyemi Kim Program Officer KOICA Dr. Kongseng Khamsyvoravong Finance Manager Global Fund Dr. Chansy Sramany Manager Global Fund Ms. Sompasong Phongphila Associate Officer CHAI Mr. Garrett Young Director CHAI Ms. Veronique Maeva Fages Program manager GAVI Mr. Viengsamay Vongkhamsao Country Director PSI Dr. Yu Xue Sr. Health Specialist ADB World Bank Mission Team Ms. Emiko Masaki Sr. Health Economist & Task Team Leader World Bank Ms. Keiko Saito Sr. Disaster Risk Management Specialist World Bank Mr. Ziauddin Hyder Cluster Lead and Senior Health Specialist World Bank Mr. Sombath Southivong Sr. Infrastructure Specialist World Bank Ms. Siriphone Vanitsaveth Sr. Financial Management Specialist World Bank Mr. Sybounheung Phandanouvong Sr. Social Development Specialist World Bank Mr. Viengkeo Phetnavongxay Sr. Environmental Specialist World Bank Mr. Khamphet Chanvongnaraz Sr. Procurement Specialist World Bank Ms. Thanongluck Oudome Resource Management Analyst World Bank Ms. Sophavanh Thitsy Operations Analyst World Bank Ms. Anita Soukhaseum Program Assistant World Bank Mr. Chanhsy Samavong Health Financing Consultant World Bank Ms. Phonethipsavanh Nouanthong Public Health Consultant World Bank Ms. Manida Unkulvasapaul Sr. Environmental Consultant World Bank Ms. Vanlaty Siphome Procurement Consultant World Bank

10 Laos COVID-19 ISM Aide Memoire – October 2020 Annex 2: Pandemic Emergency Finance Facility Grant

1. The Pandemic Emergency Finance Facility (PEF) was established in July 2017 to help countries to respond to major disease outbreaks. Part of the financing was arranged through a cash window and part from an insurance window, financed by the pandemic catastrophe bonds and swaps issued by the World Bank (IBRD - annual premiums are paid by funds from Japan, Germany, Australia, and IDA). The PEF insurance window has triggered for COVID-19 response. It has been made available for 64 PEF eligible countries that have reported cases of COVID-19 as of April 22, 2020. The allocation for Lao PDR was US$1 million.

2. In response to the request from the Ministry of Health (MOH) dated June 19, 2020, the World Bank has approved and transferred the PEF grant of US$1 million to UNICEF and WHO on July 2, 2020 for the procurement of vaccines for the immunization program and health facility training respectively. Procurement of vaccines is already complete. The health facility training commenced in July 2020 and been completed at the national level. Training at provincial and district levels are scheduled for the next 3 months and will be completed by January 31, 2021, the closing date of the PEF.

3. An amount of US$800,000 of the PEF grant has been channel through UNICEF to procure immunization vaccines. MOH has confirmed using the grant as Government co-financing with Gavi for procurement of three mandatory vaccines, including Penta, measles and rubella (MR), and human papillomavirus (HPV). The purchase order in the amount of US$761,356 for the 3 vaccines was issued on August 25, 2020 which will provide enough quantities of the MR vaccine for both 2020 and 2021, and cover half of the need for Penta and HPV in 2021.

4. Given the current stock of the vaccines, UNICEF recommends a phased delivery of 3 vaccines to avoid overloading of the current capacity of the cold chain system and ensure that the country gets the vaccines with a longer shelf life; for instance, transporting Penta into the country in March 2021, HPV in April 2021, and MR in November 2021. The new orders will be delivered to the country using the UN delivery system upon the confirmation on the date from the Ministry of Health. UNICEF guarantees the availably and delivery of the vaccine in the purchase order to the country whenever needed.

5. An amount of US$200,000 of the PEF grant has been channeled through WHO for safe, green, and disinfection training in 50 healthcare facilities at provincial and district levels. The grant supports capacity building training for water and sanitation and infection prevention and control (WASH IPC) team, implementation of the water and sanitation for health facility improvement tool (WASH FIT) with 12 modules and healthcare waste management, in setting up regular assessment, improvement planning and monitoring system at 4 provincial and 46 district hospitals in 6 Provinces in the southern region.

6. Training of trainer on the use of the WASH FIT tools at the national level has been completed; 40 people from MOH and international non-governmental organizations were trained. Development of monitoring and evaluation tools has also been completed. Currently, of the US$200,000, about US$68,600 has been disbursed which accounted for 35% of the grant allocation. The next step is to complete training for 50 health facilities, including on monitoring and evaluation. The training at sub- national level will be rolled out by the Department of Hygiene and Health Promotion and the National Center for Environmental Health, Water Supply and Sanitation (Namsaat). It is recommended that the MOH internal approval process of training budget is expedited to ensure that the remaining training activities are completed by January 31, 2021, the Closing Date of the grant.

11 Laos COVID-19 ISM Aide Memoire – October 2020 Annex 3: Status of Procurement Packages for Works, Goods and Consulting Services

Expected Review Ref. Estimated Procurement Bid Contract (Description) by Comments No. Cost (US$) Method Opening Bank Date Works and Goods 11,967,977 G-20 Procurement of medical 4,400,000 RFQ Post Apr-20 Completed; equipment Lot 1* Saimangkorn Pharmacy Co., Ltd. G-21 Procurement of medical 4,734,977 RFB Post Oct-20 equipment Lot 2 G-23 Vehicle 782,000 RFB Post Oct-20

G-24 IT equipment 100,000 RFB Post Oct-20

G-25 Sodium Hypochlorite 350,000 Post Nov-20 Gernerator G-26 Camera Camcorder 31,000 RFQ Post Oct-20 W- Improvement/small 100,000 DS Post Dec-20 02 construction of HCWM facility W-02 Construction of isolation 1,470,000 RFB Post Dec-20 and lab facilities Consulting services 759,500 C-01 Project Manager 69,000 DS Post Aug-20 Completed C-04 Project Accountant -1 23,000 DS Post June-20 Completed C-06 Safeguard Consultant 34,500 DS Post Sep-20 Completed C-07 M&E Consultant 34,500 DS Post Dec-20 C-08 Project Financial 30,000 DS Post Nov-20 Statements Audit C-09 Group of Health 194,000 DS Post TBD Consultants C-10 Design and construction 140,000 CQS Post Nov-20 supervision services for isolation and treatments COVID-19 facilities C-11 Satisfactory survey firm 200,000 CQS Post Nov-20 C-12 Environmental and Social 34,500 DS Post Nov-20 Consultant (2) Grand Total 12,727,477

12 Laos COVID-19 ISM Aide Memoire – October 2020 Annex 4: Results Framework

Project Development Objective Indicators Baseline Progress End Target

Timely detection response, and containment of COVID-19 cases Number of suspected cases of COVID-19 tested for 0.00 59,183 71,000 COVID-19 based on the national guidelines (Number) Increased capacity of healthcare institutions for COVID-19 and other emergency responses Number of acute healthcare facilities with isolation 1.00 24 21 capacity (Number) Intermediate Results Indicators by Components Baseline Progress End Target

Component 1: Emergency COVID-19 Response 500 (need Number of health staff trained in infection prevention 618 consultation 0.00 and control per MOH-approved protocols (Number) (need update) with DHR on the revised target) Percentage of COVID-19 laboratory-confirmed cases 80 notified, registered and reported within 24 hours 0.00 100 (to revise to (Percentage) 100) Component 2: Strengthening System for Emergency Response Number of designated laboratories with staff trained to 4 4.00 10 conduct COVID-19 diagnosis (Number) (need update) 75 Percentage of COVID-19 laboratory-confirmed cases 0.00 100 (to revise to treated as per national guidelines (Percentage) 100) A referral system to care for COVID-19 patients in No No Yes place (Yes/No) Component 3: Project Management and Monitoring and Evaluation M&E system established to monitor COVID-19 No Yes Yes preparedness and response plan (Yes/No) Percentage of beneficiaries who expressed satisfaction with the project interventions, including on delivery TBD TBD TBD and communication modalities (Percentage)

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