Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Project Name PROJECT INFORMATION DOCUMENT (PID) APPRAISAL STAGE REPORT NO.: AB2342 Avian and Human Influenza Control and Preparedness Emergency Project Region EAST ASIA AND PACIFIC Sector Health (50%); Animal Production (50%) Project ID P100084 Borrower(s) ROYAL GOVERNMENT OF CAMBODIA Implementing Agency Food and Agriculture Organization of the United Nations (FAO) House #5, Street 370 Phnom Penh, Cambodia Tel :+(855) 216 566/211 702 World Health Organization (WHO) 177 Corner Street 51 and 254 Phnom Penh, Cambodia Tel:+(855) 23 216 610 Fax:+(855) 23 216 211 United Nations Development Program (UNDP) 53 Street 51 Phnom Penh, Cambodia Tel:+(855) 23 216 217 Fax:+(855) 23 216 257 Environment Category [ ] A [X] B [ ] C [ ] FI [ ] TBD (to be determined) Date PID Prepared April 18, 2007 Date of Appraisal May 16, 2006 Authorization Date of Board Approval June 14, 2007 1. Country and Sector Background Introduction The continuing outbreaks of highly pathogenic avian influenza (HPAI) in recent years have caused substantial damage to the poultry industry in several regions of the world, resulted in some loss of human life, and raised concerns about a possible human pandemic. 1 Large scale 1 Avian influenza, or bird flu, is a contagious disease of animals caused by viruses that normally infect only birds and, less commonly, pigs. Avian influenza viruses are highly species-specific, but have, on rare occasions, crossed the species barrier to infect humans. In domestic poultry, infection with avian influenza viruses causes two main forms of disease, distinguished by low and high extremes of virulence. The low pathogenic form commonly causes only mild symptoms and may easily go undetected. The highly pathogenic avian influenza (HPAI) form spreads
outbreaks began in 2003 in several Southeast Asian countries, and HPAI has now reached Europe, the Middle East, and West Africa. More than 150 million birds have died from the disease or been killed as part of the effort to contain HPAI. Economic losses to the Asian poultry sector alone are estimated at around US$10 billion. Much of these losses have been suffered by millions of poor farm households who depend upon poultry for home consumption and some cash income. There have been 272 laboratory-confirmed human cases of infection with HPAI (hereafter, Avian and Human Influenza, or AHI) since 2003, and 166 of these died. Nearly all of the confirmed cases are known to have had contact with birds, and so far AHI does not transmit easily from human-to-human. However, the virus is evolving and it is believed that it may acquire the characteristics which would enable efficient human-to-human transmission. 2 Each additional human case gives the virus an opportunity to improve its transmissibility in humans, and thus develop into a pandemic strain. The recent spread of the virus to poultry and wild birds in new areas further broadens opportunities for human cases to occur. While neither the timing nor the severity of the next pandemic can be predicted, the probability that a pandemic will occur has increased. If the virus achieves high transmissibility between humans and is highly pathogenic, then a severe human pandemic could result with very large losses of human life and enormous economic disruptions and losses on a global scale. The global response to the threat of AHI in humans and domestic poultry comprises three key strategies: (i) progressively controlling and eradicating the spread of the disease in animals, thus lowering the animal-origin virus load in the environment and reducing the risks of human infection, (ii) preventing and limiting the spread of the disease among humans, thereby reducing the opportunity for the virus to improve its human transmissibility, and (iii) in the event of a pandemic, helping affected populations cope with its effects. AHI prevention and control involves many players in the areas of health, agriculture, natural disaster response, finance and planning, and a multi-sectoral approach is therefore essential. It is also recognized that individual countries are central to a coordinated and effective global response. Country strategies should be developed in accordance with country-specific needs and circumstances, and the strategies should be owned by the individual governments facing the threat of AHI. Regional Dimension In East Asia and the Pacific, cases of AHI have occurred in a number of countries, including Cambodia, China, Lao People s Democratic Republic (PDR), Indonesia, Japan, Korea, Malaysia, very rapidly through poultry flocks, causes disease affecting multiple internal organs, and has a mortality that can approach 100%, often within 48 hours. H5N1 is one strain of the HPAI virus. 2 The virus can improve its transmissibility among humans via two principal mechanisms. The first is reassortment in which genetic material is exchanged between human and avian viruses during co-infection of a human or pig. Reassortment could result in a fully transmissible pandemic virus, announced by a sudden surge of cases with explosive spread. The second mechanism is a more gradual process of adaptive mutation, whereby the capability of the virus to bind to human cells increases during subsequent infections of humans. Adaptive mutation, expressed initially as small clusters of human cases with some evidence of human-to-human transmission, would probably give the world some time to take defensive action. 2
Myanmar, Thailand, and Vietnam. Responses to the outbreaks in domestic and wild fowl have included screening, surveillance, precautions at the borders, movement control inside the country, culling programs, and control of wildlife reservoirs. The World Organization for Animal Health (OIE) reports that, for 2004, over 60 million birds were destroyed, and approximately 131 million vaccinated. This response was the result of over 800 outbreaks, with over 22 million cases (this number includes the number of fowl which have either become sick or have died from the disease), and over 4 million deaths attributed to AHI. On the human health side, since 2003 to date, there have been 230 cases reported in Cambodia, China, Indonesia, Thailand, and Vietnam, resulting in 143 deaths attributable to AHI. 2. Objectives Rationale for Bank Involvement A key justification for the Bank s involvement is the global public goods aspect of controlling AHI. There is also a national public goods perspective for countries to strengthen their veterinary services, disease surveillance, and human health system as planned in this operation. AHI control programs require a multi-disciplinary approach to integrate technical, social, economic, political, policy, and regulatory issues in addressing a complex problem. The Bank is well placed to draw on its knowledge-base concerning multi-disciplinary approaches needed in the proposed operation, and to apply the evidence and lessons learned in various regions during emergency preparedness responses. The Bank can also be helpful in bringing together the relevant ministries, government agencies and the donor community, and in helping ensure high level political coordination. The Bank has been working with WHO, FAO, OIE, multilateral, bilateral, and other partners incountry and at the international level to prepare the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI). In Cambodia, the Bank has been working with UNDP (the convenor of the donor round table), other agencies of the UN system (FAO, WHO, UNICEF), the EU, and other partners to help the government assess and improve the National Comprehensive AHI Plan. The Bank can assist Cambodia in leveraging additional resources from other bilateral and international agencies. In addition, the technical assistance provided by the Bank has been important in similar global or regional emergency situations such as SARS, and post-disaster reconstruction. The Bank has a proven comparative advantage in providing integrator skills and multi-sectoral perspectives and in addressing the institutional dimensions of the response to such emergencies. It can also contribute extensive experience and skills in understanding and addressing the social and economic impact. Country eligibility under GPAI The proposed project falls under the Global Program for Avian Influenza and Human Pandemic Preparedness and Response (GPAI), approved by the Bank s Board of Directors on January 16, 2006. GPAI support is to be provided using the horizontal Adaptable Program Loan (APL) instrument and within a global coordination framework. Under the global APL, individual countries may obtain separate loans, credits and grants, as they become available, to finance their own national projects, up to the global aggregate limit of US$500 million. Since the GPAI is 3
designed to provide emergency financing to participating countries to contain outbreaks of avian flu through early detection and rapid response measures, the country specific operations will be processed under the Bank s emergency policy OP/BP 8.50. The GPAI will treat specific emergency response projects in each country as phases of a horizontal APL (similar approaches include the Multi-Country HIV/AIDS Programs for the African and Caribbean Regions). Cambodia clearly meets the eligibility criteria specified in the GPAI document, given that: (i) it is a country in endemic situation (with repeated outbreaks in poultry and six human deaths); (ii) the National Comprehensive AHI Plan (see above paragraph), integrating both the animal and the human health sectoral plans, has been prepared and approved by Government; and (iii) the activities included under this proposed Project are fully consistent with the provisions of GPAI. 3. Country and Sector Issues Cambodia has achieved political and macroeconomic stability and, since 1991, has been experiencing rapid economic growth. Nevertheless, Cambodia's economy remains vulnerable and economic growth has not translated into widespread poverty reduction. With a GDP per capita of US$280 and social indicators showing limited progress since the 1960s, Cambodia remains one of the poorest countries in the world. About 35% of the population has expenditure levels below the national poverty line, with about 15% living in extreme poverty. Poverty in Cambodia is overwhelmingly located outside Phnom Penh, with poverty incidence of more than 50% in the worst affected areas. Cambodia was one of the first countries in Southeast Asia to experience AHI infection. The first case of AHI in Cambodia was reported on December 2003, and the first wave of the outbreak during January to May 2004 had a severe impact on smallholder farmers who raise the majority of the country's poultry under subsistence conditions and on small-scale commercial poultry farms. AHI cases emerged again in late 2004 and early 2005, and four human cases (all of which were fatal) were reported in 2005. There has been one confirmed outbreak among chicken, ducks and fighting cocks in February 2006, and this case was quickly contained (about 2500 birds were killed by disease or culling during the February 2006 outbreak). One additional human death due to contamination with the AHI virus was confirmed in 2007. The repeated outbreaks and associated loss of human life and livelihoods highlight the country's inadequate disease surveillance system and limited capacity to control the disease. Cambodia is situated between two large poultry producing countries -- Vietnam and Thailand -- both of which have experienced far greater outbreaks of avian influenza and significant human infection. The sub-region is a potential flashpoint for an expansion of avian influenza and the emergence of a human pandemic strain of influenza. The Government is now focused on the development of an integrated AHI control and human pandemic preparedness and response plan, and is working closely with the international community to build its capacity for disease surveillance, outbreak investigation, and emergency response. 4
4. Project Description Consistent with the GPAI, the Project s overall development objective is to support the implementation of the Cambodia Comprehensive AHI National Plan, which is designed to minimize the threat posed to humans and the poultry sector by AHI infection in Cambodia, and to prepare for, control, and respond if necessary to a human influenza pandemic. More specifically, the Project is expected to provide direct support to the implementation of the National Comprehensive AHI Plan to produce the following outcomes: (a) contain the spread of the disease, thus reducing losses in the livelihoods of commercial and backyard poultry growers and damages to the poultry industry and diminishing the viral load in the environment; (b) prevent or limit human morbidity and mortality by stemming opportunities for human infection, and strengthening curative care capacity; and (c) prevent or curtail macroeconomic disruption and losses by reducing the probability of a human pandemic and improving emergency preparedness and response. Project components The proposed Project would finance activities fully consistent with the objectives and the description of the National Comprehensive Plan, with a focus on the financing of items not already covered by other financiers (technical and financial gaps). The Project would include four components which are detailed in Appendix 2 of the Technical Annex, and are summarized below: Component A -- Animal Health Systems (total cost of about US$6.14 million). The objective of the animal health component is to reduce and, eventually, eradicate the H5N1 virus from the poultry sector within Cambodia. This will reduce the risk of human infection and protect the poultry sector and the livelihoods of many small holders and poor farm households. Additionally, upgrading the animal health system will improve livestock sector productivity with benefits for commercial and backyard producers alike. The component objective would be achieved through an integrated set of measures. First, strengthening both field and laboratory veterinary services will ensure quick investigation and definitive diagnosis of all suspected occurrences of HPAI infection in both commercial and backyard poultry populations. A full time hot line will enable poultry owners to notify the Department of Animal Health and Production of any suspected outbreaks. Second, an effective and rapid response system will be developed to contain the virus within infected places. This will minimize the risk of spread to adjacent and nearby places. Affected poultry will be rapidly culled through humane and environmentally-sound destruction and disposal practices. Together with cleaning and disinfection of infected places, this will eliminate the virus from affected sites. Third, specific project activities will contribute to upgrading biosecurity at commercial and small holder poultry farms and within the processing and marketing system. This will minimize the risk of virus introduction at the farm, trade and marketing levels. Finally, primary stakeholders including backyard farmers, other producers, traders, and processors will be made more aware of AHI control measures through media, extension materials, agricultural shows, and face-to-face meetings in high risk areas. Component B -- Human Health Systems (total cost of about US$3.50 million). The overall component objective is to prevent the emergence of a human pandemic in Cambodia through the rapid identification and effective management of human cases. Strengthening public health 5
systems will enhance national pandemic preparedness, and help reduce the loss of life that would result from a human pandemic caused by influenza. The first subcomponent will focus on developing a training strategy, training of health staff, the development of materials for use by health care providers and teachers, and the preparation of an integrated IEC strategy. To improve surveillance, investigation and response, the second subcomponent will support training of Provincial Rapid Response Teams, the operating costs associated with surveillance, investigation and response, and the transportation for those undertaking both activities in the field, as well as supervision costs by each level. International experts will be hired to identify activities necessary to ensure compliance with the International Health Regulations, and these findings will be disseminated. To support case management and infection control, the third subcomponent will finance the procurement and distribution of medicine, medical equipment and PPE. Financing will also be provided for transport of patients to the referral hospitals. Training in infection control will be supported, as well as the identification of, and support to, activities necessary to ensure appropriate health care waste management. The fourth subcomponent will support laboratory activities through the provision of technical assistance, specimen collection kits, laboratory consumables, and transport costs associated with sending specimens to the WHO collaborating center. Funding will also be provided for technical assistance to prepare a strategy for AHI research. Activities associated with pandemic preparedness for the health sector will be supported under subcomponent 5, and include preparation and dissemination of the plan, training Provincial level staff to prepare their plans, and simulation exercises. The final subcomponent under Human Health consists of the support necessary for overall implementation of the component, such as staff, travel costs, transport and its operation and maintenance costs, and other consumables. Component C Information, Education and Communication (total cost of about US$0.27 million). The information, education and communication (IEC) component provides support to the public awareness campaign on AHI being developed in Cambodia. The national IEC strategy is in the process of being developed through a consultative process involving line ministries, development partners and NGOs. The activities to be covered under the strategy will be targeted to the general population and will be adapted to ensure that, for dissemination to indigenous peoples, the tools are culturally appropriate and, wherever necessary, translated into minority languages. At present, UNICEF and the Academy for Educational Development (AED) have arranged to provide financing for all IEC activities except two KAP surveys to be conducted at mid-term and at the conclusion of the program, a pilot program, and a research fund. The Project will provide funding for the KAP surveys, pilot program, and research fund. Component D Interministerial Cooperation for Pandemic Preparedness (total cost of about US$1.10 million). The objective of the interministerial cooperation for pandemic preparedness component is to strengthen Cambodia s capacity to quickly and efficiently mobilize a coordinated multisectoral and society-wide response to an influenza pandemic. Strengthening the coordinated response capacity for an influenza pandemic would also improve the effectiveness of Cambodia s response to floods, droughts, and other natural disasters. This objective would be achieved through four subcomponents. First, the National Committee for Disaster Management s (NCDM) current Terms of Reference would be modified to better include interministerial cooperation for pandemic influenza preparedness, and NCDM s capacity to oversee this cooperation would be strengthened through training, staffing and other measures. Second, NCDM will prepare and test a Pandemic Preparedness, Response, and Recovery 6
Program (PPRRP). Third, an NCDM emergency MIS system and an M&E system (for the overall national PPRRP) will be designed, developed and established. Finally, pandemic preparedness, response and recovery activities would be integrated into the ongoing Community Based Disaster Risk Reduction Programs (CBDRM). 5. Financing Source: ($m.) IDA Grant 6.0 JAPAN: MINISTRY OF FINANCE - PHRD GRANTS 3.0 AVIAN AND HUMAN INFLUENZA FACILITY) 2.0 Total 11.0 6. Implementation Partnership arrangements Effective and suitable partnership arrangements for this Project have been developed in Cambodia with the international technical agencies as well as with bilateral donor agencies currently providing assistance to the country, building on productive collaborative arrangements developed over time in both the agricultural and health sectors under previous projects. Project preparation and appraisal was undertaken by a multi-agency team that included the UN System agencies (mainly UNDP, FAO, WHO, and UNICEF), representative specialists from the European Union (EU), Agence Francaise de Development (AfD), USAID, and AusAID. Work in the country involved close consultations with local staff of the multilateral and bilateral donors represented in Cambodia. Round tables were organized prior and during the appraisal mission to brief these partners on the intended program of working with the Government to strengthen its National Comprehensive Plan and to ascertain their interest in providing financial and/or technical support for the project. The Government of Japan has already approved a PHRD Co-financing Grant (PHRD Grant) of US$3 million for the Project. Some of the major donors (e.g., UNDP, FAO, WHO, GTZ, Japan/JICA, USAID, and AusAID) have already approved, or are planning to approve shortly, technical assistance projects to complement and to help jump-start the activities proposed under the National Plan, which are consistent with this proposed Project. A multi-donor trust fund --the AHI Facility-- has been established to provide financial support for HPAI preparedness to individual countries. This facility is managed by the World Bank and a total amount of US$2 million has been approved to cofinance Components A and D of the proposed project. Institutional and implementation arrangements Implementing Agencies. The Royal Government of Cambodia (RGC) has decided to delegate the implementation of the project activities to three specialized agencies of the UN System, as follows: 7
a. Animal Health Component. FAO would be the Implementing Agency (IA) of the activities, in support of the Department of Animal Health and Production (DAHP) of the Ministry of Agriculture, Forestry and Fisheries (MAFF). b. Human Health Component. WHO would be the Implementing Agency of the component activities, in support of the Ministry of Health (MOH). c. IEC Component. UNDP will be the Implementing Agency, in collaboration with other governmental agencies and external donors involved in this area. d. Inter-Ministerial Coordination for the Pandemic Preparedness Planning. UNDP would be the Implementing Agency, in support of the National Committee for Disaster Management (NCDM). Under this implementation approach, the RGC (as the Recipient of the grant financing) will enter into a Financing Agreement with the Bank for the IDA funds, as well as into corresponding Grant Agreements for the grants from the PHRD and the AHI Facility. The Financing Agreement between Cambodia and the Bank will specify the delegation of the implementation responsibilities to the UN agencies, which will be acting as Implementing Agencies (IAs) on behalf of the RGC. In accordance with the Financing Agreement, these agencies will enter into a Project Agreement with the Bank for the implementation of their respective components. These institutional implementation arrangements would contribute to fast and cost-effective implementation, providing assurances that the surveillance and response systems are fully operational in a short period, therefore, able to produce an effective response in the even of an outbreak in poultry or a large number of human cases. For the implementation of these activities, the funds from the three sources (IDA, PHRD and AHI Facility) will be advanced from the World Bank directly to designated accounts opened by each IA, in a manner acceptable to IDA. These specialized agencies will: (i) implement the activities with efficiency and in accordance with highest levels of quality, in cooperation with the appropriate counterpart agencies in the public sector responsible for these sectors, and with particular focus on their institutional strengthening to ensure long-term sustainability; (ii) carry out the procurement and financial management involved in this implementation, on behalf of the RGC, in accordance to policies and procedures agreed with the World Bank; (iii) report simultaneously to the RGC and the World Bank, including quarterly physical progress and financial reports; and (iv) be subject to supervision from the World Bank, according to its fiduciary responsibilities as financier of the project. According to World Bank normal procedures, the activities implemented by these agencies will be subject to annual auditing by independent external auditors acceptable to IDA, as well as to procurement post-review by the Bank. Each IA will prepare: (i) a Project Implementation Plan (PIP) for all project activities included in its component; (ii) annual work plans (with budgets) for each calendar year, not later than 30 of September of the previous year for discussion with IDA; (iii) annual physical progress reports and financial statements, not later than April 30 of each year and covering the preceding calendar year; (iv) Interim Financial Reports (IFRs) for each quarter, not later than 45 days after the end of the quarter, which will be the basis for the justification of the replenishment of the designated account; and (v) annual audits of these financial statements by auditors under Terms of Reference acceptable to IDA, within six months of the end of the financial year. 8
Monitoring and evaluation of outcomes/results (M&E) The agencies of the UN System in charge of project implementation (FAO, WHO and UNDP) will be also responsible for the design, establishment and operationalization of the M&E system for their respective components. For this purpose, these agencies will establish their own M&E systems for these components, including the data collection and analysis, consistent and complementary to the data gathered by the line ministries (MAFF, MOH, and NCDM). Depending on the specific situation in each case, these activities could be carried out by the regular staff of these agencies, or of MAFF, MOH and NCDM (with training and technical assistance provided by the Project), or by specialized agencies/institutes contracted for this purpose under the Project. Monitoring progress in implementation and towards the achievement of the intended objectives entails a process of continuous and systematic review of the various project activities. M&E activities are intended to: (i) measure input, output and outcome indicators; (ii) provide regular and up-to-date information on progress toward achieving the intended results and facilitate reporting to the government and IDA; (iii) alert the Specialized Agencies, government authorities and the Bank 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; and (v) provide information to allow the Specialized Agencies to reflect and improve on their performance. The findings of relevant M&E activities will be reflected in quarterly and annual progress reports. The progress reports will cover the implementation of activities related to civil works, institutional activities, training and studies, performance indicators, and FMRs. They also will cover issues identified during implementation and the strategies and actions proposed to be taken to resolve such issues that affect progress. The fourth quarterly report of each year will be an annual report, covering progress during the past year. In addition, a Mid-Term Progress Report will be prepared approximately half-way through implementation, and form one of the inputs into the Mid-Term Review, which will provide an opportunity for joint (Government, Specialized Agencies, implementers, and donors/financiers) review of the experiences and lessons to-date and discuss adjustments of design, implementation schedule and expected outcome/results, if necessary. An Implementation Completion Report will be prepared by both the Specialized Agencies and the World Bank within six months of the closing date of the support. 7. Sustainability Critical to the project sustainability will be the continuous ownership of this initiative by the various stakeholders, coupled with strong political support and an adequate flow of financial resources to carry out project activities. Institutional sustainability will be ensured by: (i) strengthening of programs to maintain public awareness of the threat of HPAI 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 of HPAI and other infectious diseases; and (iv) effectiveness of programs to control the spread of HPAI from birds to the general population. 9
8. Lessons Learned from Past Operations in the Country/Sector Previous World Bank/IDA supported emergency recovery projects provide a number of relevant lessons for project design. Lessons learned of particular relevance for an emergency AHI project include: (a) emergency projects should avoid policy conditionality, (b) project design must be simple and take into account a realistic assessment of the Borrower s capacity and other stakeholders capacity, (c) a speedy appraisal and approval are crucial to provide a prompt response and a substantial contribution to project success, (d) procurement arrangements need to be flexible and should be finalized at an early stage, and (e) realistic assessments should be made of counterparts absorption capacity, as well as of the effective communications and coordination mechanisms among all relevant stakeholders. The experiences gained through the implementation of other emergency projects provide additional important lessons. These projects include the Vietnam Avian Influenza Emergency Recovery Project, projects in response to the SARS epidemic, and projects in response to the HIVAIDS epidemic. These key additional lessons learned include: Preparation of a good quality national strategy is a key factor. For implementation arrangements, it is important to have a coordination structure which is empowered with multisectoral responsibilities, for instance at the Prime Minister s Office level, and to have full time project coordinators to implement activities in a crisis situation. Strengthening the technical, scientific and operational capacity of the relevant participating agencies is very important. It is crucial that awareness in the public and private sectors be raised as early as possible, and to strengthen effective coordination mechanisms for the implementation of the necessary technical responses, involving the Government, the donor community, the private sector and the civil society. Good quality national surveillance is clearly vital in preventing the spread of diseases. There is a need for high level and sustained political commitment and leadership. A comprehensive multisectoral approach of prevention, treatment, care and support services has the best likelihood of success. While emphasis must still be placed on prevention as the most cost-effective means of managing the AI threat, programs should seek to address the whole spectrum of prevention, treatment, care and support services. 10
9. Safeguard Policies (including public consultation) Safeguard Policies Triggered by the Project Yes No Environmental Assessment (OP/BP 4.01) [X] [ ] Natural Habitats (OP/BP 4.04) [ ] [X ] Pest Management (OP 4.09) [ ] [X ] Cultural Property (OPN 11.03, being revised as OP 4.11) [ ] [X ] Involuntary Resettlement (OP/BP 4.12) [ ] [X ] Indigenous Peoples (OP/BP 4.10) [X] [ ] Forests (OP/BP 4.36) [ ] [X ] Safety of Dams (OP/BP 4.37) [ ] [X ] Projects in Disputed Areas (OP/BP 7.60) * [ ] [X ] Projects on International Waterways (OP/BP 7.50) [ ] [X] 10. Contact point Contact: Alan Piazza Title: Senior Economist Tel: (202) 458-4067 Fax: (202) 477-2733 Email: apiazza@worldbank.org 11. For more information contact: The Infoshop The World Bank 1818 H Street, NW Washington, D.C. 20433 Telephone: (202) 458-4500 Fax: (202) 522-1500 Email: pic@worldbank.org Web: http://www.worldbank.org/infoshop * By supporting the proposed project, the Bank does not intend to prejudice the final determination of the parties claims on the disputed areas 11
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