Public Disclosure Authorized Public Disclosure Authorized The World Bank Implementation Status & Results Nepal Avian Influenza Control Project (P100342) Operation Name: Avian Influenza Control Project (P100342) Project Stage: Implementation Seq.: 12 Status: ARCHIVED Last Modified : 17-Feb-2011 Country: Nepal Approval FY: 2007 Product Line: IBRD/IDA Region: SOUTH ASIA Lending Instrument: Emergency Recovery Loan Implementing Agency(ies): Ministry of Health and Population, Ministry of Agriculture and Cooperatives Key s Board Approval 19-Jan-2007 Original Closing Planned Mid Term Review Last Archived ISR 05-Feb-2011 Effectiveness 27-Mar-2007 Revised Closing Actual Mid Term Review 23-Jul-2009 Project Development Objectives Project Development Objective (from Project Appraisal Document) The overall objectives of the Project are to minimize the threat in Nepal posed to humans by HPAI infection and other zoonotic diseases by controlling such infections among domestic poultry and to prepare for, control, and respond to an influenza epidemic and other related infectious disease emergencies in humans. These objectives will be achieved in three ways: (i) prevention; (ii) preparedness and planning; and (iii) response and containment. If these goals are achieved, the proposed Project will reduce the burden of disease, the consequent economic losses, the risk of human infection and the loss of productivity attributable to human infections in Nepal and limit the spread to other countries as well. Has the Project Development Objective been changed since Board Approval of the Project? losure Authorized Public Disclosure Authorized Component(s) Component Name Component Cost Animal Health 5.78 Human Health 5.93 Communications 2.26 Project Management 1.95 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview There have been 10 reported outbreaks in animals in Nepal, including one in Chitwan in October 2010. These outbreaks have been detected and contained through the capacities Page 1 of 8
being enhanced by the project, including surveillance, diagnostics and emergency response mechanisms. UNICEF s monitoring survey indicates high level of general Highly Pathogenic Avian Influenza (HPAI) awareness in symptoms and preventions, i.e., 81.5 percent, compared to the baseline of about 13 percent. Results Project Development Objective Indicators Positive behavioral change related to Avian Influenza among poultry farmers, health workers, and general population in term of key aspects of knowledge, attitudes, and practices 61.10 Poultry Farmer 62.6 percent; Health Workers 64.8 percent; General Population 56.0 percent 81.50 UNCEF monitoring survey in December 2010. 8 The continued absence of HPAI in Poultry and effective containment of HPAI infection in poultry in case of outbreak Custom Indicator / HPAI in Poultry Poultry Farmer 80.0 percent; Health Workers 80.0 percent; General Population 80.0 percent HPAI in poultry. 10 outbreaks, HPAI in Poultry including the one in Chitwan in Oct 2010, have been contained. Intermediate Results Indicators Page 2 of 8
Animal Health: Complete national monitoring of domestic poultry through statistically sound sampling methods - (i) commercial poultry 25.00 25% national monitoring 3 10 Detection of outbreaks has been 100% national monitoring satisfactory since previous mission in July 2009. However, active monitoring (but not yet statistically sound) takes place in only some areas of the 26 HRD and MRD without specific focus on commercial flocks, there being some reliance on reporting of disease by commercial poultry raisers. Animal Health: Complete national monitoring of domestic poultry through statistically sound sampling methods - (ii)backyard farms 3 The monitoring system has enabled identification of outbreaks in backyard poultry. 15.00 Animal Health: Percent of avian influenza outbreaks (if any) are controlled, contained, and stamped out outbreak 10 A total of 10 outbreaks have successfully been contained. 10 Page 3 of 8
Animal Health: Percent of farmers receiving the promised compensation within five days from the culling (for backyard flocks) and within 35 days (for commercial farms) outbreak 10 10 Animal Health: Percent of rapid test results fully consistent with industry standards for HPAI testing using rapid test kits outbreak 9 9 Human Health: Percent of surveillance sites submit reports to EDCD/ DoHS when required (immediate, weekly, or monthly 89.00 8 Human Health: Percent of targeted animal and human health workers in high risk districts having available personal protective equipment, anti-virals, and seasonal vaccines 95.00 10 PPE and Tamiflu are 100% available, while seasonal influenza vaccine is 90% available. Page 4 of 8
Human Health: percent of health care workers in publicly-financed health care facilities in the 13 high-risk districts have adequate knowledge 8 80 percent of staff working in health care facilities in 13 districts passed the test score on HPAI case management. 8 Communication: Comprehensive communication program launched Custom Indicator / Communication: Evidence of high level awareness of program messages among target groups 64.60 Baseline information collected indicates 64.6 percent awareness among respondents from the target groups 81.50 UNICEF monitoring survey in Dec 2010 on the awareness of flu symptom and prevention. 8 Project Coordination: Timely conduct of planned activities (measured by percent activities delayed beyond one month from the planned completion date) N/A 4 20% for DLS and 60% for DHS. 0% delay Page 5 of 8
Project Coordination: Annual financial audit reports, Trimester (IPRs), (financial monitoring, procurement monitoring and physical progress output monitoring) prepared and submitted in a timely mann N/A 3 10 Both DLS and DHS submitted third trimester reports for FY09/10. First trimester reports for FY10/11 and audit reports are overdue for both Depts. Animal health: Percent of active focused surveillance teams effectively operating in 12 HRD 10 Improved surveillance supported by AICP in 8 service centres in 26 high risk districts. Each centre reports weekly to Bird Flu Cell. 10 Human Health: Percent of quality control tests at NPHL that are correct 10 Fully consistent with WHO lab 9 Page 6 of 8
Human Health: Establishment of a national referral hospitals (NRH) Custom Indicator / Data on Financial Performance (as of 21-Oct-2010) The second wards must be established before the project closure. Financial Agreement(s) Key s Project Loan. Status Approval Signing Effectiveness Closing P100342 IDA-H2680 Effective 19-Jan-2007 09-Mar-2007 27-Mar-2007 Disbursements (in Millions) Project Loan. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P100342 IDA-H2680 Effective XDR 12.10 10.64 1.46 8.11 2.53 76.00 Disbursement Graph Page 7 of 8
Key Decisions Regarding Implementation Despite an overall modest progress in implementation, the project is fully meeting its objectives in building the Government of Nepal capacities to prevent and control avian influenza outbreaks. In view of the project closure in the next six months, both the Department of Livestock Services (DLS), and the Department of Health Services (DHS) need to complete the implementation of the planned key activities, in particular the procurement and installation of equipments for isolation wards at Teku Hospital, which is the national reference hospital (NRH), and the Bio-security Laboratory Level 2 (BSL2) at the National Public Health Laboratory (NPHL). Restructuring History Level two Approved on 05-Mar-2010, Level two Approved on 24-Jan-2011 Related Projects There are no related projects. Page 8 of 8