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Document of The World Bank FOR OFFICIAL USE ONLY Report No: 69121-TN PROJECT APPRAISAL DOCUMENT ON A PROPOSED GRANT FROM THE GLOBAL ENVIRONMENT FACILITY IN THE AMOUNT OF US$5.5 MILLION TO THE REPUBLIC OF TUNISIA FOR A DEMONSTRATING AND PROMOTING BEST TECHNIQUES AND PRACTICES FOR MANAGING HEALTHCARE WASTE AND POLYCHLORINATED BIPHENYLS (PCBS) PROJECT July 5, 2012 Sustainable Development Department Middle East and North Africa Region This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization. Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized

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Page 1: Document of The World Bank Report No: 69121-TNdocuments.worldbank.org/curated/en/304361468118491787/... · 2016-07-13 · document of the world bank for official use only report no:

Document of

The World Bank

FOR OFFICIAL USE ONLY

Report No: 69121-TN

PROJECT APPRAISAL DOCUMENT

ON A

PROPOSED GRANT FROM THE

GLOBAL ENVIRONMENT FACILITY

IN THE AMOUNT OF US$5.5 MILLION

TO THE

REPUBLIC OF TUNISIA

FOR A

DEMONSTRATING AND PROMOTING BEST TECHNIQUES AND PRACTICES

FOR MANAGING HEALTHCARE WASTE AND POLYCHLORINATED BIPHENYLS

(PCBS) PROJECT

July 5, 2012

Sustainable Development Department

Middle East and North Africa Region

This document has a restricted distribution and may be used by recipients only in the

performance of their official duties. Its contents may not otherwise be disclosed without World

Bank authorization.

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CURRENCY EQUIVALENTS

(Exchange Rate Effective June, 28, 2012)

Currency Unit = USD

1 USD = 1.5680 TD 1 TD = 0.638 USD

FISCAL YEAR

January 1, 2012 – December 31, 2012

ABBREVIATIONS AND ACRONYMS ANGed National Agency for Waste Management (Agence Nationale de la Gestion des

Déchets) ANPE National Environmental Protection Agency (Agence Nationale de Protection de

l’Environnement) APET

Analysis of Environmental Performance in Tunisia (Analyse de la Performance

Environnementale en Tunisie)

BAT Best available technology CAS Country Assistance Strategy CITET Tunis International Center for Environmental Technology (Centre International

des Technologies de l’Environnement de Tunis) CPG Gafsa Phosphate Company (Compagnie de Phosphate de Gafsa) CPS DAF

Country Partnership Strategy Administrative and Finance Department (Département Administratif et

Financier) DAS DASD DASRI DHMPE

Healthcare Waste (Déchets d'activités sanitaires) Hazardous Healthcare Waste (Déchets d'activités sanitaires dangereux) Infectious Healthcare Waste (Déchets d'activités sanitaires à risque infectieux) Department of Environmental Health and Environmental Protection (Direction

de l’hygiène du Milieu et de la Protection de l’Environnement) DT Tunisian Dinar EIB European Investment Bank EIE Environmental Impact Assessment (Etudes d’Impact sur l’Environnement) ESIAF Environmental and social impact assessment framework ESMF Environment and social management framework GCT Tunisia Chemical Group (Groupe Chimique Tunisien) GEF Global Environment Facility GoT Government of Tunisia HCW ISN

Healthcare waste Interim Strategy Note

KfW German Development Bank (Kreditanstalt fur Weideraufbau) MH Ministry of Health NIP National Implementation Plan NDP National Development Plan ODS Ozone depleting substances ONAS National Sanitation Utility (Office National d’Assainissement) PAGDS Support to the Solid Waste Management Program (Programme d’Appui à la

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Gestion des Déchets Solides) PCBs PolyChloroBiphényls (PolyChloroBiphényles) PCDD/PCDF Polychlorinated dibenzodioxins/polychlorinated dibenzofurans PCU Project Coordination Unit PGE Environmental Management Plans (Plans de Gestion Environnementale) PGDDM Municipal Solid Waste Management Project (Projet de Gestion Durable des

Déchets Municipaux) POPs Persistent Organic Pollutants (Polluants Organiques Persistants) PRONAGDES National Solid Waste Management Program (Programme National pour la

Gestion des Déchets Solides) PRONGIDD National Program for Integrated and Sustainable Management of Waste

(Programme National de Gestion Intégrée et Durable des Déchets) SC Steering Commitee STEG Tunisian Society of Electricity and Gas (Société Tunisienne de l’Electricité et du

Gaz) STIR SPCM

Tunisian Society of Refiney Industries (Société Tunisienne des Industries de

Raffinage) Permanent Secretariat for Tender Commission (Secrétariat Permanent de la

Commission des Marchés) SNCPA National Company of Cellulose and Esparto Paper (Société Nationale de

Cellulose et de Papier Alfa) TD Tunisian Dinars TEQ Toxic Equivalent (of dioxins)

Regional Vice President: Inger Andersen Country Director: Simon Gray Sector Director: Junaid Kamal Ahmad Sector Manager Hoonae Kim Task Team Leader: Taoufiq Bennouna

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REPUBLIC OF TUNISIA

DEMONSTRATING AND PROMOTING BEST TECHNIQUES AND PRACTICES FOR

MANAGING HEALTHCARE WASTE AND POLYCHLORINATED BIPHENYLS (PCBS)

PROJECT

TABLE OF CONTENTS

PAD DATA SHEET ...................................................................................................................... vi

I. STRATEGIC CONTEXT ....................................................................................................... 1

A. Country Context .................................................................................................................. 1

B. Sectoral and Institutional Context ....................................................................................... 2

C. Higher Level Objectives to which the Project Contributes ................................................ 4

II. PROJECT DEVELOPMENT OBJECTIVES......................................................................... 5

A. PDO..................................................................................................................................... 5

Project Beneficiaries ............................................................................................................... 5

PDO Level Results Indicators ................................................................................................. 5

III. PROJECT DESCRIPTION ................................................................................................. 6

A. Project components ............................................................................................................. 6

B. Project Financing ................................................................................................................ 7

1. Financing Instrument ...................................................................................................... 7

2. Project Cost and Financing ............................................................................................. 7

3. Project parallel financing and co-financing .................................................................... 9

C. Lessons Learned and Reflected in the Project Design ........................................................ 9

IV. IMPLEMENTATION ....................................................................................................... 11

A. Institutional and Implementation Arrangements .............................................................. 11

B. Results Monitoring and Evaluation .................................................................................. 12

C. Sustainability..................................................................................................................... 13

V. KEY RISKS AND MITIGATION MEASURES ................................................................. 14

A. Risk Ratings Summary Table ........................................................................................... 14

B. Overall Risk Rating Explanation ...................................................................................... 15

VI. APPRAISAL SUMMARY ............................................................................................... 15

A. Economic and Financial Analysis ..................................................................................... 15

B. Technical ........................................................................................................................... 16

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C. Financial Management ...................................................................................................... 18

D. Procurement ...................................................................................................................... 19

E. Social (including Safeguards) ........................................................................................... 20

F. Environment (including Safeguards) ................................................................................ 20

Annex 1: Results Framework and Monitoring.............................................................................. 24

Annex 2: Detailed Project Description ........................................................................................ 27

Annex 3: Implementation Arrangements ...................................................................................... 39

Annex 4 Operational Risk Assessment Framework (ORAF) ....................................................... 58

Annex 5: Implementation Support Plan ........................................................................................ 61

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PAD DATA SHEET Republic of Tunisia

PROJECT APPRAISAL DOCUMENT

DEMONSTRATING AND PROMOTING BEST TECHNIQUES AND PRACTICES

FOR MANAGING HEALTHCARE WASTE AND POLYCHLORINATED BIPHENYLS (PCBS)

PROJECT

Middle East and North Africa Region

MNSSD .

Basic Information

Date: July, 05, 2012 Sectors: Solid waste management (80%); Central government

administration (20%)

Country Director: Simon Gray Themes: Pollution management and environmental health (P);

Environmental policies and institutions (S) Sector Manager/Director: Junaid Kamal Ahmad

Project ID: P100478 EA Category: A

Lending Instrument: Global Environment

Facility Grant

Focal Area: LD & LD

Team Leader(s): Taoufiq Bennouna

Does the project include any CDD component? No

Joint IFC: No

.

Borrower: Republic of Tunisia

Responsible Agency: National Agency for Waste Management (Agence Nationale de la Gestion des Déchets, ANGed)

Contact: Taïeb ROMDHANE Title: General Manager of the ANGed

Telephone No.: (216-71) 847-493 Email: [email protected]

.

Project Implementation

Period:

Start Date: September 10,

2012

End Date: May 31, 2017

Expected Effectiveness

Date:

September 10, 2012

Expected Closing Date: May 31, 2017

.

Project Financing Data(US$M)

[ ] Loan [ X ] Grant [ ] Other

[ ] Credit [ ] Guarantee

For Loans/Credits/Others

Total Project Cost (US$M): 16.70

Total Bank Financing (US$M):

.

Financing Source Amount(US$M)

BORROWER/RECIPIENT 11.20

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Global Environment Facility 5.50

Total 16.70

.

Expected Disbursements (in US$ Million)

Fiscal Year 2013 2014 2015 2016 2017

Annual 1.25 1.42 1.3 1.05 0.48

Cumulative 1.25 2.67 3.97 5.02 5.5

.

Project Development Objective(s)

The Project Development Objective (PDO) is to reduce releases of dioxins, furans and Polychlorinated Biphenyls (PCBs) in

Tunisia by strengthening the Recipient’s legal and institutional framework and establishing sound and sustainable management

programs for improving management and final disposal of healthcare waste (HCW) and PCBs.

.

Components

Component Name Cost (USD Millions)

Component 1: Strengthening the Institutional Framework and Capacity for

HCW and PCB Management at the national, regional and local levels

2.190

Component 2: Improvement of HCW and PCBs’ Management and Disposal 12.837

Component 3: Project Management 0.378

.

Compliance

Policy

Does the project depart from the CAS in content or in other significant respects? Yes [ ] No [X]

.

Does the project require any exceptions from Bank policies? Yes [ ] No [X]

Have these been approved by Bank management? Yes [ ] No [ ]

Is approval for any policy exception sought from the Board? Yes [ ] No [X]

Does the project meet the Regional criteria for readiness for implementation? Yes [X] No [ ]

.

Safeguard Policies Triggered by the Project Yes No

Environmental Assessment OP/BP 4.01 X

Natural Habitats OP/BP 4.04 X

Forests OP/BP 4.36 X

Pest Management OP 4.09 X

Physical Cultural Resources OP/BP 4.11 X

Indigenous Peoples OP/BP 4.10 X

Involuntary Resettlement OP/BP 4.12 X

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Safety of Dams OP/BP 4.37 X

Projects on International Waters OP/BP 7.50 X

Projects in Disputed Areas OP/BP 7.60 X

.

Legal Covenants

Name Recurrent Due Date Frequency

Section 5.01 of the Grant Agreement Effectiveness

Description of Covenant

(A) The Recipient and the Project Implementing Entity have adopted the Operations Manual, satisfactory to the World Bank.

Section I.A of Schedule 2 to the Grant

Agreement Throughout the project

(B) Institutional Arrangements:

(1) The Recipient shall cause the Project Implementing Entity to carry out the Project in accordance with the Operations

Manual and, except as the World Bank shall otherwise agree, the Recipient and/or the Project Implementing Entity shall not

amend or waive any provision of the Operations Manual if, in the opinion of the World Bank, such amendment or waiver may

materially and adversely affect the carrying out of the Project or the achievement of the objectives thereof.

(2) The Recipient shall cause the Project Implementing Entity to maintain throughout Project implementation the Project

Coordination Unit (PCU) under terms of reference and with resources and a staff composition acceptable to the World Bank for

purposes of the day to day management of the Project including financial management, monitoring and evaluation, preparation

of progress reports and procurement.

(3) The Recipient shall maintain, throughout Project implementation, a Steering Committee to oversee Project implementation,

under terms of references and with a membership composition acceptable to the World Bank. The Steering Committee shall be

chaired by the Minister of Environment. The purpose of this Committee is to provide strategic guidance to, and overall

monitoring of the Project, and facilitate the coordination and collaboration between the different ministries and agencies

concerned by the Project.

(4) The Recipient shall cause the Project Implementing Entity to: (i) not later than six months after the Effective Date, enter

into conventions with the Ministries and other entities involved in the implementation of the Project, which shall specify

partnership and operational responsibilities of the respective Ministries and entities; and (ii) maintain such conventions

throughout Project implementation.

Section I.C of Schedule 2 to the Grant

Agreement Throughout the project

(C) Safeguards:

(1) The Recipient shall cause the Project to be carried out by the Project Implementing Entity in accordance with the provisions

of the ESIAF, ESMF, and ESMP in a manner satisfactory to the World Bank. The Recipient and/or the Project Implementing

Entity shall not assign, amend, abrogate or waive the Environmental and social impact assessment framework (ESIAF),

Environment and social management framework (ESMF), and/or ESMP(s) or any provision thereof, without the written prior

approval of the World Bank.

(2) For purposes of Part B of the Project, the Recipient shall cause the Project Implementing Entity to: (a) develop site-specific

ESMPs in accordance with the ESMF prior to starting any activity requiring an ESMP pursuant to the ESMF; (b) (i) subject to

(b) (ii) below, submit such ESMPs to the World Bank for its review and approval, or (ii) after receipt of written confirmation by

the World Bank based on an assessment of Agence National pour l’Environnement (ANPE) environmental and social capacity

no earlier than one year after the Effective Date, submit such ESMPs to ANPE for its review and approval, (c) make

arrangements for public review and comment of the site-specific ESMPs, ensure that any comments received during such

public review shall be addressed in a manner satisfactory to the World Bank , and ensure that the final version of the site-

specific ESMPs, as approved by the World Bank or ANPE, as applicable, shall be disclosed locally ; and (d) prior to the

issuance of the bidding documents for each contract regarding the implementation of Part B of the Project, prepare and submit

for approval to either the World Bank or after receipt of written confirmation by the World Bank no earlier than one year after

the Effective Date, to ANPE: (i) the proposed activity and site covered by such contract and the related ESMP in form and

substance satisfactory to the World Bank; and (ii) the draft contract for said activity to ensure that the provisions of said ESMP

are adequately included in said contract.

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(3) The Recipient shall, and shall cause the Project Implementing Entity to: (a) ensure that all activities undertaken for the

purpose of carrying out of the Project comply with environmental standards and guidelines satisfactory to the World Bank; (b)

ensure that the selection of any activity under Part B of the Project is done in accordance with the provisions of the ESMF; (c)

ensure the complete implementation of the ESIAF, ESMF, and ESMPs in a manner acceptable to the World Bank, including all

necessary measures to minimize and to mitigate any adverse environmental impacts caused by the implementation of the

Project; and (d) ensure that adequate information on the implementation of the ESIAF, ESMF, and ESMPs is suitably included

in the Project Reports.

.

Team Composition

Bank Staff

Name Title Specialization Unit

Taoufiq Bennouna Senior NRM Specialist, TTL NRM MNSSD

Maged Mahmoud Hamed Regional Safeguards specialist,

former TTL

Safeguards MENA

Dahlia Lotayef Program coordinator, former

TTL

Safeguards AFTEN

Song Li Environmental Specialist, and

GEF Coordinator

Environment and GEF

policies

MNSSD

Hassine Hedda Finance Officer Controller CRTLA

Aissatou Diallo Senior Finance Officer Finance CTRLA

Jean-Charles de Daruvar Senior Counsel Lawyer LEGEM

Walid Dhouibi Procurement Specialist Procurement MNAPR

Marie A. F. How Yew Kin Language Program Assistant Assistant MNSRE

Catalina Marulanda

Suiok Yoshijima Environmental Specialist Environment and GEF

policies

MNSSD

Catalina Marulanda Senior Environmental

Specialist

Environment LCSEN

Name Title Office Phone City

Sherif Arif Environmental and Social

Safeguards specialist

Lelia Croitoru Environmental Economist

Bekir Onursal Sr. Environmental Specialist

Locations

Country First Administrative

Division

Location Planned Actual Comments

Tunisia Gouvernorat of Greater

Tunis

Gouvernorat of Greater

Tunis X X

Tunisia Sousse Sousse X X

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Tunisia Monastir Monastir X X

Tunisia Mahdia Mahdia X X

Tunisia Sfax Sfax X X

Tunisia Gabes Gabes X X

Tunisia Tataouine Tataouine X X

Tunisia Medenine Medenine X X .

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I. STRATEGIC CONTEXT

A. Country Context

1. Tunisia’s economic performance deteriorated sharply in 2011, after having recovered

in late 2010 from the global financial, fuel and food price crisis. With growth stable at 3

percent, the fiscal deficit down to 1.3 percent and official reserves equivalent to 5 months of

imports at end 2010, the Government began 2011 with the fiscal space to absorb some of the

economic shock caused by the January revolution, the spillover from Libya conflict and the

sharp downturn in tourism and Foreign Direct Investments (FDI). The economic situation in

2012 is likely to remain difficult, with GDP growth only moderately positive.

2. Tunisia integrated environment into main sectoral strategies. Since the 1980s, Tunisia

has been a pioneer among developing countries in emphasizing environmental conservation,

rationalizing energy use and managing its water resources prudently as a key component in the

country’s economic and social policies. The cost of environmental degradation has been

estimated at 2.1 percent of GDP (TD 522 million), the lowest among the Maghreb countries. The

global indicator on Adjusted Net Savings (ANS) increased from 2.6 percent of GDP in 1980 to

19 percent of GDP in 1999, with about a 15 percent prevalence and regular growth from 1993 to

1999. Over the decade, Tunisia thus allocated TD 2.1 billion, or 1.03 percent of its GDP, to

public expenditure on environmental and natural resource management, placing it at a level

comparable to that of some European countries. Under the leadership of the Ministry of

Environment, the implementation of the seventh Millennium Development Goal (MDG) on

environmental sustainability from the Johannesburg Summit relies on a participatory approach in

order to guarantee beneficial impacts on the quality of life of its citizens.

3. Improved waste management is among the Government’s 11th

National Development

Plan. In 2007, the Government launched its 11th National Development Plan (NDP) which

covers 2007-2011. The Government is currently updating the NDP to adapt it to a rolling

development plan to respond to new challenges and demands as they present themselves and

assess risks and constraints regularly. One of the five axes of the NDP is a comprehensive

development approach that guarantees sustainable growth and a harmonious balance among

economic, social and environmental priorities. This axis focuses on integrating the environment

dimension into programs, generalization of environment upgrading, increased energy efficiency,

improved waste management and rationalization of natural resources exploitation. This is also

supported by the second area and the Objective 5 “Improving access to basic services for

underserved communities” of the new Bank Group Interim Strategy Note (ISN) for fiscal year 13

and 14.

4. Tunisia is committed to the Stockholm Convention. Tunisia became a Party to the

Stockholm Convention on Persistent Organic Pollutants (POPs) in June 2004, which requires the

elimination or the restriction of production and use of all POPs, with particular attention to

reducing emissions of dioxins and furans, and removing Polychlorinated Biphenyls (PCBs)

containing equipment from use by 2025. Tunisia developed its National Implementation Plan

(NIP) to ensure the ecologically sound management of POPs. The proposed project will support

the Government of Tunisia (GoT) in implementing its NIP by strengthening the country’s

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regulatory and institutional frameworks to handle POPs, improving the healthcare waste (HCW)

management system, and phasing out the existing PCB equipment.

B. Sectoral and Institutional Context

5. Several important reforms are being undertaken by the Tunisian authorities in waste

management. Cognizant of the high cost of inaction and of the harm associated with the

uncontrolled and inefficient waste management, including HCW and PCBs, the Tunisian

authorities have initiated a number of reforms aimed at establishing an environment conducive to

the sound management of waste in Tunisia. These reforms include: (a) development and

initiation in 1993 of a national program for the management of solid waste, known as

PRONAGDES (National Waste Management Program), which subsequently evolved into

PRONGIDD (National Integrated and Sustainable Waste Management Program); (b)

development of the legal framework, including promulgation of a framework law on waste

management (Law No. 96-41); (c) development of the management of subsectors devoted to

managing packaging waste, used oil, batteries; (d) promotion of private sector participation in

the waste management, including waste collection, transfer, and placement in landfills; (e)

enhancing public awareness of the impacts of poor waste management; and (f) creation, in

August 2005, of the National Waste Management Agency (ANGed), as a public establishment

with a financial autonomy, and placed under the auspices of the Ministry of Environment with a

mandate to manage and coordinate with other entities the management of all types of waste,

including HCW and PCBs. In spite of all the efforts which have been made to regulate waste

management, from generation to final disposal in Tunisia, the Government of Tunisia (GoT) still

faces challenges particularly in the areas of HCW and PCBs. Some critical deficiencies of the

current system of Healthcare Waste and PCB management have been identified, at the policy and

at the technical level, which the government has chosen to address as a matter of priority.

6. Challenges persist in the management of HCW. Major deficiencies in HCW

management exist at both institutional and operational levels. In the current structure the roles

and responsibilities of different agencies are unclear, and no agency has overall control of HCW

management in Tunisia. The responsibilities for the management of HCW are shared between: a)

the Ministry of Health (MH); b) the Ministry of Environment; and c) the Ministry of Interior

(MI) through municipal governments. The Ministry of Environment is responsible for the

elaboration of the regulatory and administrative texts relating waste management including

HCW in consultation with Ministry of Health. The ME is also responsible for the elaboration of

national programs and the implementation of the projects related to waste management.

However, the agency responsible for overseeing operations and ensuring compliance with HCW

management guidelines is the MH. The applicable MH guidelines for handling of HCW are not

legally binding, and no specific regulation addresses technological alternatives for HCW

disposal. Therefore, the existing legal framework does not provide the means to prosecute

healthcare facilities for waste-related pollution issues although the Waste Law1 dictates that

polluters are financially responsible for handling and disposal of their waste. On the operational

side, healthcare facilities in Tunisia produce 16,000 tons of waste per year, of which

approximately 40 percent are produced in the area of Greater Tunis. Surveys conducted around

the country by the Ministry of Environment indicate that, on average, 40 percent of the total

1 Law 96-41 of June 10, 1996

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national volume, namely 7,000 tons, is risky waste (i.e. infectious, anatomical, radiological,

chemical and others). Guidelines for waste separation were developed and disseminated by the

MH as early as 1992, and despite considerable efforts to improve HCW management,

performance remains low: separation of waste tends not to be practiced in smaller facilities;

collection and transport of HCW from healthcare facilities to final disposal sites has greatly

deteriorated; and use of incineration for HCW destruction led to high levels of dioxins and furan

emissions.

7. The country has a large stock of PCBs-contaminated materials. The presence of PCBs

containing oils and contaminated equipment constitutes a significant threat to human health and

to the environment, aggravated by the current storage conditions. The country still possesses a

considerable number of PCB-contaminated equipment, particularly transformers. A recent

inventory shows that public entities possess about 1,200 PCB equipments, of which 900 are off-

line and the rest are on line in good or bad state. The private sector also has transformers and

capacitors containing PCBs. In 1986 the import of PCB-containing equipment was banned in the

country and maintenance and repair of any PCBs contaminated equipment was prohibited. Since

then, all PCB-contaminated transformers and capacitors should have been decommissioned. It is

known that the total number of PCB-containing transformers currently owned by the Société

Tunisienne de l’Electricité et du Gaz (STEG) is 734, of which 55 remain in service. In-service

transformers contain roughly 43 tons of PCB contaminated oils, 60 tons of liquid PCB oils and

238 tons of contaminated equipment are stored in a storage facility in Naassen, owned and

operated by STEG. It is estimated that as many as 1,203 PCB-contaminated transformers and up

to 400 tons of PCB containing oils are scattered everywhere throughout the country and

concentrated in the Governorates of Grand Tunis, of Gafsa and of Bizerte.

8. Programs and project to improve waste management under the NDP. Numerous

projects and programs have been developed in recent years with a view to modernizing the

management of the sector and providing the country with the installations necessary for the

proper treatment and disposal of the various categories of waste. The investments made to date in

disposal and related infrastructures for the management of municipal and comparable waste have

totaled TD54 million (US$36 million equivalent). A central chemical and physical treatment of

industrial waste including a hazardous landfill became operational in November 2009 in Jradou

at an investment cost of TD33 million (US$22 million). The projects under way, with a total

investment of TD62 million (US$47 million), concern nine (9) landfills and the corresponding

transfer centers, making it possible to increase the proportion of waste collected and deposited in

landfills to 85 percent from the current level of 40 percent. Tunisia is also implementing a

project which aims at phasing out the ozone depleting substances (ODS). Major co-financing has

been provided by the World Bank, Global Environment Facility (GEF), Kreditanstalt fur

Weideraufbau (KfW), the European Investment Bank (EIB) and the Government of Italy for

these efforts.

9. Rationale for the World Bank involvement. Both the World Bank and the Government

of Tunisia stressed that they were able to establish good relations, and also recall the importance

of flexibility to evolving needs. The Constituent Assembly Government has often expressed its

appreciation for the knowledge services of the World Bank and it considers the Bank's dialogue

and analysis as useful inputs to their sectoral strategies. The knowledge role of the Bank is

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especially valued because the Bank has undertaken economic and sector reports in a fully

collaborative way, with strong ownership from government. Equally important, the Bank has

been able to mobilize rapidly its team and resources to respond flexibly when requested and to

focus on providing just-in-time policy advice. The financing role of the Bank has also remained

flexible and has adapted rapidly to the needs of post-revolution Tunisia.

10. The Bank's support to Tunisia is outlined in the Interim Strategy Note (ISN, FY13-14)

aimed at reinforcing governance and inclusion and fostering economic growth based on the

creation of sustainable jobs in the medium-term. The three priority areas for the ISN are: (i)

Laying the foundations for renewed sustainable growth and job creation, (ii) Promoting social

and economic inclusion, and (iii) strengthening governance: Voice, Transparency and

Accountability. In addition, the Bank already has an ongoing portfolio in Tunisia in the water

and sanitation sector, in which it has helped the government to strengthen institutions and

establish a cost recovery system, and financed operations with significant quality-of-life

implications for all Tunisians, and the current projects complement existing efforts in the

municipal and hazardous waste management sectors, namely the Municipal Solid Waste

Management Project. In particular, the Bank's engagement in Tunisia has focused on quality

analysis and global knowledge which has underpinned all lending operations.

C. Higher Level Objectives to which the Project Contributes

11. From the global environment perspective, the Project would contribute to the

implementation of the Tunisian National Implementation Plan (NIP), being part of the

government’s commitment to the Stockholm Convention on Persistent Organic Pollutants

(POPs), which requires the elimination or the restriction of production and use of all POPs, with

particular attention to reducing emissions of dioxins and furans, and removing Polychlorinated

Biphenyls (PCBs) containing equipment from use by 2025. This will further protect human

health and the environment, which is also the main goal of the GEF operational program goal of

POPs focal area.

12. The total amount of dioxin and furan emissions in Tunisia is estimated at 209 g

TEQ/year. Roughly 77 percent of this amount is emitted through uncontrolled combustion

processes, including combustion of poorly managed HCW at open dumps. An additional 15

percent of the emissions are released during incineration of healthcare wastes. The Project aims

at eliminating 3200 t of dangerous HCW resulting from the 85 public bodies linked to the

project. The adoption of sound and sustainable management practices will allow the reduction of

8 percent emissions from the 15 percent which are generated from unsustainable and awful

practices.

13. The PCB contaminated equipment contains 1,700 tons of PCBs in accordance with the

inventory of the NIP. The Project aims at eliminating around 1,100 tons of PCBs through

elimination of high risk PCB-contaminated equipment and wastes. This represents 65 percent of

the total inventoried PCBs in Tunisia.

14. The Project will specifically contribute to the three GEF-4 Strategic Priorities (SP) of the

POPs focal area:

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Strengthening Capacities for NIP Implementation,

Partnering in Investments for NIP Implementation, and;

Partnering in the Demonstration of Feasible Innovative Technologies and Best Practices

for POPs Reduction and Substitution.

II. PROJECT DEVELOPMENT OBJECTIVES

A. PDO

15. The Project Development Objective (PDO) is to reduce releases of dioxins, furans and

Polychlorinated Biphenyls (PCBs) in Tunisia by strengthening the Recipient’s legal and

institutional framework and establishing sound and sustainable management programs for

improving management and final disposal of healthcare waste (HCW) and PCBs.

Project Beneficiaries

16. The project will contribute to the overall improvement of public health in the country by

minimizing the risks of contamination and of illnesses closely related to HCW and PCBs. The

project will also help strengthen institutional and management capacity of related agencies in the

area of HCW and PCBs. Two million people are estimated to benefit from POPs reductions

through sound management of HCW and PCBs at the project sites - 85 hospitals and 55 PCBs

sites covering 22 out of 24 governorates in Tunisia. Direct beneficiaries namely include: i)

healthcare facility staff (doctors, nurses and other medical workers, as well as service providers),

patients, and waste management personnel because of better HCW management; ii) people

working close to PCB-containing equipment at project sites since removing PCBs will make

their working conditions safer; iii) municipal landfill operators and scavengers exposed to

hazardous waste and healthcare waste disposed off without any treatment and mixed with

municipal waste; iv) staff from the ANGed, other national and local agencies, as well as related

people from project selected hospitals, and public enterprises in terms of capacity building; and

v) local people who would benefit from job opportunities created for HCW and PCBs

management at project sites.

PDO Level Results Indicators

17. The proposed key indicators of project success include:

Tons of HCW processed under the project;

Tons of PCBs removed under the project.

18. The Project’s Results Framework is provided in Annex 1.

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III. PROJECT DESCRIPTION

A. Project components

19. The project consists of the following three components and Annex 2 provides a detailed

description of these components.

Component 1: Strengthening the Institutional Framework and Capacity for HCW and PCBs’

Management at the national, regional and local levels (US$2.190 million: GEF US$1.095

million and co-financing US$1.095 million).

1.1 Institutional support and adoption of best practices for HCW management by: (a)

strengthening the institutional and regulatory framework and for HCW management at the

national, regional and local levels; (b) conducting awareness and outreach campaigns, workshops

and information and monitoring seminars for HCW management; and (c) providing training in

HCW management, environmental assessment, collection and disposal of HCW, monitoring and

evaluation, through the provision of consultants’ services and training.

1.2 Capacity and awareness enhancement for management and final disposal of PCBs by:

(a) strengthening the regulatory framework for PCBs’ management; (b) conducting awareness

and outreach campaigns for PCBs’ management; and (c) providing training in PCBs’

management, through the provision of consultants’ services and Training.

Component 2: Improvement of HCW and PCBs’ Management and Disposal (US$12.837

million: GEF US$3.872 million and co-financing US$8.965 million).

2.1 Improvement of HCW management and disposal (US$8.240 million – GEF US$1.548

million and co-financing US$6.692 million) through: (a) the acquisition of equipment for

internal collection, and in situ storage of HCW in public healthcare facilities; (b) the supply of

equipment to the intermediate and central storage units in public healthcare facilities in Grand

Tunis, Sousse-Kairouan, Monastir-Mahdia, Sfax, Gabes, Medenine and Tataouine; and the

preparation of ESMPs for such storage units; and (c) the transportation, and treatment of HCW in

privately owned treatment facilities and final disposal in controlled landfills, through the

provision of goods and consultants’ services.

Through the sub-component (a), the GEF will finance the following three lots (i) the acquisition

of local and centralized interim storage (lot 1); (ii) the acquisition of equipment for collection

and in-situ transportation of HCW (lot 2); and (iii) the acquisition of freezers for storage of

placentas in the maternity services covered by the project (lot 3). Sub Component b (the supply

of equipment to the intermediate and central storage units) and sub component c (the

transportation, and treatment of HCW) will be financed by the recipient through its co financing

to the project, no GEF resources will be allocated to these 2 sub components.

2.2 Improvement of PCBs management and disposal (US$4.597 million-GEF US$2.324

million and co-financing US$2.273 million) through: (a) the transportation and elimination of

in-stock PCBs-equipment, wastes and in-service PCBs-equipment in bad condition belonging to

sector ministries; (b) the transportation and elimination of in-stock PCBs-equipment, wastes and

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in-service PCBs-equipment in bad condition belonging to public entities (of which GEF will co-

finance with these entities 40 percent of the cost); (c) the preparation of ESMPs for PCBs

contaminated sites, and a study on the rehabilitation of contaminated sites; and (d) the

decontamination of sites, through the provision of goods and carrying out of consultants’ and

non-consultants’ services. This sub Component (d) will be financed by the recipient through its

co financing to the project, no GEF resources will be allocated to this sub-component.

Component 3: Project Management (US$0.378 million: GEF US$0.140 million and co-

financing US$0.238 million). Supporting the Project Coordination Unit (PCU) in carrying out

the Project management, coordination, implementation, monitoring and evaluation through the

provision of goods, non-consulting services and consultants' services.

20. This component will include (a) operational costs for the Project Coordination Unit

(PCU). The PCU within ANGed is in charge of implementation, coordination and technical and

financial management of the Project. The unit will participate in policy coordination, assist in the

preparation of the national program and planning review, coordinate training, oversee

operational research and studies, monitor and evaluate the program, convene meetings with the

Steering Committee and will provide it with necessary information; (b) establishment and

maintenance of a monitoring and evaluation system. This will include elaborating and

implementing the overall results framework, data collection and monitoring of POP emissions

from project sites, as well as financial reporting; and (c) purchase of office equipment and

materials.

B. Project Financing

1. Financing Instrument

21. The total cost of the project is estimated at US$16.7 million, the Government of Tunisia

and the state companies and public entities financing US$11.2 million and GEF providing a

parallel co-financing of US$5.5 million (GEF funding will be used only to fund separate

contracts, except for sub component 2.2.2 “the elimination of in-stock PCBs-equipment, wastes

and in-service PCBs-equipment in bad condition belonging to public entities” of which the GEF

will co- finance with these entities 40 percent of the cost”). The project cost and financing, as

well as the co-financing have been confirmed by all participating ministries and institutions,

through exchange of official correspondences initiated at the level of the Inter-ministerial

Committee, presided by the former Prime Minister.

2. Project Cost and Financing

22. The project cost and financing is presented in table 1 below:

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Table 1: Allocation of the project funds by category

GEF

(000 US$)

Parallel and

Co-

Financing

(000 US$)

Total cost

(000 US$)

1. Strengthening the Institutional Framework and

Capacity for HCW and PCBs’ Management at the

national, regional and local levels

1,095 1,095 2,190

1.1. Institutional support and adoption of best practices

for HCW management

507 507 1,014

1.1.1. Strengthening the institutional and regulatory

framework

120 120 240

1.1.2. Conducting awareness and outreach campaigns,

workshops and information and monitoring

seminars for HCW management

126 126 252

1.1.3. Providing training in HCW management,

environmental assessment, collection and

disposal of HCW, monitoring and evaluation,

through the provision of consultants’ services and

Training

261 261 522

1.2. Capacity and awareness enhancement for

management and final disposal of PCBs

588 588 1,176

1.2.1. Strengthening the regulatory framework for

PCBs management

149 149 298

1.2.2. Conducting awareness and outreach campaigns

for PCBs’ management

135 135 270

1.2.3. Providing training in PCBs’ management,

through the provision of consultants’ services and

Training

304 304 608

2. Improvement of HCW and PCBs’ Management and

Disposal

3,872 8,965 12,837

2.1. Improvement of HCW management and disposal 1,548 6,692 8,240

2.1.1. The acquisition of equipment for internal

collection, and in situ storage of HCW in public

healthcare facilities

1,548 - 1,548

2.1.2. The supply of equipment to the intermediate and

central storage units in public healthcare

facilities in Grand Tunis, Sousse-Kairouan,

Monastir-Mahdia, Sfax, Gabes, Medenine and

Tataouine, and the preparation of ESMPs for

such storage units.

- 1,692 1,692

2.1.3 The transportation, and treatment of HCW in

privately owned treatment facilities and final

disposal in controlled landfills, through the

provision of goods and consultants’ services

- 5,000 5,000

2.2. Improvement of PCBs Management and disposal 2,324 2,273 4,597

2.2.1. The transportation of in-stock PCBs-equipment,

wastes and in-service PCBs-equipment in bad

condition belonging to sector ministries

1,116 - 1,116

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2.2.2. The elimination of in-stock PCBs-equipment,

wastes and in-service PCBs-equipment in bad

condition belonging to public entities (of which

GEF will co- finance with these entities 40% of

the cost)

1,100 1,650 2,750

2.2.3. The preparation of ESMPs for PCBs

contaminated sites, and a study on the

rehabilitation of contaminated sites

108 108 216

2.2.4. Decontamination of sites - 515 515

3. Project Management 140 238 378

3.1. Operational Costs 0 84 84

3.2. Establishment and Maintenance of Monitoring and

Evaluation System

47 21 68

3.3. Equipment 93 133 226

4. Project physical contingency 393 902 1,295

Total cost of project + physical contingency 5,500 11,200 16,700

3. Project parallel financing and co-financing

23. The project parallel co-financing amount is US$11.2 millions. It will be provided by

several national entities, in particular, the Health Ministry (US$6.7 million), ANGed (US$1365

million), Société tunisienne d'électricité et du gaz (US$743000), Compagnie de phosphate de

Gafsa (US$480,000), the El Fouledh (US$411,000), Groupe chimique tunisien (US$300,000),

the MoA (US$90,000), Société tunisienne des industries de raffinage (US$90,000), and several

other public entities.

C. Lessons Learned and Reflected in the Project Design

24. Key lessons were derived from a number of relevant projects in the area of municipal and

hazardous waste management, including the Africa Stockpile Program – Tunisia Project

(P075776), Sustainable Municipal Solid Waste Management project (P095012), as well as

persistent organic pollutant, and PCB projects from other countries, such as China -

Demonstration of PCB Management and Disposal Project (2006-2010), and China -

Demonstration of Alternatives to Chlordane and Mirex in Termite Control Project (2006-2010),

Moldova - Persistent organic pollutants (POPS) Stockpile Management and Destruction Project

(2006-2010), Philippines - Integrated Persistent organic pollutants Management Project (2010-

2016) and Vietnam- PCB Management Project (2009-2014). The main lessons learned and

conclusions derived from activities under these projects were incorporated into the design of this

Project and may be summarized as follows:

Local capacity building and cooperation must be strengthened: The institutional

structuring exercise based on the creation of the national waste management agency

(ANGed) would be incomplete if it were not accompanied by greater local cooperation

–a prerequisite for integrated and sustainable management of HCW and PCBs– and by

full empowerment of local stakeholders. Support to ANGed included under this Project,

to initiate the development of local emergency plans to prevent and handle with

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accidental leakages from PCBs and HCW during handling and transport, is designed to

meet this need.

Private sector participation: The healthcare waste sector has substantial scope and

potential for private sector participation. However, the national and local capacity to

steer and manage the delegation process is still fairly weak. There is little familiarity

with the delegation of public services, weak oversight capacity, lack of personnel

trained in delegation processes, etc. In addition, the type of contract used has led to a

dispersal of responsibilities among the designer, the entrepreneur, the supplier of

materials, and the operator. In the end, ANGed is the entity that ultimately bears

responsibility and the costs. Having learned from this previous experience, this Project

will better help ANGed create a climate conducive to private participation and

demonstrate the viability of private sector involvement.

Country ownership and capability: projects to implement the Montreal Protocol from

other countries showed the importance of establishing a capable Project coordination

unit (PCU) for the successful project implementation. Consequently, the Bank will

continue to emphasize helping further strengthen the capacity of the ANGed and the

PCU which will be created under ANGed. This will include providing extensive and

continuing training to relevant staff on project management, procurement and

disbursement procedures, monitoring and evaluation, and the Bank’s safeguard policies.

Comprehensiveness. Like many Bank-implemented HCW and PCB management

projects, this project also includes components and subcomponents that: (i) strengthen

the legal and institutional framework; (ii) invest in the elimination of PCBs, and in-

service PCB-containing equipment, as well as sound management of HCWs; and

(iii) establish a capable Project Coordination Unit (PCU). These components are inter-

linked with carefully designed timelines to ensure successful project implementation

and achieve project sustainability.

Accurate inventories are helpful for project design and the bidding process. The

feasibility studies conducted for the preparation of this project involved detailed

inventories of PCB equipment and wastes at each PCB holder. This information was

used to estimate the transportation, storage, and destruction requirements of risky PCB

wastes as well as the based information for the on-site management and subsequent

phase-out of the lower risk in-service PCB equipment. In the case of HCW, detailed

environmental audits were conducted at various types of healthcare facilities to estimate

the waste composition and generation rates. This information was subsequently used to

estimate the HCW generation rates for similar types of establishments at other locations

and determine the specific investments and service requirements (e.g. cold box storage

capacity, treatment capacity, amount of HCW to be transported) for selected

metropolitan areas or regions.

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IV. IMPLEMENTATION

A. Institutional and Implementation Arrangements

25. The project will be implemented by the Ministry of Environment through ANGed in

close collaboration with the Ministry of Health, the Ministry of Industry and its affiliated

companies and the Tunisian Society for Electricity and Gaz. ANGed is mandated, as per its

decree of establishment dated August 2005, to implement projects identified within waste

management national programs, to provide technical assistance to industries for enhanced waste

management and to contribute to the elaboration of necessary regulations for all types of waste

management. A Steering Committee (SC) has been established by the Ministry of Environment

in December, 2010 through a Ministerial Decision. The SC is to provide strategic guidance to,

and overall monitoring of, the program, and facilitate the coordination and collaboration between

the different ministries and agencies concerned by the program. The committee includes

representatives from key ministries, such as: the Ministries of Industry, Finance, Health, and

other stakeholders concerned by the project, including ANGed, GEF Focal Point, National

Environmental Protection Agency (ANPE), la Société Tunisienne de l’Electricité et du Gaz

(STEG), The Tunisian Chemical Group (Groupe Chimique Tunisien (GCT)), Compagnie des

Phosphates de Gafsa (CPG) and the Fouledh. The Steering Committee has delegated the

responsibility for managing the project to the Director General (DG) of ANGed, and the DG will

be the World Bank’s main interlocutor on aspects of project policy and decision-making.

26. A Project Coordination Unit (PCU) has been established within ANGed. It is composed

of ANGed’s staff who have direct responsibilities in their respective units for daily management

of hazardous waste in general and healthcare waste and PCBs in specific. This set-up is ideal to

ensure the sustainability of the project and its complete integration with the functions of ANGed

and its work program beyond the life time of the project. The PCU is responsible for the overall

supervision and coordination of the project, monitoring the project’s progress and that the

outputs and outcomes are consistent with the planned indicators and for the dissemination of the

project’s information and results. The PCU is headed by a Project Director and two project chiefs

respectively responsible for HCW and PCBs. The major responsibility of the Director is to

(i) coordinate project activities; (ii) supervise executing units of the two components HCW and

PCBs, (iii) insure that project progress and results are in conformity with recommendations of

the SC; and (iv) be responsible for the dissemination of the program. The two chiefs ensure day

to day project management and implementation, technical supervision of project activities of

respective components. They will also participate in monitoring and evaluation missions and

supervise the consultants and advisors financed under their respective components. The chiefs

will be supported by technical experts of HCW and PCBs.

27. The PCU is supported by two departments within ANGed for fiduciary aspects (financial

management and procurement) and the Legal Department. Two senior officials from these two

departments are also to provide their respective technical support to the components of HCW and

PCBs and will be the interlocutors to the World Bank during their appraisal and supervision

missions. In addition, a high level professional from ANPE is responsible for the environmental

monitoring of the project. ANGed is currently implementing four Bank projects, namely:

Sustainable Municipal Solid Waste Management (P095012), Jebel Chekir Solid Waste Carbon

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(P099670), Nine Landfills Carbon Finance (P099672) and the Africa Stockpiles Program

(TF055745-P075776).

28. The project will be implemented on the basis of partnership of different government

agencies and sectors. Joint Working Groups with the Ministry of Health, the Ministry of Industry

and STEG have been established for the implementation of the project, and have been involved

with ANGed at all stages of project preparation. To make the partnership implementation more

effective, ANGed, the PCU and the Legal Unit are preparing framework conventions with the

line ministries and specific conventions with the related entities have been drafted in view of

confirming the partnership, operational agreement. Co-financing for the project implementation

has already been confirmed by exchange of correspondences between the Ministry and

beneficiary ministries and institutions. This procedure is clearly spelled out in the Operations

Manual.

29. The National Agency for the Protection of the Environment (ANPE) will, as required by

the Tunisian EIA decree, review and approve all Environmental and Social Management Plans

for all activities. ANPE has a long track record of reviewing EIAs and this was recognized in the

Safeguard Diagnostic Review that the Bank carried out under the Sustainable Municipal Solid

Waste Management Project.

30. An organizational chart for the management of the project has been developed and

endorsed by the Minister Environment (see Annex 3).

B. Results Monitoring and Evaluation

31. In order to ensure effective and continued monitoring and results evaluation of project

operations, ANGed, acting through the project management unit, will be responsible for

reporting on the overall results framework with the indicators presented in Annex 1. The project

coordination unit is responsible for developing a Project’s Results Monitoring and Evaluation

System. Semi-annual, technical and financial progress reports will be prepared and submitted to

the Bank for review. These reports will deal with the progress made at the level of each

component and include a preliminary analysis of the project’s performance as related to the key

indicators.

32. Technical, organizational, accounting, and financial audits will be carried out annually to:

(i) monitor, a posteriori, the status of operations and overall progress of the project, and for the

quality and coherence of the means of project execution as compared to the results obtained;

(ii) ensure that ANGed (and the various contributors) adheres strictly to the procedures and to the

technical, financial, social, and environmental instruments developed during execution; and

(iii) ensure that international accounting norms and sound bookkeeping standards are respected.

ANGed will also develop, in consultation with the Bank, a system for disseminating data

periodically to strengthen the participatory nature of the activities and to involve the stakeholders

and groups affected by the project.

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C. Sustainability

33. The Project clearly supports the continued efforts of the Government of Tunisia (GOT)

to implement its 11th National Development Plan and the updated Plan of 2010-2014. One of the

NDP’s objectives is to strike a harmonious balance between economic, social and environmental

priorities. The Project is also a critical component of a series of complementary interventions

supported by the GOT, the Bank and other donors to reduce hazardous and toxic wastes which

threaten the public health, human’s living conditions, and natural environment in Tunisia. The

Project also supports Tunisia in implementing its National Implementation Plan (NIP) to ensure

it meets its legal obligations under the Stockholm Convention on Persistent Organic Pollutants

(POPs) with particular attention to reducing emissions of dioxins and furans, and eliminating

PCBs containing equipment from use by 2025.

34. This Project’s sustainability is one of its fundamental design considerations, since its very

purpose is to achieve sustainability in certain aspects of healthcare waste and PCBs management,

particularly in the institutional, financial, and environmental areas. A clear and precise definition

of the project’s components will thus help ensure its sustainability. The key aspects of Project

activities that will help with sustainability are the following: (i) strengthening of technical and

institutional capacities, including institutionalization of best techniques and practices; (ii)

engagement of local stakeholders so that they can play a greater role in the entire chain of

healthcare waste management; and (iii) strengthening public/private partnerships for HCW and

PCBs waste management.

35. The role of the private sector in the implementation of the project has evolved. Indeed,

the private sector will be responsible for the collection, transport, treatment, and final disposal of

hazardous health care waste (HHCW) from centralized storage facilities, generated by public

structure and healthcare facilities targeted by this project. The total annual quantity of health care

waste generated by structures and public health facilities in the North 1,555 T/y, in the Center

937 T/y, and in the South 962 T/y. In addition, private structures and institutions are also

required to manage their health care waste, according to the regulation in force, and

consequently, the private sector will be responsible for the disposal of the following quantities:

845 T/y, 163 T/y and 253 T/y respectively, generated in the zones of the Greater Tunis, the

Center and the South-East in Tunisia.

36. Under this project, state-of-the-art HCW management schemes will be developed to

reduce or eliminate dioxins and furans emissions and other hazardous pollutants, therefore

mitigating the risk to human health and the environment. This will be in accordance with Decree

No. 2745 which relates to management arrangements (particularly, sorting, packaging,

collection, transport and treatment). Through its co-financing of the project, the GOT) will

finance: (i) the collection; (ii) the transport of DASRI to the private facilities; (iii) DASRI

processing; (iv) remove of processed DASRI in controlled disposals; and (v) the acquisition of

furniture (utilities for DASRI preparation and the protection equipment) to the benefit of public

health center of Grand Tunis, the governorats of Sousse-Kairouan, Monastir-Mahdia, Sfax,

Gabes, Médenine and Tataouine. Several consultations with private sector operators have

indicated their willingness to finance up-front the establishment of the treatment facilities given

the commitment of both the Ministry of Health and ANGed in enforcing the

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environmental/hazardous waste regulation. They believe such actions would create a market and

an enabling environment conducive to the expansion of this type of green investments among the

private sector.

37. Another strategic focus of the Project for sustainability is on its replicability by

demonstrating and promoting best techniques and practices for the HCW and PCBs management

through engaging key partners, and an evaluation and strategy for replication which will be

developed under the project. Specifically the Project will engage governmental partners at

several levels (financial, technical and contractual) to reflect the rights of all the parties

participating in this Project, to formalize the agreements and modes of operation, to guarantee

co-financing, and to provide financial management arrangements of the project transactions. The

Project will also provide incentives to private partners and thus making good practices a part of

their own business. In addition, the project scheduled a Risk Study of PCBs equipments that are

in service and in good condition will serve as the basis for another PCBs elimination project in

the near future.

38. In addition to the elements of institutional, financial and technical sustainability indicated

above, the project benefits from organizational and operational elements of sustainability due to

the fact that no artificial or temporary set-ups have been created specifically for the

implementation of the project. It relies completely on existing structures and existing staff in

ANGed already mandated with the supervision and monitoring of healthcare waste and PCBs

management and elimination. Other partners are also collaborating through existing structures,

e.g. STEG has an Environment Unit established in 2002 and an Instructions Letter (Lettre

d’instructions) governs its operations.

V. KEY RISKS AND MITIGATION MEASURES

A. Risk Ratings Summary Table

Risk Rating Stakeholder Risk Moderate Implementing Agency Risk

- Capacity Low

- Governance Moderate Project Risk

- Design Low

- Social and Environmental Moderate

- Program and Donor N/A

- Delivery Monitoring and Sustainability Moderate

- Other (Optional)

- Other (Optional) Overall Implementation Risk Moderate

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B. Overall Risk Rating Explanation

39. The overall project preparation risk is rated Moderate. The nature of the project and the

specificity of HCW and PCBs management in the country mean that project implementation will

have to ensure appropriate technical assistance and capacity building to the implementing agency

as well as coordination mechanisms.

40. The overall project implementation risk is rated Moderate. The counterpart has

experience in implementing other Bank/GEF projects. However, the task team will need to

closely monitor project activity progress, especially given the lengthy national procurement

processes.

41. Appropriate mitigation measures will be taken so as to ensure, among others: i) directly

help with revisions to the regulatory and institutional framework needed to develop a climate

conducive to private sector participation with clear technical standards and guidelines, as well as

monitoring systems; ii) knowledge sharing and capacity building to encourage the private

participation; iii) provide incentives to micro-enterprises to undertake the HCWM from

collection to disposal in remote areas; iv) using reviews and the M&E framework, including the

midterm review, to monitor and evaluate private participation in view of adjusting and improving

it throughout the project implementation; v) increasing public awareness on PCBs and other

hazardous waste; and vi) ensuring coordination among different agencies and stakeholders’

awareness and participation.

VI. APPRAISAL SUMMARY

A. Economic and Financial Analysis

42. This project will contribute to local and global public goods by reducing releases of PCBs

and of dioxins and furans from combustion of infectious HCW, thus reducing the threats to

human health and environment. Theoretically, it is possible to apply cost-benefit analysis;

however the lack of reliable baseline data and the difficulty to identify cause-and-effect

relationships between exposure to PCBs and HCW and health impacts make this analysis not

possible in the context of this project. Therefore, for each component, cost-effectiveness analysis

of several options to manage PCBs and HCW was carried out. A partial cost-benefit analysis is

possible for the HCW component, and the results would be only indicative.

43. HCW component: It aims at improving the collection, transport and treatment of HCW

from public and private facilities in the zones of Grand Tunis, Centre and South-East of Tunisia,

by involving the private sector in these operations. The analysis suggests that disinfection by

centralized autoclaves is the most cost-effective option of treating HCW in Grand Tunis, the

Center and the South-East of Tunisia. Using a 500 to 600-ton capacity treatment plant is the most

cost-effective option for HCW management. This would be profitable for private operators with

a payment of TD800 per ton of waste. For payments lower than TD600 per ton, the private

operator’s profitability would depend on the extension of the contract after the first 5-year phase.

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44. PCBs component: It aims at eliminating the PCB-contaminated equipments that are

either off-line or in-service but in bad condition, and at decontaminating the sites where the off-

line equipment was disposed of. A cost-effectiveness analysis of alternative management options

of the PCB-contaminated equipments suggests that exporting all PCB-contaminated equipments

and wastes to Europe for treatment and recycling is the most cost-effective option for this

component.

B. Technical

Healthcare Waste Management

45. The audits of all HCW incinerators installed at healthcare facilities in Tunisia revealed

that these incinerators were out of compliance with the international standards. These audits

recommended decommissioning and dismantling of all these incinerators. Based on the

evaluation of alternative HCW treatment technologies (incineration, autoclave, and microwave

technologies), the autoclave technology was determined to be the most cost-effective approach

for Tunisia. This led the Government of Tunisia to adopt the autoclave technology for HCW by

reversing its older decision of HCW incineration.

46. Based on feasibility studies conducted for the pilot geographical areas, the following

results have been observed:

There are four populated urban areas with highly concentrated healthcare facilities.

These areas are: a) Greater Tunis area, b) Sousse-Kairouan area, c) Monastir-Mahdia

area, and d) South-east area.

For public structures and health care facilities located at a distance greater than or equal

to 50 km from the treatment center authorized by the Ministry of Environment, transport

will take place once or twice a week to optimize transport costs, since generated HCW

will be stored in centralized refrigerated storage facilities.

HCWs at each healthcare facility would be segregated, pre-treated (if necessary),

contained, transported and stored. These HCWs would then be transported from the

healthcare facilities to the central treatment facility for autoclave treatment. The treated

wastes would then be transported to the municipal landfill for disposal. The Grand Tunis

area will be further divided into zones, each with a different HCW collection and

treatment network.

For the project’s HCW management activities, the Government will engage services of

the private sector for processed HCW collection from healthcare facilities, transportation

to the central treatment center, treatment at the central treatment center, transportation of

the treated waste to the landfill, and disposal at the landfill; and the investments borne

within the healthcare facilities (such as needle crushers, bins, carts, civil works to

upgrade storage room, , refrigerators, personal protection equipment, supplies) will be

covered by the Government.

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PCBs Management

47. The feasibility study for PCBs management evaluated alternative options and

technologies of PCBs wastes and equipment at public sector entities. The feasibility study

recommended immediate elimination of all PCBs wastes (including PCBs oils and PCBs-

containing equipment in stock) in Tunisia through export to Europe. For the remaining in-

service PCBs equipment, the study recommended elimination according to a schedule based on

risks posed by such equipment (considering the age and condition of the PCBs equipment) as

well as potential adverse impacts on people and property (i.e. high priority for the elimination of

PCBs equipment that are located in schools, other public buildings, and populated areas). The

feasibility study also identified contaminated areas and recommended cleanup of these areas.

48. The project will finance the collection, containment, transportation as well as export and

elimination of PCBs in Europe using international specialized firms.

49. Since are no funds available under this project to dispose the remaining in-service PCB

equipment that are in good condition, and the Government cannot provide the necessary funds to

replace these equipments immediately, the project will only finance a study to assess the risks

associated with the in-service PCB equipment that are in good condition2 for eventual phasing

out in the future. For each in-service PCB transformer that is in good condition, a specific

management plan will be prepared to require the equipment holder to operate the equipment

according to a contract program, retrofitting the equipment with a PCB concentration within 50

pm-2,000 ppm, exporting all recovered PCB-containing oil to Europe for treatment or disposal,

replacing other transformers and capacitors with non-PCB transformers and capacitors, and

exporting all out-of-service equipment to Europe for disposal. The details of such contract

programs will be developed during project implementation.

50. As to the PCBs contaminated sites, the project will finance consulting services for the

preparation of remedial investigation/feasibility studies (RI/FS) and remedial plan for PCBs

contaminated sites at public entities. Counterpart funds under the project will be used to

decontaminate each of these sites according to the remedial plan.

Operations Manual for Project Implementation

51. Considering that the project will cover technical, financial, and procurement matters

involving many agencies, an Operations Manual has been prepared to clearly spell out the

organizational structure and coordination mechanisms, the responsibilities of all parties involved

as well as the procedures to be followed for environmental and social safeguards, procurement

and financial aspects, and project supervision. Adopting the Operations Manual, satisfactory to

the World Bank, is an effectiveness condition.

2 There are 71 in-service PCB equipment that are in good condition. Out of these, 67 are owned by the Ministry of

Agriculture. A preliminary cost estimation for the replacement of the 71 in-service PCB equipment is

approximately US$ 400,000.

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C. Financial Management

52. Assessment of ANGed financial arrangements including the accounting system and

accounting policies and procedures, budgeting system, reporting, staffing, internal controls

policies and procedures, internal auditing and external auditing arrangements reflects that these

arrangements are satisfactory and meet the Bank’s minimum requirements. These procedures

required by the Bank are well known since ANGed have four Bank projects, namely: Sustainable

Municipal Solid Waste Management (P095912), Jebel Chekir Solid Waste Carbon (P099670),

Nine Landfills Carbon Finance (P099672) and the Africa Stockpiles Program (TF055745-

P075776). However, the accounting system in place, the chart of account and the ANGed

policies will need to be enhanced to follow on the project accounts and generate timely financial

reports for project management and decision making.

53. ANGed’s capacity to oversee the program’s financial management has been judged

satisfactory, presenting only a relatively low financial risk. Moreover, the framework for the

financial and accounting management system, included in the texts governing public enterprises

in particular and the law in general, satisfies Bank requirements.

54. The essential measures recommended by the Bank during the preparation missions have

been adopted, namely: preparing on annual basis the project disbursement plan; amend the

existing chart of account in order to use separate accounts and sub-accounts for the project

transactions, Submit to the bank IFRs format, and the recruitment of a second internal auditor. In

addition, within Sustainable Solid Waste Management Project financed by The World Bank,

ANGed is currently preparing terms of reference to select consulting firms in order to the

preparation of: i) training strategy and program; ii) ANGed’s organizational chart and job

descriptions; and iii) ANGed procedures manual. It is expected that these actions will be

completed at the end of 2012.

55. ANGed, throughout the Project, will be responsible for managing the project funds and

all related financial transactions on behalf of the Ministry of Investment and International

Cooperation which will hold the Grant funds for the Recipient. The ANGed accounting and

financial department will be following on the project finances including the project accounting

functions and reporting. ANGed is compliant with PB10.02 Financial Management. In addition

ANGed will be responsible to prepare and furnish to the Bank, through the Ministry of

Investment and International Cooperation, not later than forty five (45) days after the end of each

calendar semester, interim unaudited financial reports for the Project covering the semester, in

form and substance satisfactory to the Bank.

56. The Project’s financial statements, including the Designated Account (DA) will be

audited annually by an external independent auditor, acceptable to the Bank, in accordance with

internationally accepted auditing standards. ANGed will be responsible for hiring the external

auditor ANGed will submit the audit report to the Bank no later than six months following the

closing of the fiscal year subject to the audit. The audit’s TOR will be prepared and submitted for

the Bank’s no objection.

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57. In addition, the ANGed audit report (entity) reflecting the ANGed financial statements

and operating results will be remitted to the Bank within 6 months from the end of each calendar

year. ANGed is complaint with BP 10.02 especially regarding audit requirements.

58. The Grant funds will not be transferred to ANGED, the Project Implementation Entity,

but will remain with the Republic of Tunisia, the Recipient of the Grant. The Ministry of

Investment and International Cooperation will open a Designated Account (DA) at the Central

Bank of Tunisia, ANGed will be authorized to use this DA for financing of eligible expenditures.

Replenishment Withdrawal Applications will be submitted to the Bank by the Authorized

Signatories at the Central Bank of Tunisia. Separately, the Ministry of Investment and

International Cooperation will provide the Bank with the name and specimen of signature of the

Authorized Officers in ANGED who would send to the Bank Withdrawal Applications for direct

payments that are above the minimum value. Consequently a Subsidiary Grant Agreement

between the Republic of Tunisia and ANGED is not required. This designated account will be

opened in US dollar and will receive an initial advance of $US 600,000 of the grant amount.

Withdrawals of grant amounts will be based on the Bank’s traditional disbursement methods and

will be used to finance project activities by means of the disbursement procedures currently used,

that is, requests for withdrawals for direct payments, requests for special commitments and/or

requests for reimbursement, either with documentary evidence or expenditure statements, in

accordance with the procedures described in the Bank’s Disbursement Letter and Disbursements

Handbook.

D. Procurement

59. Procurement in ANGed is managed as follows: the Permanent Secretariat of SPCM

(Secrétariat Permanent de la Commission des Marchés) which, under the direct authority of the

agency Director General, oversees all tendering processes; and the technical units (Direction

Etudes et Travaux, Direction Déchets Dangereux, Direction Filières) provide technical support

in the preparation of bidding documents as well as in the evaluation process. The projects

managers and heads of units are responsible for drafting the bidding documents for procurement

and selection of consultants, particularly with regard to the technical specifications and the

Terms of Reference respectively. Staff in ANGed has had previous experience with other Bank’s

projects. In addition, all units have sufficient space in furnished offices, including computers, to

accommodate the staff. Consequently, ANGed would have the capacity to carry out and manage

the procurement under this financing, provided that training is carried out for those staff who will

be involved in procurement under this project on the Bank on the main procurement procedures.

60. Overall, and after its revision in May 2011, the Tunisian procurement legislation for

goods is in line with the Bank's guidelines for procurement and the country has adequate control

organizations. However, substantial divergences exist in the procedures for the selection and

employment of consultants which, following local legislation, are based on open competitive

bidding. Procurement for the proposed project will be carried out in accordance with the World

Bank Procurement Guidelines, and the provisions stipulated in the Grant Agreement.

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E. Social (including Safeguards)

61. The project will deliver considerable social benefits by reducing risks from existing

HCW in public and private health facilities, specifically healthcare staff, as well as workers

involved in PCB equipment. The project will also implement measures to prevent HCW stock

accumulation in the future and will eliminate off-line PCB contaminated equipment through their

export outside Tunisia. Due to the correlation between health and environmental risks and

poverty, the delivery of benefits will likely be progressive, affecting the population at large and

the poor in particular. Given the present low level of awareness of the general population with

regard to the consequences of exposure to contaminated HCW and PCB equipment, the project

include a specific subcomponent under component 1, for communication and awareness raising.

This is to ensure the active participation and collaboration of the project affected people who

would be identified during the preparation of the operational manual for the HCW facilities.

Activities include awareness campaigns, workshops and seminars, pamphlets, posters, brochures,

billboards and media clips so that proper information could be conveyed to workers and nearby

communities and help raise the level of awareness and encourage safe handling and transport of

HCW.

62. The project does not trigger OP 4.12 involuntary resettlement as all the HCW storage

facilities are in the existing public hospitals and PCB containing equipment will be removed

from sites belonging to public entities (Ministries and state companies) which possess about

1200 PCBs equipment, of which 900 are off-line and the rest are on line. Most of the PCBs

belong to the company STEG and to the Compagnie des Phosphates de Gafsa. There is no

resettlement, no physical displacement of persons or total or partial loss of revenues resulting

from the project. However, there is an office of complaints which has been established in

ANGed to receive and respond to any complaints from citizens on any issue related to any type

of waste. This office also follows up on any complaints, dispatches the complaints to the

appropriate departments and reports the results to the ANGed director general.

F. Environment (including Safeguards)

63. An environmental and social impact assessment framework (ESIAF) was prepared by an

independent national consulting firm in accordance with OP 4.01 and the Tunisia EIA decree No

2005-1991. The Project is essentially an extensive cleanup and contamination-prevention

operation which will bring substantial environmental health benefits, both locally and globally,

by removing PCBs equipment and treatment of HCW and preparing plans for remediating

contaminated sites. The Project components include the mitigation, monitoring and institutional

measures to reduce/eliminate the adverse project impacts.

64. However, the project carries some potential environmental risks. For the HCW

component of this Project, potential risk is related to illnesses or lesions due to this waste,

namely: infectious agents, sharp or cutting objects, genotoxic substances, and chemical or

pharmaceutical substances (toxic and hazardous), etc. The project through the HCW proper

treatment and disposal will eradicate health danger or risks associated with the waste residues as

will eliminate the emission of carcinogenic emissions of dioxins and furans due to inadequate

incineration without effective emission treatment, as well heavy metals such as mercury, lead

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and cadmium. The potential risks associated with the inadequate management of PCBs with a

concentration of more than 50 ppm by weight are: (i) contamination of soils, fauna, groundwater

and surface water; (ii) health risks related to the manipulation of PCB containing equipment by

unqualified workers; and (iii) security risks due to poor stocking of equipment and oil

contaminated by PCB.

65. In line with the project design, (under which the detailed technical design and location of

storage areas and disposal and treatment sites will be completed during the Project

implementation), the preparation of the Environment and Social Impact Assessment will take

place in two stages:

Stage 1: An Environmental and Social Impact Assessment Framework (ESIAF) was

prepared prior to appraisal, and mitigation, monitoring and institutional measures were

outlined in an Environmental and Social Management Framework (ESMF) for each of

the two major components for HCW and PCBs. The ESIAF was prepared by GEREP, an

independent national consulting firm before appraisal, was submitted for public

consultation on February 11, 2009 and disclosed in Tunisia on August 14, 2009 and in

the Bank InfoShop on August 16, 2010. The Project Integrated Safeguards Data Sheet at

appraisal was disclosed in September 23, 2010. The ESIAF executive summary in

English was disclosed to the Board on August 16, 2010.

Stage 2: The second stage will be the preparation during project implementation of site or

group of sites- specific environment and social management plans (ESMPs) for HCW

storage and treatment sites; and in case visual audit results on PCB contaminated sites

(for which PCBs concentration will exceed 50 ppm as required by the Stockholm

Convention) show potential negative impacts, a specific environmental and social

management plan of the site or group of sites, will be prepared, in accordance with the

Environmental and Social Impact assessment Framework (ESIAF) and included in PCBs

disposal bidding document. All ESMPs will be prepared by local consultants to be

contracted by ANGed. These ESMPs will be reviewed and approved by Agence

Nationale de Protection de l’Environnement (ANPE) as required by the Tunisian EIA

decree. ANPE has a long track record of reviewing EIAs and this was recognized in the

Safeguard Diagnostic Review that the Bank carried out under the Sustainable Municipal

Solid Waste Management Project3. During the first year of project implementation, the

World Bank will review and clear the individual subproject specific ESMPs. All ESMPs

will be disclosed on the ANGed website, and in the corresponding municipality and site

for PCBs and hospital for HCW, and in the InfoShop according to the Bank's Policy on

Disclosure of Information. As executing agency for the Project, ANGed will be

responsible to follow up on the mitigating measures and will report them as part of the

progress report to the project. After the confirmation by the World Bank based on an

assessment of the Agence Nationale de Protection de l'Environnement (ANPE)’s

environmental and social capacity (which will be conducted no earlier than one year after

the Effective Date), the ANPE will review and clear the ESMPs. ANPE is the national

regulatory agency and it has a strong technical capacity and track record, especially as a

result of fulfilling the gap filling measures related to the Use of Country System's

3 World Bank Report 35611-TN, February 2007

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implementation of the Sustainable Solid Waste Management Project implemented by

ANGeD. Even during the process of the ANPE review of the EMPs during years 2 to 5 of

project implementation in a manner acceptable to the Bank, the Bank will conduct spot

checks to ascertain the quality and efficacy of the review and clearance process by

ANPE."

66. For the HCW component, the project will finance monitoring and mitigating measures

for: (i) HCW separation at the source in accordance with the operational manual; (ii) storage in

proper intra muros refrigerated facilities; (iii) collection and transport extra muros by the private

sector in accordance with hazardous waste law no 97-37, the Decree No. 2008-2745 on

conditions and modalities for sanitary waste management activities, and Decree No. 2009-1064

on permits issued for the treatment of hazardous waste which require each operator to prepare an

EIA approved by the ANPE; (iv) HCW treatment using autoclaving technology; and (v) disposal

of sterilized HCW in sanitary landfills managed by ANGed. An environment and social

management framework (ESMF) in the ESIAF plan was prepared which includes the estimated

incremental cost of US$100,000 for the preparation of environment management plans for sites-

specific or group of sites specific for HCW storage facilities. This is over and above the cost of

institutional strengthening and investments related to HCW treatment estimated at US$1.013

million and US$8.24 million respectively.

67. For the PCB component, the ESIAF stated that during collection, packaging and transport

within Tunisia, visual environmental audits would be conducted by independent consultants for

all PCB sites. If audit results show potential negative impacts, a specific environmental and

social management plan will be prepared, in accordance with the Environmental and Social

Impact Assessment Framework (ESIAF) and included in PCBs disposal bidding documents. The

ESMF plan for PCB sites has identified the need for a rehabilitation and decontamination site

plan which will be published on ANGed’s website. The remedial investigations study will assess

the extent of PCB contamination, if any, of the soils, structures (buildings, storage areas), and

associated risks. The feasibility study will evaluate alternative options for cleaning the sites to

acceptable levels and present a specific recommendation. The remedial action plan will provide

detailed measures for site remediation with an estimated budget and schedule. Six –nine sites

would be candidates for rehabilitation and would be financed from the project counterpart

funding. Regarding PCB treatment overseas, the operator will comply with the recipient

country’s regulations and directives for hazardous waste treatment. The bidding documents will

require that proposals provide detailed procedures, conditions and guidelines to be followed

during the treatment of PCBs overseas. Non-compliance with these procedures will result in the

proposal being rejected.

68. An environment and social management framework (ESMF) plan was prepared which

includes the estimated incremental costs of US$154,000 for the preparation of the site specific-or

group sites specific environment management plans or environmental audits. Decontamination of

a limited number of sites was estimated at US$515,000. This is over and above the cost of

institutional strengthening and investments related to PCB treatment of US$829,000 and

US$4.26 million respectively.

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Public Consultation and Dissemination

69. A number of consultations have been held with several stakeholders during the project

preparation. An ultimate public consultation was held on February 11, 2009, at ANGed. Twenty

five participants attended from the ministries of interior, environment, industry and energy,

health public and private health facility representatives, private contractors as well as five NGOs.

The participants confirmed the importance of the project and endorsed its upcoming

implementation. Some participants requested that the companies and industries that will benefit

from the project should have qualified staff for the monitoring and follow up on environmental

measures. Also awareness campaigns should be increased specifically on health impacts related

to HCW and PCBs and NGOs should be more involved. Other participants requested that the

treatment of HCW should be left open as there could be new technologies that can be more

adapted in Tunisia and that existing equipment containing PCBs should be also replaced. All

these recommendations were included in the project component on institutional strengthening.

After all these consultations held at an institutional level, more extensive and broader

consultations will be carried out for each site specific ESMP.

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 ]

Piloting the use of Borrower Systems to address

Environmental and Social Safeguard Issues in Bank-

supported Projects (OP/BP 4.00)

[ ] [X ]

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Annex 1: Results Framework and Monitoring

Tunisia: Demonstrating and promoting best techniques and practices

for managing healthcare waste and polychlorinated biphenyls (PCBs) project

Project Development Objective (PDO):

to reduce releases of dioxins, furans and PCBs in Tunisia by strengthening the country’s legal and institutional framework and establishing sound and sustainable management

programs for improving management and final disposal of healthcare wastes and PCBs.

PDO Level Results

Indicators

Core

Unit of

Measure Baseline

Cumulative Target Values

Frequency

Data

Source/

Methodo-

logy

Responsibility

for Data

Collection

Description

(indicator

definition

etc.) YR 1 YR 2 YR3 YR 4 YR5

Indicator One:

Tons of dangerous

HCW processed

resulting from the

85 public entities

linked to the project

Tons of

HCW

0 0 1800 2700 3200 Annual Annual

reports,

Mid –term

review

MH and

ANGed

Quantificatio

n of HCW

processed

Indicator Two:

Tons of PCBs

removed

Tons of

PCBs

0 300 700 900 1100 Annual Annual

reports,

Mid –term

review

PCBs holding

entity

beneficiary to

the project;

responsible

ministries; and

ANGed

Quantificatio

n of PCBs

removed

INTERMEDIATE RESULTS

Intermediate Result (Component One):

Strengthening the Institutional Framework and Capacity for HCW and PCBs’ Management at the national, regional and local levels

Intermediate Result

indicator One: The

decree on HCW

management

finalized and the

associated guidance

documents prepared

Decree

issued

Guidelines

produced Annual

Published

decree

MPH and

ANGed

Intermediate Result

indicator Two: The

framework manual

for the management

of healthcare waste

and the technical

guidelines are

prepared for the

Specific

manuals

and

technical

guidelines

prepared

for The

Grand

Specific

manuals

and

technical

guidelines

prepared

for

Sousse,

Specific

manuals

and

technical

guidelines

prepared

for Sfax,

Gabès,

Medenine

Annual Prepared

standard

specifications

MH and

ANGed

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public health care

facilities which are

beneficiaries of the

project

Tunis Nabeul,

Mahdia et

Monastir

et

Tataouine

Intermediate Result

indicator Three:

HCW personnel

trained at national,

regional and local

levels

Nb. of

personnel

trained

0 60 140 240 340 Annual Prepared

standard

specifications

MH and

ANGed

Intermediate Result

indicator For:

Decree and

guidelines for

PCBs’ management

have been prepared

Decree is

issued

Guidelines

prepared

Annual

Published

decree

STEG, ME,

ANGed

Intermediate Result

indicator Five:

PCBs’ specific

management plans

for each entity

holding PCBs-

containing

equipment, wastes,

and contaminated

soil

Nb. Of

Manage-

ment

plans

developed

0 5 10 13 Annual Published

Management

plans

STEG, ME,

ANGed

Intermediate Result

indicator six: Staff

training on handling

PCBs-containing

electrical equipment

Number

of staff

trained

0 60 140 240 340 Annual N/A PCBs holding

entities/minis

tries, ME,

ANGed

Intermediate Result (Component Two):

Improvement of HCW and PCBs’ Management and Disposal

Intermediate Result

indicator One:

Better techniques

and management

practice for the

health care waste

are identified and

implemented in the

project sites

Nb. of

Treatment

Centers

using

better

techniques

and

manage-

ment

practices

for

0 2 6 Annual Healthcare

facility report

regarding

receipt of

equipment/su

pplies and

facility audits

Contractor

reports and

facility audits

MH, ANGed

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dangerous

healthcare

waste

Intermediate Result

indicator Two:

Quantity of PCBs

removed

Tons of

PCBs

0 300 700 900 1,100 Annual Contractor

reports/site

audits by

PCBs holding

entity

PCBs holding

entity and

responsible

ministry

Intermediate Result

indicator Three:

PIU is in place and

operational

PIU

operational

Intermediate Result (Component Three):

Component 3: Project Management

An M&E system in

place and

operational

M&E is in

place

Annual Independent

auditor

ME

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Annex 2: Detailed Project Description

Tunisia: Demonstrating and promoting best techniques and practices

for managing healthcare waste and polychlorinated biphenyls (PCBs) project

1. The Project Development Objective (PDO) is to reduce releases of dioxins, furans and

Polychlorinated Biphenyls (PCBs) in Tunisia by strengthening the Recipient’s legal and

institutional framework and establishing sound and sustainable management programs for

improving management and final disposal of healthcare waste (HCW) and PCBs. The project

consists of three interrelated components:

Component 1: Strengthening the Institutional Framework and Capacity for HCW and

PCBs’ Management at the national, regional and local levels

Component 2: Improvement of HCW and PCBs’ Management and Disposal

Component 3: Project Management

Component 1: Strengthening the Institutional Framework and Capacity for HCW and PCBs’

Management at the national, regional and local levels (US$2.190 million – GEF US$1.095

million and co-financing US$1.095 million).

2. This component aims to strengthen the institutional and regulatory framework and

technical capacities for HCW and PCBs’ management at the national, regional, and local levels

in Tunisia. HCW and PCBs management activities at the national level entail the finalization of

decrees for HCW and PCBs management, the development of management manual for

Dangerous HCW, technical guides for HCW and PCBs management, technical data sheets, and

the formulation of action plans for awareness-raising and training.

Sub component 1.1: Institutional support and adoption of best practices for HCW

management by:

Sub component 1.1.1 Strengthening the institutional and Regulatory Framework

3. Definition of the roles and responsibilities and strengthening of the entities involved in

HCW management, pursuant to the Minister of Public Health’s Decree of June 16, 2009. The

entities under the Ministry of Health include:

Public health centers: (public administrative entities such as regional hospital, district

hospitals, and primary healthcare units)

Private health facilities

Private healthcare providers and centers

Other health institutions, curative establishments (teaching, and research institutions)

Entities involved in HCW collection and transportation

Entities involved in HCW disposal.

4. Strengthening the existing regulations by issuing standards and technical guidelines for

the operation, monitoring, and enforcement of public and private healthcare facilities and HCW

management facilities. The technical assistance will be provided in view of harmonizing and

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supplementing the regulatory framework, pursuant to the provisions of Articles 8 and 13 of

Tunisian Decree No. 2008-2745 of July 28, 2008 on Healthcare Waste Management Procedures,

particularly formulating:

An agreement (convention) between the public and private health centers and facilities

and the authorized service firms (in accordance with the provisions set forth in Article 31

bis of Law 96-41 of June 10, 1996 on waste and oversight of its management and

disposal); and

A framework manual for managing hazardous HCW, to be approved by a joint decree

(arrêté) issued by the Minister of Environment and the Minister of Health. This

framework manual will serve as a global template for tailored specifics manuals which

will be applied by each public and private health center or facility in Tunisia.

5. Preparation of the Manual. A manual will be designed specifically for each public and

private health entity or facility. This individually designed manual for each public and private

health entity or facility (based on numbers and type of services offered, and on the type of

facility: multidisciplinary or specialized, multi-wing or single wing, etc.), will serve as a

benchmark for sound and optimal management, from waste generation to its processing and

disposal within each public and private health entity or facility.

6. Technical data sheets laying out the HCW regulations, definitions, and sound

management practices will be designed for use at public and private healthcare facilities. Internal

and external oversight will be strengthened through internal audits and, particularly, by oversight

and monitoring bodies, including:

Establishment of a HCW management unit at each public and private healthcare facility

and assignment of responsibilities to each member of this unit (HCW management should

be supervised by a physician or an engineer specialized in public health engineering, or

by a senior technician responsible for supervising HCW management, pursuant to Article

7 of Tunisian No. 2008-2745 of July 28, 2008 on conditions and modality of management

of sanitary waste activities;

Development of standard specifications to be included in the bidding documents for the

collection, transportation, storage, and treatment of potentially infectious HCW, and

disposal of treated HCW at sanitary landfills. The bidding documents, which have been

prepared for national competitive bidding, are divided into six lots, of which: (i) three are

for Greater Tunis, with approximately 500 T/lot; (ii) two for central Tunisia, grouping

together the Sousse and Kairouan (500 metric tons per year) and the Monastir and

Mahdia (430 T/year) governorates, respectively; and (iii) one lot grouping together the

Sfax, Gabès, Médenine, and Tataouine governorates with produced quantities estimated

at 690 pT/ year; and

Technical assistance will be provided to finalize the bidding documents relating to sub-

components 2.1.1, 2.1.2 and 2.1.3.

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Sub component 1.1.2 Conducting awareness and outreach campaigns, workshops and

information and monitoring seminars for HCW management

7. Conducting awareness campaigns about the risks of HCW to raise awareness among all

personnel involved in HCW management. This task is intended to minimize the risks associated

with the exposure to HCW through better personnel protection and sound HCW management

practices. A communication strategy and a communication action plan will be prepared. The

targeted groups include:

Healthcare facility personnel: physicians, hygienists, HCW unit managers, nurses,

stretcher bearers, support personnel, non-medical personnel in health facilities:

maintenance personnel, engineers, technicians;

Personnel from companies authorized to transport and process HCW;

Managers of the cleaning services from the municipalities in question;

Municipal employees tasked with waste collection and transportation;

Auditors and inspectors for HCWM; and

All other individuals or legal entities involved in HCW management.

Educational brochures, posters, films, and video projectors will be used to carry out these

awareness-raising campaigns. The media and NGOs will also play a pivotal role in

information dissemination. Action will also be taken for educating and raising awareness

among patients and visitors about the risks engendered by HCW, the improvements that

have been made, and the practices that they can adopt to avoid exposure to risk from

HCW.

8. Organizing regular information and monitoring workshops and seminars for sector

stakeholders:

At least one large-scale workshop will be organized each year in each of the three areas

involved in this project. Senior officials and policy makers will participate in these

workshops (ministers, governors, etc.) with a view to broaden outreach and scope.

Healthcare personnel (physicians, nurses, and others, paramedical professionals, workers)

will also participate. Other participants will include nongovernmental organizations

(NGOs), students, and the general public to ensure improved collaboration and increased

awareness; and

Specific smaller-scale information workshops will be organized: Each stakeholder in the

HCWM process will acquire the knowledge and skills needed to ensure standard

management provided by the manual that poses no risk to human health or the

environment.

9. HCW reduction programs through distribution of technical guidance documents,

brochures, posters, and films:

Short films on HCW will be produced. These films will illustrate uncontrolled

management as well as the risks posed by inappropriate management of HCW

(scavengers at uncontrolled landfills, presence of rodents and domestic animals, as well

as mosquitoes and carriers of pathogenic germs); and sound management practices with

appropriate storage, treatment, and disposal units; and

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Technical data sheets, brochures, slogans, guides, and posters will be designed for display

(facility entrances, departments, treatment rooms, seating areas, surgical units) or

educational purposes, with a view to raising awareness among all relevant stakeholders.

These posters will serve as performance indicators for improved HCW management.

Sub component 1.1.3: Providing training in HCW management, environmental assessment,

collection and disposal of HCW, monitoring and evaluation.

10. Training will help support the activities pertaining to the implementation of the project. It

will aim to strengthen capacity in sound HCWM in Tunisia. It will involve preparation of

training materials, organization of training workshops, and delivery of training courses, media

programs, and press coverage. A training strategy will be formulated and a training plan will be

prepared in collaboration with the Ministry of Health, particularly the Directorate of

Environmental Health and Protection (DHMPE), it will include:

Training of HCWM personnel at healthcare facilities will cover: Project management;

Environmental assessment; Risks associated with poor HCWM to healthcare facility

personnel, other HCW management personnel and general public (psycho-emotional,

infectious risks, chemical or toxicological risks, cytotoxic, genotoxic substances, heavy

metals etc.); risk of skin and/or mucous membrane radiation; ground, water, and air

pollution risks; flammable or explosive risks; risks linked to handling (overfilling,

spillage); Safeguard policies; Sound HCW management; Identification of necessary

awareness-raising and training themes; Promotion, organization, and coordination of

internal and external professional training actions; and Introduction of training and

information actions that are either targeted and immediate, or part of a medium-term

programming plan;

Training of all HCW management personnel outside the healthcare facilities that are

involved in collecting/transporting and treating HCW. Training will pertain to the

specific areas of responsibilities of each group;

Strengthening of institutions under the Ministry of Health and the Ministry of

Environment (ANPE, DHMPE, ANGed) for monitoring and enforcement of HCW

management activities; and

Participation in various international and national events, seminars and

workshops/courses. The theoretical and practical aspects of these events will be covered

by specialists. Participants will essentially be outreach officers from the public and

private sectors and NGOs, healthcare personnel, HCW management companies, and local

authorities.

Sub component 1.2: Capacity and awareness enhancement for management and final disposal

of PCBs:

Sub component 1.2.1 Strengthening the regulatory framework for PCBs management:

11. Institutions and government agencies involved in PCB management in Tunisia can be

regrouped into four categories, namely, a) Government institutions involved in PCB

management, monitoring and enforcement (such as, ME, ANGed, ANPE, Center for

International Environment Technology (CITET), MH, Ministry of Interior; b) Holders of PCB

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wastes (such as: Ministry of Industry, Ministry of Agriculture, MH, Ministry of Higher

Education, Ministry of Equipment, Ministry of Social Affairs, STEG, Groupe Chimique

Tunisien (GCT), Phosphate Company of Gafsa (CPG), the company El FOULEDH, Tunisian

Petroleum Refining Company (STIR), ONAS, National Society of Cellulose and Alfa Paper

(SNCPA) and General Store); c) Specialized companies authorized to manage PCB wastes, such

as, companies involved in the maintenance of PCB-containing equipment, companies involved in

the management of PCB-contaminated waste (dismantling, draining, storage, packaging,

labeling, transport, treatment and disposal; and d) Laboratory(ies) involved in the analysis of

PCBs, dioxins and furans. Activities include:

Preparation of a decree for PCB management in Tunisia. This decree will be prepared in

accordance with Article No. 24 of the Framework Law 96-41 of June 10, 1996 on

management of wastes, including their disposal in accordance with the requirements of

the Stockholm Convention on Persistent Organic Pollutants (POPs), which was ratified

by Tunisia in 2004. Tunisia has already prepared its National Action Plan (NAP), but the

associated details will be set by statutory instruments including: concerned shareholders,

sound management methods, and timing of disposal of PCB-contaminated equipment and

wastes from 2010 to 2025. The detailed provisions should include emergency treatment

and disposal of PCB waste and PCB-containing/contaminated equipment, removal and

immediate replacement of equipment in service but in bad condition, removal and

immediate replacement of equipment located in sensitive areas and phasing out of

equipment containing PCBs in concentrations greater than 50 ppm before the end of the

year 2025.

Preparation of a guidance document for sound PCB management. This guidance

document will be made available to all PCB equipment and waste holders and other

interested parties involved in PCB management in Tunisia (e.g. companies holding PCB

wastes/equipment, PCB equipment maintenance companies, PCB waste management

companies, laboratories providing PCB analytical services). This guidance will discuss

potential risks to the environment and human health by the use of PCB-containing/

contaminated equipment, measures to prevent PCB pollution (leak, spills), maintenance

techniques, maintenance and decontamination, management procedures (removing,

changing, storing, packaging, labeling, transportation, treatment and disposal) in

accordance with the existing regulations.

Preparation of specific management plans for each PCB-holding entity: A PCB

management plan will be prepared for each of the 15 entities surveyed and identified to

hold in-service PCB equipment in the preliminary diagnosis study. These plans will be

derived from Tunisia’s national PCB management plan and tailored to each specific

entity based on the PCB content, and applicable technical requirements and regulations.

A retirement schedule for in-service PCB equipment, which will be beyond the 5-year

implementation period of this Project, will also be developed based on the number, age,

condition, and performance of the equipment as well as the financial capacity of the

entity in charge of the treatment and replacement of the PCB-contaminated equipment.

The specific PCB management plan will be governed by a contract program which

commits the holding entity to the competent authorities to properly manage its fleet of in-

use PCB equipment that is in good condition. The contract program will make the entities

commit to activities, such as, retro-filling transformers containing PCB concentrations

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between 50 and 2,000 ppm; analysis of the PCB content of new oils after retro-filling;

updating the inventory with new concentrations of PCBs in oils; recovery of all PCB oils

to export for treatment or disposal. This could also include establishment of framework

agreements with concerned departments and separate agreements with the entities

holding PCB wastes.

Risk study of PCB equipments that are in service and in good condition. A consultant will

be hired to conduct a risk study of PCB equipments that are in service and in good

condition. This study will: (i) assess the potential risks of in-service PCB equipment on

human health (workers or nearby residents), and the surrounding environment; and (ii)

assess the sensitivity of the receiving environment; and (iii) propose short-term

mitigation measures. The findings from this study will be used to develop specific PCB

management plans and program contracts. The results of this study could potentially

serve as the basis for another elimination project in the future.

Preparation of a master plan for the management of PCB equipment held by the private

sector. The objective of the master plan is to ensure project sustainability beyond the

project period. This plan is a standard (generic) document which will serve as guidelines

for Tunisia for the management of PCB equipment that was not inventoried during the

first diagnosis (NIP). This could include encouraging establishment of specialized private

companies authorized by the Ministry of Environment, for the restoration of in-service

transformers with a view to reuse them after decontamination (through retrofilling or de-

halogenation), removal, packaging, and transport by land and sea.

Design and implementation of a computerized system for monitoring and evaluating, and

update of the national inventory of PCB equipment. This system will assist the unit

responsible for project management in project monitoring, PCB equipment monitoring,

monitoring of contract programs schedules, updating the inventory, and developing a

national and international network in order to bring together owners and managers of

PCB waste.

Sub-component 1.2.2 Conducting awareness and outreach campaigns for PCBs’

management

12. This sub-component will include the following activities:

Development of a national information dissemination and awareness strategy for all

stakeholders involved in PCB management. This will serve to develop a detailed action

plan, create awareness and prevention of the risks associated with PCB exposure, and

information on proper management of PCB equipment and wastes. This strategy will

eventually strengthen the human capacity to manage PCBs as well as other hazardous

substances. The targeted groups include: (i) Management, monitoring and enforcement

authorities; (ii) The unit responsible for management of PCBs; (iii) Holders of PCB

waste; (iv) Authorized companies for the transportation and treatment of hazardous

wastes; (v) The laboratory(ies) involved in the analysis of PCBs, dioxins and furans; and

(vi) Any other person or entity involved in the management of PCBs.

Organization of large-scale information workshops/seminars: (i) Organize regular

workshops and information seminars and monitoring in the presence of all concerned

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parties mentioned above; and (ii) Organize specific information workshops for different

beneficiaries by target audience.

Awareness campaign for the management of PCBs: (i) Educational leaflets, posters, films

and video projectors will be used for these awareness campaigns. The media will also

play an important role in spreading information; (ii) Actions for education and awareness

of employees in companies that own equipment containing PCBs to warn them against

potential risks that may be caused by exposure or improper waste management; and (iii)

Programs for the minimization of HCW: Technical guides, flyers, media, posters, films).

Sub-component 1.2.3 Providing training in PCBs’ management

13. Training in PCBs will be provided through the provision of consultants’ services and

Training. The main activities are as below:

Training for the different stakeholders in the management of PCBs and participation in

events and study tours:

o Specialized programs will be designed for targeted groups of people involved in

different tasks for implementing specific action plans, including the PCB project

manager;

o This action will support the steps and activities related to the establishment of a

national prevention program, which will include, among other things, the

formation of committees involved in the project. It will focus on capacity building

activities in Tunisia for sound management of PCBs (training workshops,

documentation, media programs, press coverage, training courses);

o Training of all staff involved in the management of PCB wastes (packaging,

storage, transportation, and handling of different types of PCB waste);

o Training of trainers at training workshops;

o Strengthening management and monitoring and enforcement teams at the

organizational level mentioned under 1.2.1;

o Training and technical assistance to staff monitoring PCB management: staff in

charge of waste handling regarding storage, operation and maintenance of

treatment equipment; and the transportation staff on the regulations concerning

the transportation of hazardous materials; and

o Participation in various national and international events related to PCBs and

POPs; seminars and workshops/courses will be handled by experts covering

theoretical and practical aspects. Participants will be divided into the public

sector, private sector, and NGOs.

Technical assistance and support to staff responsible for monitoring PCB management.

These are specific consultations that require a short-term technical assistance from an

expert for:

o Drawing up the terms of reference of different tasks and bidding documents for

the project;

o Assessing studies and reports made by consultants;

o Monitoring the project;

o Monitoring collection, transportation and disposal activities; and

o Preparing training and awareness programs.

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Component 2: Improvement of HCW and PCBs’ Management and Disposal (US$12.837

million: GEF US$3.872 million and co-financing US$8.965 million)

14. The objective of this component is to establish the state of-the-art and economically

feasible models of HCW and PCB management in Tunisia for reducing or eliminating

environmental discharges of HCW and PCBs, and air emissions of dioxins, and furans as well as

other hazardous pollutants, and thus mitigating the associated human health and environmental

exposures and risks.

Sub component 2.1: Improvement of HCW management and disposal:

15. This sub-component will include: (i) the acquisition of equipment for internal collection,

and in situ storage of HCW in public healthcare facilities; (ii) the supply of equipment to the

intermediate and central storage units in public healthcare facilities in Grand Tunis, Sousse-

Kairouan, Monastir-Mahdia, Sfax, Gabes, Medenine and Tataouine; and the preparation of

ESMPs for such storage units; and (iii) the transportation, and treatment of HCW in privately

owned treatment facilities and final disposal in controlled landfills, through the provision of

goods and consultants’ services.

16. Through the sub-component (a), the Project will finance the following three lots: (i) the

acquisition of local and centralized interim storage (lot 1); (ii) the acquisition of equipment for

collection and in-situ transportation of HCW (lot 2); and (iii) the acquisition of freezers for

storage of placentas in the maternity services covered by the project (lot 3). Sub Component b

(the supply of equipment to the intermediate and central storage units) and sub component c (the

transportation, and treatment of HCW) will be financed by the recipient through its co financing

to the project, no GEF resources will be allocated to these 2 sub components.

17. This subcomponent involves investments at public healthcare facilities for sound HCW

management. Transportation of HCW from public healthcare centralized storage of entities to

the authorized private processing facilities and transport of treated waste to the controlled landfill

will be provided by licensed private sector companies. This component is expected to reduce or

eliminate furan and dioxin from HCW incinerations. The component will also contribute to the

reduction of other adverse human health impacts and environmental discharges resulting from

improper HCW management. In addition, this component is expected to improve HCW

management practices and hygiene at healthcare facilities, allow private sector participation in

HCW treatment and treatment at a large scale in various regions of the country. The component

aims at processing 3184 t of dangerous HCW, thus reducing 8 percent of the total emissions of

furan and dioxin in Tunisia out of 15 percent.

18. Under this sub-component, an appropriate management system will be put in place, in

accordance with the provisions of Tunisian Decree No. 2008-2745 of July 28, 2008 on

modalities and conditions of sanitary waste management (in particular with regard to sorting,

packaging, collection, storage, transportation, and processing). The subcomponent includes the

management of 3,184 T/year of HCW generated by public healthcare facilities:

In the North (1,555 T/ year in the governorates of Tunis, Ariana, Manouba, and Ben

Arous),

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The Central region (937 T/year in the governorates of Sousse, Monastir, Mahdia, and

Kairouan), and

The South (692 T/year in the governorates of Sfax, Gabès, Tataouine, and Médenine).

19. Also covered by this project, in particular under the “Awareness raising, training, and

capacity building” component, are private healthcare facilities, which produce 845 T/year in

Greater Tunis, 163 T/year in the Central region, and 253 T/year in the South.

Sub-component 2.1.1 Acquisition of equipment for internal collection, and in situ storage of

HCW in public healthcare facilities:

20. Through this sub-component, the GEF will finance the following three lots (i) the

acquisition of local and centralized storage facilities (lot 1), (ii) the acquisition of equipment for

collection and in-situ transportation of HCW (lot 2); and (iii) the acquisition of freezers for

storage of placentas in the maternity services covered by the project (lot 3).

21. Preliminary feasibility studies conducted in this context have helped identify the number

of intermediate and central units included in this invitation to bid, which are summarized in the

table 2 below.

Table 2: number of intermediate and central units included in this invitation to bid

Governorate No. of Public

Healthcare Facilities No. of Intermediate

Storage Units No. of Central Storage

Units

Greater Tunis

Greater Tunis 128 128 22

East Central

Sousse 46 46 6

Monastir 39 39 10

Mahdia 24 24 11

Kairouan 27 27 10

Subtotal 136 136 37

South East

Sfax 51 51 10

Gabes 21 21 5

Tataouine 11 11 4

Medenine 31 31 7

Subtotal 114 114 26

Total 378 378 85

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Sub-component 2.1.2: The supply of equipment to the intermediate and central storage

units in public healthcare facilities in Grand Tunis, Sousse-Kairouan, Monastir-Mahdia,

Sfax, Gabes, Medenine and Tataouine.

22. Preparation of international standard bidding documents and environmental and social

impact management plans. Throughout its co-financing, the Government will finance the

following activities:

Preparation of an environmental and social impact management plan consistent with the

environmental and social impact assessment framework at the determined areas for

intermediate and central storage units; and

Supply of equipment fixed equipment in good condition and in sufficient quantity to

carry out internal collection and packaging activities (consommables : gants, sacs,

conteneurs, etc. ainsi que des équipements de protection); and sufficient equipment

supply for three months’ worth of operation must always be available in advance.

Sub-component 2.1.3: Transportation, and treatment of HCW in privately owned treatment

facilities and final disposal in controlled landfills (with co-financing provided by

counterparts):

23. The proposed co-financing will supply mobile equipment for external transportation, in

order to ensure traceability.

24. The equipment required is expected to be able to manage HCW generated by State

institutions. The quantity of HCW generated in the study zone is indicated in the following table:

Table 3: Quantity of HCW generated in the study zone

Zones Areas of

intervention Amounts of Potentially

Infectious HCW (from public

healthcare facilities) in T/year

Total No. of Common

Treatment

Installation

(CTI)

Greater Tunis Greater Tunis 1,555 1,555 3

Central region Sousse & Kairouan 522 937

1

Monastir & Mahdia 415 1

South East Sfax 457

692

1

Gabès 107 -

Tataouine 31 -

Médenine 97

TOTAL 3,184 6

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Sub-component 2.2 Improvement of PCBs’ management and disposal through:

25. This sub-component will include: (i) the transportation and elimination of in-stock PCBs-

equipment, wastes and in-service PCBs-equipment in bad condition belonging to sector

Ministries; (ii) the transportation and elimination of in-stock PCBs-equipment, wastes and in-

service PCBs-equipment in bad condition belonging to public entities (of which GEF will co-

finance with these entities 40 percent of the cost); (iii) the preparation of ESMPs for PCBs

contaminated sites, and a study on the rehabilitation of contaminated sites focusing on the

environmental and geotechnical analysis; and (iv) the decontamination of sites, through the

provision of goods, non-consulting services and consultants services.

26. The specific objective of this subcomponent is to eliminate PCB-contaminated equipment

and PCB wastes held by fifteen state companies associated with six ministries. The amount of

equipment contaminated by PCBs and PCB oils to be treated as a priority under this project is

approximately 1,100 tons. This includes discarded PCB equipment and oils as well as other PCB

equipment that are still functional, but in poor condition. These PCB equipment and wastes will

be removed, packaged, transported to a temporary storage facility, and then exported to Europe

for destruction. A temporary storage facility will be used for PCB-contaminated equipment and

PCB wastes.4 Elimination of high-risk PCB wastes and equipment from Tunisia and sound

management of the remaining PCB equipment in good condition will reduce considerably the

associated human health and environmental impacts. In addition, Tunisia will gain considerable

experience through both the private and public sector participation in PCB management, and this

experience will greatly facilitate the remaining PCBs from the country by 2025. The Project aims

at eliminating 1,100 tons of PCBs, representing 65 percent of 1700 tons of PCBs inventoried in

Tunisia.

Sub-component 2.2.1 The transportation and elimination of in-stock PCBs-equipment,

wastes and in-service PCBs-equipment in bad condition belonging to sector ministries.

27. The activities include: (i) on-site dismantling of PCB equipment in bad condition, (ii)

packaging of dismantled PCBs equipment along with other PCBs equipment and wastes

(including PCBs oils) in stock, (iii) land transportation of packaged PCBs equipment and wastes

to a temporary storage facility, (iv) storage at temporary storage facility, (v) land transportation

from the transportation facility to the port of Tunis, (vi) shipping from the port of Tunis to the

port in Europe, (vii) land or rail transportation from the port in Europe to the treatment/

destruction facility in Europe, and (viii) treatment/destruction of the PCBs equipment and wastes

at the treatment/destruction facility in Europe.

4 This would require preparation of the environmental and social impact assessment (ESIA) and permitting of this

temporary storage facility by the regulatory authority

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Sub-component 2.2.2 The transportation and elimination of in-stock PCBs-equipment,

wastes and in-service PCBs-equipment in bad condition belonging to public entities (of

which GEF will co- finance with these entities 40 percent of the cost of elimination):

28. The activities include: (i) on-site dismantling of PCB equipment in bad condition, (ii)

packaging of dismantled PCBs equipment along with other PCBs equipment and wastes

(including PCBs oils) in stock, (iii) land transportation of packaged PCBs equipment and wastes

to a temporary storage facility, (iv) storage at temporary storage facility, (v) land transportation

from the transportation facility to the port of Tunis, (vi) shipping from the port of Tunis to the

port in Europe, (vii) land or rail transportation from the port in Europe to the treatment/

destruction facility in Europe, and (viii) treatment/destruction of the PCBs equipment and wastes

at the treatment/destruction facility in Europe.

Sub-component 2.2.3 Preparation of environmental and social management plans for

PCBs contaminated sites, and a study on the rehabilitation of contaminated sites.

29. Specific activities include: (i) based on the findings of the environmental audit of PCBs-

contaminated sites, environmental and social management plans (ESMP) will be prepared for

PCBs-contaminated sites; (ii) preparation of management plan pour each PCBs contaminated

site; and (iii) preparation of a remedial investigations study which will assess the extent of PCBs

contamination, if any, of the soils, structures (buildings, storage areas), and associated risks. The

feasibility study will evaluate alternative options for cleaning the sites to acceptable levels and

present a specific recommendation. The remedial action plan will provide a detail plan for site

remediation with an estimated budget and schedule.

Sub-component 2.2.4. Decontamination of sites (financed by counterpart funding).

30. The decontamination of sites will be carried out with the co-financing provided by

counterparts.

Component 3: Project Management (US$0.378 million – GEF US$0.140 million and co-

financing US$0.238 million).

31. Supporting the PCU in carrying out the Project management, coordination,

implementation and monitoring and evaluation through the provision of goods and consultants

services. This component will include: (i) operational costs for the Project Coordination Unit

(PCU). The PCU within ANGed is in charge of implementation, coordination and technical and

financial management of the Project. The unit will participate in policy coordination, assist in the

preparation of the national program and planning review, coordinate training, oversee

operational research and studies, monitor and evaluate the program, convene meetings with the

Steering Committee and will provide it with necessary information; (ii) establishment of a

monitoring and evaluation system. This will include elaborating and implementing the overall

results framework, data collection and monitoring of ODS emissions of project sites, as well as

financial reporting; and (iii) purchase of office equipment and materials.

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Annex 3: Implementation Arrangements

Tunisia: Demonstrating and promoting best techniques and practices

for managing healthcare waste and polychlorinated biphenyls (PCBs) project

I. PROJECT ADMINISTRATION MECHANISMS

The implementation arrangements for the project are as follows:

1. The project will be implemented by the Agence Nationale de Gestion des Dechets

(ANGed) in close collaboration with the Ministry of Health, the Ministry of Industry and the

Tunisian Society for Electricity and Gaz. ANGed is mandated, as per its decree of establishment

dated August 2005, to implement projects identified within waste management national

programs, to provide technical assistance to industries for enhanced waste management and to

contribute to the elaboration of necessary regulations for all types of waste management. A

Steering Committee (SC) has been established by the Ministry of Environment in December,

2010 through a Ministerial Decision. The SC is to provide strategic guidance to, and overall

monitoring of, the program, and facilitate the coordination and collaboration between the

different ministries and agencies concerned by the program. The committee includes

representatives from key ministries, such as: the Ministries of Industry, Finance, Interior and

Local Development, Public Health, and other stakeholders concerned by the project, including

ANGed, GEF Focal Point, National Environmental Protection Agency (ANPE), la Société

Tunisienne de l’Electricité et du Gaz (STEG), le Groupe Chimique Tunisien (GCT), la

Compagnie des Phosphates de Gafsa (CPG) and Le Fouledh. The Steering Committee has

delegated the responsibility for managing the project to the Director General (DG) of ANGed,

and the DG will be the World Bank’s main interlocutor on aspects of project policy and decision-

making.

2. A Project Coordination Unit (PCU has been established within ANGed. This unit is a

virtual one, not specifically created for the implementation of the project, as it is composed of

ANGed’s staff who have direct responsibilities in their respective units for daily management of

hazardous waste in general and healthcare waste and PCBs in specific. This set-up is ideal to

ensure the sustainability of the project and its complete integration with the functions of ANGed

and its work program beyond the life time of the project. The PCU is responsible for the overall

supervision and coordination of the project, monitoring the project’s progress and that the

outputs and outcomes are consistent with the planned indicators and for the dissemination of the

project’s information and results. The PCU is headed by a Project Director and two project chiefs

respectively responsible for HCW and PCBs. The major responsibility of the Director is to:

(i) coordinate project activities; (ii) supervise executing units of the two components HCW and

PCBs; and (iii) insure that project progress and results are in conformity with recommendations

of the SC, and responsible for the dissemination of the program. The two chiefs ensure day to

day project management and implementation, technical supervision of project activities of

respective components. They will also participate in monitoring and evaluation missions and

supervise the consultants and advisors financed under their respective components. The chiefs

will be supported by technical experts of HCW and PCBs.

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3. The PCU is supported by two departments within ANGed for fiduciary aspects (financial

management and procurement) and the Legal Department. Two senior officials from these two

departments are also to provide their respective technical support to the components of HCW and

PCBs during project implementation. In addition, a high level professional from ANPE is

responsible for the environmental monitoring of the project. ANGed is currently implementing

four Bank projects, namely: Sustainable Municipal Solid Waste Management (P095012), Jebel

Chekir Solid Waste Carbon (P099670), Nine Landfills Carbon Finance (P099672).

4. The project will be implemented on the basis of partnership of different government

agencies and sectors. Joint Working Groups with the Ministry of Health, the Ministry of Industry

and STEG have been established for the implementation of the project, and have been involved

with ANGed at all stages of project preparation. To make the partnership implementation more

effective, ANGed, the PCU and the Legal Unit are preparing framework conventions with the

line ministries and specific conventions with the related entities have been drafted in view of

confirming the partnership, operational agreement. Co-financing for the project implementation

has already been confirmed by exchange of correspondences between the Ministry and

beneficiary ministries and institutions. This procedure is clearly spelled out in the Operations

Manual.

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ANGED PDS (D.Soins/PCB)

Project Manager

Procurement

Financial Management

ANPE

Environmental

Monitoring

HCW project chief PCBs Project Chief

ANGED

General Manager

Steering Committee

President Ministry of Environment

Secretariat Project Coordinator

Participants M.E (DGEQV); M. Industry; M. Finances; M.

Interior (DGCPL); GEF Focal point; M. Invest. and

International coop.; M. Health (DHMPE); ANGed ;

ANPE ; ANME and STEG

Chart 1: Project Management flowchart

Working Groups / Implementing

units :

Ministry of Health

Ministry of Industry

Coordination – International

Cooperation

Legal

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II. FINANCIAL MANAGEMENT, DISBURSEMENTS AND PROCUREMENT

A. Financial Management

5. Demonstrating and Promoting Best Techniques and Practices for Managing Healthcare

Waste and Polychlorinated Biphenyls (PCBs) project will be implemented by the ANGed. A

financial management (FM) assessment was carried out in the course of the preparation of the

Project, in accordance with the Financial Management Practices in World Bank Financed

Investment Operations Manual, dated March, 2010. The purpose of the assessment was to

determine whether the ANGed, Executing Agency, has acceptable financial management and

disbursements arrangements in place to adequately control, manage, account and report about the

funds to be allocated to this Project.

6. These arrangements include, but are not limited to its capacity to: (a) properly manage

and account for all Project’s proceeds and transactions, (b) produce timely, accurate and reliable

financial statements and reports, including Interim Financial Report (IFRs) for Project

Management and other Bank purposes, and (c) disburse Bank funds in the most efficient way, in

accordance to applicable Bank rules and procedures. For that purpose, field visits and work

sessions with ANGed staff were held to obtain an understanding of the current applicable FM

systems and to discuss and agree on the FM arrangements to be in place during project

implementation.

7. The findings of the FM assessment concluded that financial management arrangement as

set out for this Project satisfy the Bank’s minimum requirements and that financial management

arrangements in place can provide, with reasonable assurance, a accurate and timely information

on the progress of project implementation.

8. Although minor interventions will be required in order to enable the FM systems to adapt

to the project needs, the overall FM risk has been assessed as “Moderate” provided that the

mitigating measures outlined above will be carried out successfully:

• Preparing on annual basis the project disbursement plan;

• Ensuring that the management information system is in place and implemented

efficiently;

• Updating the ANGed procedures to reflect Bank project implementation arrangements;

• Amend the existing chart of account in order to use separate accounts and sub-accounts

for the project transactions; and

• Submit to the bank IFRs format.

9. Fiduciary management: The 2010 PEFA concluded that the legal and administrative

framework for public financial management (PFM) is sound and offers a solid level of assurance

regarding the reliability of information and a strong control environment; however the report also

identified transparency and accountability failures notably in the preparation of the budget, as

well as in the execution reporting. Good progress has been made in improving transparency since

the January revolution; however external accountability and transparency would need to be

secured by the constitution under revision.

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10. Corruption/transparency and civil society: Governance problems have been a key factor

preventing higher growth and employment. Corruption, cronyism and anti-competitive practices

helped to foment popular discontent that led to the overthrow of the previous regime, as well as

lack of adequate participation, transparency and accountability. Redressing these issues is at the

heart of the political transition and the Constituent Assembly Government’s reform program.

11. Experience in the sector: the Bank has a prior experience in the sector through ANPE

(Agence Nationale de Protection de l’Environnement) and ANGed. In addition ANGed have

currently 4 on-going projects financed by the World Bank and have a significant experience in

the management of externally funded projects.

12. Project Risks: the project will be implemented by the Agence Nationale de Gestion des

Déchets (ANGed) which is a public enterprise with financial, but not administrative, autonomy

under the tutelage of the Ministry of Environment. ANGed was created in 2005 by decree No.

3005-2317 of August 22, 2005, following the separation of the Solid Waste Department from the

ANPE. ANGed will create a Project Coordination Unit (PCU) for project implementation and

will rely on financial department to oversee financial management issues.

13. Assessment of ANGed financial management being the accounting system and

accounting policies and procedures, budgeting system, reporting, staffing, internal controls

policies and procedures, internal auditing and external auditing arrangements reflected that these

arrangements are satisfactory and meet the Bank’s minimum requirements. These procedures are

well known by the Bank since ANGed has on-going projects. However, the accounting system in

place, the chart of account and the ANGed policies will need to be amended or enhanced to

become capable to follow on the project accounts and generate timely financial reports for

project management and decision making.

Financial Risk Assessment and Mitigation

14. The project will be implemented by ANGed. ANGed is a public enterprise and, as such

must comply with current legislation governing the administrative, technical and financial

operations of public enterprises. ANGed is also under the State’s financial control. The general

legislation governing the organization of public enterprises as well as specific guidelines for

ANGed specify the framework for its organization and operation, particularly as regards

financial and accounting procedures. The main provisions are described below.

15. Administrative Structure: ANGed is headed by a director general (DG) nominated by

decree. The DG is authorized to make decisions according to current legislative and regulatory

provisions for non-administrative public enterprises. A governing board comprising 11 various

ministry representatives was also created to support the DG in his functions.

16. Budgetary System: The DG is responsible for finalizing the annual provisional operating

and investment budget as well as the financing plans for investment projects which he then

submits to the board of director by the end of August. This budget must then be approved by the

tutelage ministry and the Ministry of finance.

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17. The budgetary process is conducted by ANGed performance control and management

department. (Direction du contrôle de gestion). This department has good planning and

budgeting capacity which would enable ANGed to prepare sound plans and budgets. Project

disbursed plan would be prepared during the preparation of the project and up-dated each year.

18. Accounting System: The accounting system of the ANGed is considered acceptable to the

World Bank. ANGed staff is familiar with World Bank requirements having been involved in

several projects financed by the Bank. The ANGed maintains proper accounting books and

records in compliance with the provisions of the Tunisian accounting system for enterprises

which that follows the accrual basis of accounting. Bookkeeping is automated through MIS -

system. Supporting documentation is kept properly.

19. The budgetary year starts on January 1 and ends on December 31. The General Director

of ANGed prepares financial statements and submits them to the board of director for approval,

not later than three months after the close of the budgetary year and based on a report prepared

by the external auditor. ANGed is also required to publish by August 31 of each year the

approved financial statements for the previous year in the official journal of the Tunisian

Republic.

20. Project accounting will be integrated to ANGed accounting system.

However it is agreed to:

• Amend the existing chart of account in order to use a separate accounts and sub-accounts

for the project transactions; and

• Up-date fund management MIS by configuring agreed project IFRs format.

21. Internal Control: There are several levels of internal control: (a) ANGed’s official

structure which clearly separates specific functions from independent control mechanisms; (b)

the General Director of ANGed as payment originator; (c) the State controller appointed by the

Prime Ministry responsible for adherence to regulations; (d) the Central Bank of Tunisia as

payment department; and (e) the Prime Minister, the Ministry of Finance and the Ministry of

International Cooperation in compliance with current legislation and regulations on tutelage over

public, non-administrative enterprises.

22. Internal Control & Auditing: Procedures have by large been established by the ANGed

and institutionalized in the form of Financial Management Manual, and Internal instruction.

Nevertheless, the financial policies and procedures in place needs to be updated to reflect project

implementation arrangements and adequately communicated to all employees.

23. The Internal Audit Department is responsible for conducting internal audit for all ANGed

departments. The Internal Audit Department staff is composed of two persons, a recruitment of a

third one is plan in 2012. It is recommended to assess the Internal Audit Department in order to

appreciate its capacity to meet ANGed needs.

24. ANGed is always subject to an external audit, to the Control of the Cour des Comptes, to

the General control of Ministry of Finance and to the General control of public services.

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B. Disbursements

25. The counterpart funds for the Project will be made available to ANGed in accordance

with the applicable Tunisian procedures and legislation; and in a timely manner so as to ensure

the good execution of the project.

26. The Grant funds will not be transferred to ANGED, the Project Implementation Entity,

but will remain with the Republic of Tunisia, the Recipient of the Grant. The Ministry of

Investment and International Cooperation (MoIIC) will open a Designated Account (DA) at the

Central Bank of Tunisia, ANGED will be authorized to use this DA for financing of eligible

expenditures. Replenishment Withdrawal Applications will be submitted to the Bank by the

Authorized Signatories at the Central Bank of Tunisia. Separately, MoPIC will provide the Bank

with the name and specimen of signature of the Authorized Officers in ANGED who would send

to the Bank Withdrawal Applications for direct payments that are above the minimum value.

Consequently, this is the reason why there is no need to have a Subsidiary Grant Agreement

between the Republic of Tunisia and ANGED. This designated account will be opened in US

dollar and will receive an initial advance of US$600,000 of the grant amount. Withdrawals of

grant amounts will be based on the Bank’s traditional disbursement methods and will be used to

finance project activities by means of the disbursement procedures currently used, that is,

requests for withdrawals for direct payments, requests for special commitments and/or requests

for reimbursement, either with documentary evidence or expenditure statements, in accordance

with the procedures described in the Bank’s Disbursement Letter and Disbursements Handbook

27. ANGed will be responsible for submitting the documentary proof of services rendered or

activities carried out to the Central Bank of Tunisia (BCT) so that payments can be made from

the Designated Account opened for that purpose, or to submit requests for direct payment to the

Bank. In the event that payments are to be made from the Designated Account, ANGed should

send payment orders to the BCT for services rendered or activities carried, together with

documentary proof. The BCT shall examine the documentation received as well as the

admissibility of the expenditures committed, and then make the payment if the expenditures are

deemed admissible. The BCT shall track the level of the designated account and prepare and

submit requests for withdrawals to the Bank for purposes of replenishing the Designated

Account. In the context of existing disbursement procedures, ANGed shall also be authorized to

submit withdrawal requests for direct payments accompanied by the documentary proof required.

Disbursements will be terminated four months after the project is closed for expenditures

incurred prior to the closing date. ANGed will be responsible to prepare and furnish to the Bank

not later than forty five (45) days after the end of each calendar semester, interim unaudited

financial reports (IFRs) for the Project covering the semester, in form and substance satisfactory

to the Bank. The format of the IFRs will be included in the financial management manual.

Statement of Expenditures

28. Necessary supporting documents will be sent to the Bank in connection with contract that

are above the prior review threshold, except for expenditures under contracts with an estimated

value of : (a) US$300,000 or less for non-consulting services and goods (b) US$100,000 or less

for consulting firms; (c) US$50,000. or less for individual consultants, as well as incremental

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operating costs and training, , which will be claimed on the basis of SOEs. The documentation

supporting expenditures will be retained at ANGed and will be readily accessible for review by

the external auditors and periods Bank supervision missions. All disbursements will be subject to

the conditions of the Grant Agreement and disbursement procedures as defined in the

Disbursement Letter.

External Audit

29. There will be annual audit of the project financial statements, covering all aspects of the

project. The external audit will be performed by independent auditors acceptable to the Bank,

and in accordance with International Standards on Auditing (ISA), and the Bank’s guidelines on

auditing as stated in the guidelines: Annual Financial Reporting and Auditing for World Bank-

financed Activities (June 2003). The auditors’ terms of reference (TORs) will be prepared by

ANGed and cleared by the Bank before the engagement of the auditor. TORs will include both

the audit of the financial transactions and an assessment of the internal control.

30. The annual audit report will consist of a single opinion on the financial statements of the

project, including the reconciliation of the Designated Account, and the Statement of

Expenditures (SOEs) and Withdrawal applications. In addition to the audit report, the auditor

will be required to prepare a management letter. In the management letter the auditor should:

Comment on the accounting records, systems, and controls that were examined during the

audit, including but not limited to flow of funds mechanisms; adherence to policies and

procedures; segregation of duties; proper recording and cut-off of payables and accruals;

and so on.

Comment on other specific systems and processes, such as the administration system and

management information system, monitoring and evaluation, reporting and internal audit.

Recommend improvements where specific weaknesses are identified in any of the above

systems and controls.

Communicate any other matters identified during the audit that might significantly affect

the future implementation of the Project, or that the auditor considers pertinent.

Comment specifically on the appropriateness, and consistency of application of policies.

31. The audit report will be submitted to the Bank no later than six months after the end of

the fiscal year to which they relate. ANGed will provide the auditor with full access to project-

related documents and records, and with the information required for the purpose of the audit. A

draft of audit TORs will be finalized during the preparation of the project.

32. In addition, annual audit reports on financial position and operating results of ANGed

will be due to the Bank within 6 months of the end of each calendar year. ANGed is compliant

with World Bank BP 10.02 with especially regards to audits while implementing the current

World Bank projects.

Supervision Plan

33. Based on the assessed low risk level, the Bank-accredited FMS will conduct annually two

supervision missions for the project in addition to follow up visits if deemed necessary. However

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for the first year of implementation, it is envisaged more FMS implication to ensure proper

implementation of FM arrangements and agreed action plan. The semiannual IFSs for the Project

and the financial audit reports will be reviewed on a regular basis by the Bank FMS and the

results or issues will be followed up in real-time. During the Bank’s supervision missions, the

Project’s financial management and disbursement arrangements (including a review of a sample

of SOEs if applicable) will be reviewed to ensure compliance with the Bank’s requirements and

to develop the financial management rating to the Implementation Status Report (ISR).

Disbursement Arrangements

Table 4: Disbursement categories and amounts

Category Amount of the Grant

Allocated (expressed in

USD)

Percentage of Expenditures to be

Financed (inclusive of Taxes)

(1) Consultants’ services, non-

consulting services and Training:

(a)under Part A , Part B.1 (a),

Part B. 2 (c) and Part C of the

Project;

(b) under Part B.2 (a) of the

Project; and

(c) under Part B.2 (b) of the

Project

1,250,000

1,116,000

1,100,000

100%

100%

100%

(2) Goods under Part A , Part

B.1 (a), Part B. 2 (a), (b) and (c)

and Part C of the Project

1,641,000 100%

(3) Incremental Operating Costs 393,000 100%

TOTAL AMOUNT 5,500,000

“Incremental Operating Costs” means the incremental expenses incurred by the PCU on account of

reasonable and necessary activities directly related to the Project implementation, management and

monitoring, including office supplies, travel and salaries, but excluding the salaries of the civil servants.

The category “Training” means the costs of: (i) reasonable expenditures for local and international travel,

room and board and per diem expenditures incurred by trainers and trainees and by non-consultant

training facilitators in connection with training provided under the Project; (ii) course fees; (iii) training

facility rentals; (iv) training material preparation, acquisition, reproduction, and distribution expenses; and

(v) participating in international workshops and conferences.

Retroactive Financing

34. The Recipient has indicated its intention to pre-finance eligible project expenditures in

order to accelerate implementation and as such Board approval will be sought for retroactive

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financing for payments made prior to the legal agreement date for an aggregate amount not to

exceed US$550,000 equivalent for payments made prior to this date but after June 1, 2011, for

Eligible Expenditures as indicated in the Disbursement Table above.

C. Procurement

General

35. Procurement for the proposed project will be carried out in accordance with the World

Bank Guidelines:

36. Procurement of goods, and non-consulting services under IBRD loans and IDA credits &

grants by World Bank borrowers” dated January 2011 (“Procurement Guidelines”), and

"Guidelines: Selection and Employment of Consultants under IBRD Loans and IDA Credits and

Grants by World Bank Borrowers” dated January 2011(“Consultant Guidelines”) (“Consultant

Guidelines”), and the provisions stipulated in the Grant Agreement. National Competitive

Bidding (NCB) will be carried out with procedures acceptable to IBRD. The methods to be used

for the procurement under this project, and the estimated amounts for each method, as well as the

threshold contract values for the use of each method are set in Table 6.

37. Overall, the revised Tunisian procurement legislation for goods is in line with the Bank's

guidelines for procurement – except for the special provisions mentioned below – and the

country has adequate control organizations. However, substantial divergences exist in the

procedures for the Selection and Employment of Consultants which, following local legislation,

are based on open competitive bidding. Under the project, Tunisian implementing agencies

would apply the Bank's procedures for the Selection and Employment of Consultants.

NCB Special Provisions

38. Except in the cases provided for below, goods shall be procured under contracts awarded

on the basis of paragraphs 3.3 and 3.4 of the guidelines and paragraphs below. Contracts of

goods procured under the National Competitive Bidding procedure shall comply with the

following additional provisions:

(i) The bidding document clearly explains the bid evaluation, award criteria and bidder

qualification criteria;

(ii) Any bidder registered in an eligible country, as defined in paragraphs 1.8 to 1.10 of

the Procurement Guidelines will be eligible to bid; therefore no restriction based on

nationality of bidders or origin of goods shall apply and foreign bidders shall not be

subject to any unjustified requirement which will affect their ability to bid;

(iii) Government-owned enterprises in the Borrower’s country may participate only if they

can establish that they (i) are legally and financially autonomous; (ii) operate under

commercial law, and (iii) are independent from contracting entity;

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(iv) Bidders will be allowed to deliver their bids by mail or by hand before the expiration

of the deadline for submitting bids;

(v) Technical and financial envelopes are submitted together and opened in public,

simultaneously during a unique session open to the public for goods and non-

consulting services; amounts shall be read aloud during the public session; bidders or

their representatives are authorized to attend the bid opening session. The date, time

and place for bid opening shall be announced in the invitation to bid; these date and

time shall be the same as for the deadline for receipt of bids or immediately thereafter;

(vi) Bids are evaluated on price and any other criteria disclosed in the bidding documents

and quantified in monetary terms and contracts are awarded to the qualified bidder

having submitted the lowest evaluated responsive bid, and price shall not be

negotiated with the lowest evaluated bidder except under the provisions stated in

paragraph 2.63 of the Procurement Guidelines;

(vii) Procedures will include the publication of the evaluation results, the contract award

and provision for bidders to protest;

(viii) If foreign firms wish to participate, they shall be allowed to do so and no provision

for preferential treatment of national firms or mandatory association with a national

firm or prior registration in the country of the Borrower shall be applied;

(ix) Prior to issuing the first call for bids, a draft standard bidding document to be used

under National Competitive Bidding procurement must be submitted to and found

acceptable by the Bank; and

(x) Each bidding document and contract for goods to be financed from the proceeds of

the Grant shall provide that the supplier, contractor and subcontractor shall permit the

Bank, at its request, to inspect their accounts and records relating to the bid

submission and performance of the contract, and to have said accounts and records

audited by auditors appointed by the Bank. The deliberate and material violation by

the supplier, contractor or subcontractor of such provision may amount to obstructive

practice.

Project Management

39. A Project coordination unit is already established within ANGed. The PCU is responsible

for the overall supervision and coordination of the project, monitoring the project’s progress and

that the outputs and outcomes are consistent with the planned indicators and for the

dissemination of the project’s information and results. The PCU will be supported by a

Monitoring and Evaluation (M&E) Committee consisting of agencies and department of

ministries outside of ANGed, and two departments within ANGed for financial management and

procurement. Two senior officials from these two departments will also provide their respective

technical support to the components of HCW and PCBs and will be the interlocutors to the

World Bank during their supervision and appraisal missions. In addition, another senior official

from the National Environmental Agency will be responsible for environmental monitoring of

the project.

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Procurement of Works

40. No works are currently foreseen under this project.

Procurement of Goods

41. Goods to be financed for the PCBs component will mainly include vehicles, office

equipment, computer hardware and software, and various other equipment and materials for the

implementation units and provision of reference data. For the HCW component the goods will

mainly include equipment and supplies for healthcare waste collection and storage, office

furniture and equipment, teaching material (guides, flyers, etc.) . The equipment for healthcare

waste collection and storage will be procured thru an ICB using the Bank’s Standard Bidding

document for Goods. However, and given the size of the contracts and the availability locally of

the other goods, their procurement will be through National Competitive Bidding (NCB),

Shopping and Direct Contracting in special circumstances comply with clause 3.7 of the

Guidelines. The procurement will be carried out using the National Standard Bidding

Documents (SBDs) agreed with and satisfactory to the Bank for NCBs.

Procurement of non-consulting Services

42. The main non-consulting services to be financed for the PCB component will cover the

disposal of PCB-contaminated equipment and the decontamination of the contaminated sites.

This will include PCB-contaminated oils owned by STEG and other privately-owned oils that are

stored in inadequate facilities around the country and (ii) the establishment of a temporary

storage. Given that Tunisia has no facilities for PCB treatment, this contract will be procured

through an international competitive bidding (ICB) and the Bank’s standard bidding documents

for the procurement of non-consultant services shall be used.

Consultants’ services

43. The services of consultants, for an overall amount equivalent to US$937,000 for technical

assistance for institutional support, monitoring and evaluation, studies, will be provided by

national and international consultants. Requests for expressions of interest in consulting services

expected to cost more than the equivalent of US$200,000 are to be published on the UN

Development Business web site and in its publication, and in at least one national daily

newspaper. For such contracts, the procedure to be used will be the Bank’s standard Request for

Proposal (RFP) documents; a short list of qualified consulting firms will be selected, and the

default method used will be Quality- and Cost-Based Selection (QCBS). For all contracts in

amounts exceeding US$200,000, the Quality- and Cost-Based Selection (QCBS) method will be

used. For contracts valued at less than the equivalent of US$200,000, the short list may include

only national consultants if a sufficient number of Tunisian firms exist and if those firms are cost

competitive. However, if foreign firms express interest, they may not be excluded from

consideration.

44. For contracts with an estimated value equal to or less than the equivalent of US$200,000,

the selection method may be based on the Consultant’s Qualifications, selection under a Fixed

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Budget, Quality Based Selection or Least-Cost Selection. Individual consultants will be

selected and employed in compliance with the provisions of paragraphs 5.1 to 5.6 of the

Consultant Guidelines. The need for Single-Source Selection of consultants is not currently

foreseen, but should it prove warranted it must be carried out in compliance with the provisions

of paragraphs 3.8, to 3.11.

Assessment of ANGed’s capacity to execute the project procurement activities

45. ANGed’s capacity to execute procurement activities in the framework of this project has

been assessed and the report is filed with the project documents. The executing agency, ANGeD,

would have the capacity to carry out and manage the procurement under this financing, provided

that the actions recommended in the Action Plan are taken before effectiveness. This does not

apply to the Procurement Plan which should be provided by the negotiation date. The risk has

been rated as Moderate. The frequency of procurement supervision including PPR/Audit will

be every 6 months.

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46. The Action Plan is summarized below:

Table 5: ANGed Action Plan

Analysis of Procurement

Capacity Issues/Risks Mitigation Measures

1. Organization.

ANGeD PCU is not

committed to this

responsibility and the tasks

that it entails.

Make the implementation

arrangements including

coordination and reporting

responsibilities clear in the

Project Operation Manual. 2. Facilities, Support Capacity

and Staffing/Professional

Experience.

There are some doubts

about the full availability of

the other staff and capacity

to produce adequate

procurement documentation

in a timely manner.

(i) Carry out a training to brief

and update the staff

responsible for the HSW

and PCB components on

the Bank on the main

procurement procedures --

expected to be used in the

project implementation --

before its start; and (ii) Provide for outside

technical assistance from a

procurement specialist to

help in the preparation of

the documents for

procurement and selection

of consultants. 3. Record Keeping and Filing

System.

Capacity to cope with the

project volume of

transactions.

Instructions and training given

to ensure that project specific

files are kept for all

procurement and related

transactions and recorded

contract by contract.

4. Procurement Planning.

Procurement Plan not

updated The executing agency should,

periodically, update the

procurement plan

5. Monitoring/Control Systems.

Procedures used are not

fully compliant with the

Bank ones.

Have a Procurement Operation

Manual, describing in a clear

manner the adequate

procedures to follow for the

implementation of the project.

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47. The methods to be used for the procurement under this project, and the estimated

amounts for each method, as well as the threshold contract values for the use of each method are

set in Table A below.

Table 6. Thresholds by Method and Prior Review

Category of

Expenditures

Threshold of

Contracts Cost

Estimate (‘000 US$)

Procurement or

Selection Method

Contract Subject to Bank Prior

Review

1. GOODS ≥ 1,000 ICB ≥ 3,000,000 and first contract

regardless of its value > 100& <1,000 NCB First contract, then post review ≤ 100 Shopping

(3 quotations) First contract, then post review

2. NON-

CONSULTING

SERVICES

≥ 1,000 ICB ≥ 3,000,000 and first contract

regardless of its value > 100& <1,000 NCB First contract, then post review ≤ 100 Shopping

(3 quotations) First contract, then post review

3.C

ON

SU

LT

AN

T S

ER

VIC

ES

Fir

ms

≥ 200 QCBS ≥ 1,000,000 and first contract

regardless of its value >100 &<200 QCBS

CQS/LCS/FBS post review

≤ 100 QCBS

CQS/LCS/FBS First contract, if any, then post

review NA SSS All contract regardless of value

Ind

ivid

ual

Co

nsu

ltan

ts

≥ 50

Consultants

Guidelines Section V

≥ 300,000 Evaluation report

comparison of CVs, TORs, and

draft contracts.

<50

Consultants

Guidelines Section V

First contract, if any, as above,

then post review

NA SSS All contracts regardless of value

QCBS = Quality- and cost-based selection

LCS = Least cost selection

SSS = Single-source selection

CQS = Selection based on consultant’s qualifications

FBS = Selection under a fixed budget

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Procurement Planning

48. As agreed during the appraisal, a Project Operation Manual was prepared and include the

description of applicable procurement procedures, as well as the detailed procurement plan for

the first 18 months of activity which should have been approved during negotiations.

Goods/Non-consulting services

49. One ICB contract is expected for the purchase of healthcare waste collection and storage

equipment. . In addition, the disposal of PCB-contaminated equipment and the decontamination

of the contaminated sites will be carried under an ICB and the Bank’s standard bidding

documents for the procurement of non-consultant services shall be used.

Consultants’ Services

50. The consulting services are detailed in the procurement plan. However, there are no

consulting assignments with short-list of international firms foreseen during the first 18 months

of project implementation

III. ENVIRONMENTAL AND SOCIAL (INCLUDING SAFEGUARDS)

Measures taken to address safeguard issues

51. An environmental and social impact assessment framework (ESIAF) was prepared by an

independent national consulting firm in accordance with OP 4.01 and the Tunisia EIA decree No

2005-1991. The Project is essentially an extensive cleanup and contamination-prevention

operation which will bring substantial environmental health benefits, both locally and globally,

by removing PCBs equipment and treatment of HCW and preparing plans for remediating

contaminated site. The project components constitute the mitigating, monitoring and

institutional measures to reduce/eliminate the adverse project impacts. However, the project

carries some short-term high environmental risks, specifically as related to the removal and

transportation of HCW and PCB equipment. These risks are discussed in Annex 8 as part of a

summary of the environment safeguards.

52. An environment and social management framework (ESMF) was prepared which

includes the incremental cost for the preparation of environment management plans for sites

specific or group of sites specific the HCW storage facilities estimated at US$100,000. This is

additional to the cost of institutional strengthening and investments related to HCW treatment

estimated at US$1.13 million and US$8.14 million respectively. The ESMF plan also includes

the incremental costs of the preparation of the site specific-or group specific environment

management plans or environmental audits estimated at US$154,000 for PCBs. Decontamination

of the sites was estimated at US$515,000. This is additional to the cost of institutional

strengthening and investments related to PCB treatment of US$829,000 and US$4.26 million

respectively.

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53. A public consultation was held on February 11, 2009, at ANGed. Twenty five

participants attended from the ministries of interior, environment, industry and energy, health

public and private health facility representatives, private contractors as well as five NGOs. The

participants confirmed the importance of the project and endorsed its upcoming implementation.

Some of the comments from the consolation have been taken into account in the project design.

54. The project does not trigger OP 4.12 involuntary resettlement as all the HCW storage

facilities are in the public hospitals and PCB containing equipment will be removed from sites

belonging to public entities (Ministries and state companies) which possess about 1,200 PCB

equipment, of which 900 are off-line and the rest are on line. Most of the PCBs belong to the

company (Société Tunisienne de l’Electricité et du Gaz - STEG and to the Compagnie des

Phosphates de Gafsa). There is therefore no resettlement, no physical displacement of persons or

total or partial loss of revenues resulting from the project. However, there is an office of

complaints which has been established in ANGed to receive and respond to any complaints from

citizens on any issue related to any type of waste. This office also follows up on any complaints,

dispatches the complaints to the appropriate departments and reports the results to the ANGed

director general.

Mechanisms to supervise and monitor agreed plans

55. Given the framework nature of the Project (under which the detailed technical design and

location of storage areas and disposal and treatment sites will be completed during the Project

implementation), the preparation of the Environment and Social Impact Assessment will take

place in two stages:

56. Stage 1: An Environmental and Social Impact Assessment Framework (ESIAF) was

prepared prior to appraisal, and mitigation, monitoring and institutional measures were outlined

in an Environmental and Social Management Framework (ESMF) for each of the two major

components for HCW and PCBs. The ESIAF was prepared by GEREP, an independent national

consulting firm before appraisal, was submitted for public consultation on February 11, 2009 and

disclosed in Tunisia on August 14, 2009 and in the Bank InfoShop on August 16, 2010. The

Project Integrated Safeguards Data Sheet at appraisal was disclosed in September 23, 2010. The

ESIAF executive summary in English was disclosed to the Board on August 16, 2010.

57. Stage 2: The second stage will be the preparation during project implementation of site or

group of sites- specific environment and social management plans (ESMPs) for HCW storage

and treatment sites; and in case visual audit results on PCB contaminated sites (for which PCBs

concentration will exceed 50 ppm as required by the Stockholm Convention) show potential

negative impacts, a specific environmental and social management plan of the site or group of

sites, will be prepared, in accordance with the Environmental and Social Impact assessment

Framework (ESIAF) and included in PCBs disposal bidding document. All ESMPs will be

prepared by local consultants to be contracted by ANGed. These ESMPs will be reviewed and

approved by Agence Nationale de Protection de l’Environnement (ANPE) as required by the

Tunisian EIA decree. ANPE has a long track record of reviewing EIAs and this was recognized

in the Safeguard Diagnostic Review that the Bank carried out under the Sustainable Municipal

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Solid Waste Management Project5. During the first year of project implementation, the World

Bank will review and clear the individual subproject specific ESMPs. All ESMPs will be

disclosed on the ANGed website and in the corresponding municipality and site for PCBs and

hospital for HCW, and in the InfoShop according to the Bank's Policy on Disclosure of

Information. As executing agency for the Project, ANGed will be responsible to follow up on

the mitigating measures and will report them as part of the progress report to the project. After

the confirmation by the World Bank based on an assessment of the Agence Nationale de

Protection de l'Environnement (ANPE)’s environmental and social capacity (which will be

conducted no earlier than one year after the Effective Date), the ANPE will review and clear the

ESMPs. ANPE is the national regulatory agency and it has a strong technical capacity and track

record, especially as a result of fulfilling the gap filling measures related to the Use of Country

System's implementation of the Sustainable Solid Waste Management Project implemented by

ANGeD. Even during the process of the ANPE review of the EMPs during years 2 to 5 of project

implementation in a manner acceptable to the Bank, the Bank will conduct spot checks to

ascertain the quality and efficacy of the review and clearance process by ANPE.

58. The PCU will be responsible to follow up with the implementation of the ESMF,

including the stage 2 sites specific environmental and social management plans. A staff member

in the PCU will be dedicated for the environmental and social safeguards issues. Specific

measures also include: i) training and capacity building, ii) safeguards provisions will be

included into the project operational manual, iii) reporting through the project M&E system, and

iv) World Bank supervision missions.

IV. MONITORING & EVALUATION

59. In order to ensure careful monitoring and continuous results evaluation of project

operations, ANGed, acting through the Project coordination unit and project support, will be

responsible for elaborating and implementing the overall results framework with the indicators

presented in Annex 1. With the support of the Project, the Project Coordination Unit will be

responsible for developing a result monitoring and evaluation system for HCW and PCBs. The

PCU will include a staff member specialized for M&E. Similarly, a higher level professional

from ANPE will be responsible for the environmental monitoring of the project, including

monitoring the application of the national system for environmental monitoring of the PGDDM.

60. Semi-annual, monitoring reports will be prepared and submitted to the Bank for review.

These reports will deal with the progress made at the level of each component and include a

preliminary analysis of the project’s performance as related to the key indicators contained in

Annex 1.

61. Technical, organizational, accounting, and financial audits will be carried out annually to:

(i) monitor, a posteriori, the status of operations and overall progress of the project, and for the

quality and coherence of the means of project execution as compared to the results obtained; (ii)

ensure that ANGed (and the various contributors) adheres strictly to the procedures and to the

technical, financial, social, and environmental instruments developed during execution; and (iii)

5 World Bank Report 35611-TN, February 2007

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ensure that ANGed has the capacity to manage the financial resources mobilized for project

financing and report on its use of funds, and that international accounting norms and sound

bookkeeping standards are respected. ANGed will also develop, in consultation with the Bank, a

system for disseminating data periodically to strengthen the participatory nature of the activities

and to involve the stakeholders and groups affected by the project. The data will refer to the

financial and environmental sustainability aspects that the project is trying to promote and put in

place.

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Annex 4

Operational Risk Assessment Framework (ORAF)

Tunisia: Demonstrating and promoting best techniques and practices

for managing healthcare waste and polychlorinated biphenyls (PCBs) project

Project Stakeholder Risks Rating M

Description :

Coordination and participation have the tendency to focus at the

national level. Management of HCW and PCBs needs joint

efforts from both national and regional/local governments. The

national agencies are responsible for improving the institutional

and regulatory framework for HCW and PCB management and

integrating it into the national development process, while the

regional and local agencies will be responsible for project

implementation at the regional/local level.

The private sector participation would represent a substantial

risk because of the following major reasons: i) lack of

knowledge and information of standards of hazardous waste

management among private waste management companies; ii)

lack of funding from the public health establishments for

hazardous waste management; and iii) there is little competition

given the limited number of qualified private companies in the

waste management sector on one hand and the fact, on the other

hand, that the quantity of HCW generated in certain zones of the

country is not enough to attract private sector operators.

Risk Management :

At the national level, a Steering Committee, chaired by the Minister of Environment, is in place

and has been formalized before the negotiation. For monitoring and enforcement of project

activities at the regional/local levels, regional/local units will be established within the participating

stakeholders.

Implementation arrangements will be specified in the Operation Manual, with clear description of

the Coordinator functions and indication of responsibilities; and the relations between departments

at both the national and local levels.

Several business procedures and forms of reporting will be implemented under this project and the

relevant measures will also be included into the emergency plans.

Specific measures that the project would take to mitigate private participation risks include: i)

directly help with revisions to the regulatory and institutional framework needed to develop a

climate conducive to private sector participation with clear technical standards and guidelines, as

well as monitoring systems; ii) knowledge sharing and capacity building to encourage the private

participation. For example, the Project will help strengthen awareness of private sector of HCW

standards and guidelines, and training in HCWM, environmental assessment, collection and

disposal of HCW; iii) the HCWM pilots have been designed to demonstrate the viability of private

sector involvement which should also include ownership; and iv) using reviews and the M&E

system, including the mid-term review, to monitor and evaluate private participation in view of

adjusting and improving it throughout the project implementation.

Resp: ANGed : Stage: Implementation Due Date : September

2014

Status: under

preparation

Implementing Agency Risks (including fiduciary)

Capacity Rating: L

Description :

ANGed within the Ministry of Environment will be the

Executing Agency for the project. ANGed is currently

implementing four Bank projects, namely: Sustainable

Risk Management :

The PCU has been adequately staffed and strongly based on ANGed existing staff to include a

Director, two chiefs in charge respectively for HCW and PCBs, a Finance Officer, Procurement

and Technical Officers, and an Environment M&E Officer. FM supervision will be provided on an

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Municipal Solid Waste Management (P095912), Jebel Chekir

Solid Waste Carbon (P099670), Nine Landfills Carbon Finance

(P099672), and Africa Stock piles (TF055745). ANGed is

familiar with the Bank requirements in the financial

management and procurement, as well as related reporting and

audits. A Project coordination unit (PCU) has been in place

within ANGed for this project.

ANGed’s capacity to oversee the program’s financial

management has been judged satisfactory, presenting only a

relatively low financial risk. Staff in all implementing agencies

is highly competent with respect to procurement, and

demonstrates an understanding of the main differences between

national procurement directives and those of the Bank, in

addition to goodwill and appreciable capacity in executing

projects according to Bank procedures.

ANGed’s capacity to meet the World Bank’s environmental

safeguard requirements for PCBs still needs to be strengthened.

ongoing basis through the World Bank’s field FM Specialist. Technical training will be provided to

PCU and ANGed.

PCU has an adequate automated accounting system which follows cash basis accounting and

capable of recording all project activities, generating required reports such as the semester IFRs,

and annual financial statements.

ANGed has developed an acceptable Financial Management Manual which defines the project’s

financial management policies and procedures to be followed by the PCU during project

implementation. These procedures are based on having the PCU applying appropriate internal

controls (e.g. segregation of duties, ex-ante reviews, controls over inventory and fixed assets, etc.),

ensuring proper use of funds including safeguarding of the original supporting documents.

Under this unit, the project will finance a dedicated local procurement expert as staff of the PCU.

The procurement officer should be trained immediately and preferably before the Grant Agreement

is signed.

This need has been reflected in Project Component 1 with adequate budget. Expertise and training

will also be provided.

Resp: ANGed Stage: Implementation Due Date : September

2012

Status: Done

partially

Project Risks

Design Rating: L

Description :

Quantification of the reductions in dioxin, furan, and PCB

releases to the environment from different sources/activities is

not always easy to monitor and document.

Anticipated reductions in POPs emissions may not materialize

on time because removing all existing incinerators and shifting

to alternative waste disposals will take time.

Risk Management :

Besides clearly defined baselines and outcome indicators, the project will include a workable and

practical tracking system to monitor POP reduction. This would also be accompanied by training.

In addition, the environment impact assessment for category A project will help further strengthen

the design of the project and increase implementation monitoring.

This project has been designed in conjunction with the National Implementation Plan (NIP). This

plan guarantees that emissions reduction will be addressed by concrete measures within the overall

reforms put in place for the management of HCW and PCBs together with other related World

Bank waste management projects.

Resp: ANGed Stage: Implementation Due Date : Annual Status: To be

done

Social & Environmental Rating: M

Description :

Improper management of PCB equipment/wastes and HCW

may result in adverse impacts on human health and the

environment. These mishaps may happen during poor handling

of HCW with no personal protection equipment, poor

segregation of HCW resulting in infectious waste mixed with

sanitary waste, improper containment resulting in broken bags,

inadequately designed/ operated storage facilities that are

accessible to rodents or insects, poor treatment of HCW in

Risk Management :

The project is designed to strengthen the legal framework. Specific mitigation measures include: i)

issuing the needed HCW and PCB management legislation and guidance documents that are in line

with the strict, internationally accepted protocols; ii) training HCW and PCB personnel in sound

HCW and PCB management techniques and emergency response procedures; iii) carefully

selecting only competent and experienced private sector contractors for transportation and

treatment of HCW and management of PCBs; iv) close coordination with the other institutions in

case of emergencies (e.g. fire houses, hospitals, police); and the controlled landfill already

constructed and made operational by ANGed will be used.

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improperly designed or operated equipment (e.g. incinerators),

transportation in unsafe vehicles, and disposal in improperly

designed or operated landfills. Unsafe handling of PCBs may

also result in PCB spills leading to human exposure and

environmental damage, or fires causing human injuries, or

property damage.

In addition, the project will undertake public awareness campaigns on environmental health for

workers and the communities adjacent to the disposal facilities concerned in order to address the

health and safety requirements as set forth in the ESIAF.

Resp: ANGed and

DGEQV Stage: Implementation Due Date : Annual

Status: under

preparation

Program & Donor (N/A) Rating:

Description :

Risk Management :

.

Resp: Stage: Due Date : Status:

Delivery Monitoring & Sustainability Rating: M

Description :

PCU would have rather high capacity and this will ensure the

delivery quality though national clearance procedures need to be

improved to avoid project implementation delays.

The project involves 85 hospitals and 55 PCBs sites. They also

belong to other ministries than the ME. The capacity at local

and site levels could be quite weak.

Risk Management :

A comprehensive study on Process Simplification will be carried out under the project to assess

and formulate action plan to enhance delegation of authority and reduce levels of required

clearances.

The project will use several ways to prevent delays: i) using the SC to strongly engage other

partners at the national level; ii) using conventions/contracts to recognize the rights of other

partners in the project and have them take the responsibilities; iii) training for stakeholders,

including participating staff at hospital and site levels; iv) regular monitoring and follow ups

Resp: SC and ANGed Stage: Implementation Due Date : annual Status: under

preparation

Implementation Risk Rating Rating: Moderate

Comments: Appropriate mitigation measures will be taken so as to ensure, among others: i)

directly help with revisions to the regulatory and institutional framework needed to develop a

climate conducive to private sector participation with clear technical standards and guidelines, as

well as monitoring systems; ii) knowledge sharing and capacity building to encourage the private

participation; iii) provide incentives to micro-enterprises to undertake the HCWM from collection

to disposal in remote areas; iv) using reviews and the M&E framework, including the midterm

review, to monitor and evaluate private participation in view of adjusting and improving it

throughout the project implementation; v) increasing public awareness on PCBs and other

hazardous waste; and vi) ensuring coordination among different agencies and stakeholders’

awareness and participation.

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Annex 5: Implementation Support Plan

Tunisia: Demonstrating and promoting best techniques and practices

for managing healthcare waste and polychlorinated biphenyls (PCBs) project

What would be the main focus in terms of support to implementation? Time Focus Skills Needed Resource Estimate Partner Role

First twelve

months

Technical and

procurement review of

the bidding documents

Financial

management/reporting

Monitoring and

Evaluation system

HCW and PCBs

Environmental

safeguard

Institutional

arrangements and

project supervision

coordination

Team Leadership

Procurement

specialist

FM specialist

Waste

management and

IT experts

Environmental

specialist

Operations officers

Procurement 4SW

FM 3SW

Environmental

engineer 3SW

Safeguard

specialist 3SW

Operations 3SW

TL 10SW

12-48 months Technical and

procurement review of

the bidding documents

Financial

management/reporting

Environmental

safeguard

Operation

Team Leadership

Procurement 4SW

FM 3SW

Environmental

engineer 3SW

Safeguard

specialist 3SW

Operations 3SW

TTL 30SW

Other

Skills Mix Required

Skills Needed Number of Staff Weeks Number of Trips Comments

Environment specialist

Operations Officer

Procurement

FM specialist

Task Team Leader

3-4 SW annually

3-4 SW annually

3-4 SW annually

3-4 SW annually

10 SW annually

Field trips as

required