public disclosure authorized - world...

Document o f The World Bank

FOR OFFICIAL USE ONLY

Report No 43545-UG

EMERGENCY PROJECT PAPER

ON A

PROPOSED CREDIT

IN THE AMOUNT OF SDR 6.20 MILLION (US10 MILLION EQUIVALENT)

TO THE

REPUBLIC OF UGANDA

FOR THE

AVIAN AND HUMAN INFLUENZA PREPAREDNESS AND RESPONSE PROJECT

UNDER THE

GLOBAL PROGRAM FOR AVIAN INFLUENZA CONTROL AND HUMAN PANDEMIC PREPAREDNESS AND RESPONSE

MAY 28,2008

Agriculture and Rural Development Sustainable Development Department Eastern Africa Country Cluster 1 Africa Region

This document has a restricted distribution and may be used by recipients only in the performance o f their official duties. I t s contents may not otherwise be disclosed without World Bank authorization.

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CURRENCY EQUIVALENTS

(Exchange Rate Effective April 30,2008) Currency Unit = Uganda Shilling

U S $ 1 = U S h 1,705 SDR 1 = US$1.6298

FISCAL YEAR July 1 - June 30

ABBREVIATIONS AND ACRONYMS

AH1 AHIP AI AHITF APL AU-IBAR BL

C A O CAS CBPP CBSS CDC CFP CHS/CH C W G DANIDA DAR DDHS D D M C DFID DHO DLH&E D M T DOs DPs D V O E A C EC/EU ESD ERC FA0 FAQs FVM MUK GOU

BSL-3

Avian and Human Influenza Avian and Human Influenza Preparedness and Response Project Avian Influenza Avian and Human Influenza Trust Fund Adaptable Program Loan African Un ion / Inter-African Bureau for Animal Resources Bio-security Level Bio-Safety Level Chief Administrative Officer Country Assistance Strategy Contagious Bovine Pleuropneumonia Community-Based Surveillance System Centre for Disease Control Communication Focal Point Commissioner for Health ServicedCommunity Health Department Communication Working Group Danish International Development Agency Directorate o f Animal Resources Distr ict Department o f Health Services District Disaster Management Committee Department for International Development District Health Officer Department o f Livestock Health and Entomology Disaster Management Team Development Objectives Development Partners District Veterinary Officer Eastern African Community European CommissiodEuropean Union Epidemiology and Surveillance Division Emergency Recovery Credit Food and Agriculture Organization Frequently Asked Questions Faculty o f Veterinary Medicine, Makerere University, Kampala Makerere University Government o f Uganda


GPAI

HPAI BAR IDA IDSR ICs ICRC IEC IGAD ILRI INAP KAP LCS LIRI LPAI MAAIF M&E MFPED M O H MOLG M O U M T T I MUWR NAADS NARO ND NDA NGO NIC NIMES NLPIP NPA NPSC NTF/AI N V S OIE OPM PACE PEAP PCR P&P PPPH PARC PAU PCT PDS PHS

Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response Highly Pathogenic Avian Influenza Inter-African Bureau o f Animal Resources International Development Association Integrated Disease Surveillance & Response Incident Command System International Committee o f Red Cross and Red Crescent Information Education Communication Intergovernmental Authority on Development International Livestock Research Institute Integrated National Action Plan. Knowledge Attitude Practice Local Councils Livestock Research Institute Low Pathogenic Avian Influenza Ministry o f Agriculture, Animal Industry and Fisheries Monitoring and Evaluation Ministry o f Finance, Planning and Economic Development Ministry o f Health Ministry o f Local Government Memorandum o f Understanding Ministry o f Tourism, Trade and Industry Makerere University Walter Reed National Agricultural Advisory Services National Agricultural Research Organization Newcastle Disease National Drug Authority Non Governmental Organization National Influenza Centre National Implementation, Monitoring and Evaluation System National Livestock Productivity Improvement Project National Plan o f Action National Project Steering Committee National Task Force on Avian Influenza National Veterinary Services World Organization for Animal Health Office o f the Prime Minister Pan African Control o f Epizootics Poverty Eradication Action Plan Polymerase Chain Reaction Prevention and Preparedness Public Private Partnership for Health Pan African Rinderpest Campaign Poultry Association o f Uganda Project Coordination Team Participatory Disease Surveillance Public Health Service

This document has a restricted distribution and may be used by recipients only in the performance o f their official duties. I t s contents may not be otherwise disclosed without World Bank authorization.

PPE PPP PPR PS PIM PVS Q&As R&R RCC RP RRT RT-PCR SOP TAD TOT TWG UK UN UNICEF

Personal Protective Equipment Public Private Partnership Peste des Petites Ruminants Permanent Secretary Project Implementation Manual Performance, Vision and Strategy (OIE evaluation system) Questions and Answers Response and Recovery Response Command Center Rinderpest Rapid Response Team Real Time Polymerase Chain Reaction Standard Operating Procedures Transboundary Animal Disease Training o f Trainers Technical Working Group United Kingdom United Nations United Nations Children’s Fund

UPHOLD Uganda Program for Human and Holistic Development URA Uganda Revenue Authority U S AID United States Agency for International Development U S D A United States Department o f Agriculture U S D United States Dollars UShs Ugandan Shillings WRI Uganda Virus Research Institute UWA Uganda Wildlife Authority UWEC Uganda Wildlife Education Centre V P H Veterinary Public Health WAHIS WB World Bank WHO Wor ld Health Organization

World Animal Health Information System

Vice President: Obiageli K. Ezekwesili Country Director: John M. McIntire

Sector Manager: Karen M. Brooks Task Team Leader: Wilson. 0. Odwongo


REPUBLIC OF UGANDA AVIAN AND HUMAN INFLUENZA PREPAREDNESS AND RESPONSE

PROJECT

TABLE OF CONTENTS

A . Introduction .................................................................................................................... 1 B . Emergency Challenge: Country Context and Rationale for Proposed Bank Emergency

Project ............................................................................................................................ 2 Country Context ........................................................................................................ 2

C . Bank Response and Strategy: The Project .................................................................... 4 Br ie f description of Bank’s strategy o f emergency support ...................................... 4

Rationale for Bank Involvement ............................................................................... 3

Project Development Objectives ............................................................................... 4 Summary o f Project Components ............................................................................. 5 Eligibility for Processing under OP/BP 8.00 ............................................................ 9 Consistency with Country Assistance Strategy (CAS) ............................................. 9 Expected Outcomes ................................................................................................... 9 Monitoring and Evaluation of OutcomesResults ................................................... 10

D . Appraisal o f Project Activities, Benefits and R isks ..................................................... 10 Economic and Financial Analysis ........................................................................... 10 Technical ................................................................................................................. 11 Institutional .............................................................................................................. 11 Fiduciary .................................................................................................................. 11 Social ....................................................................................................................... 13 Environmental ......................................................................................................... 13

Policy Exceptions and Readiness ............................................................................ 14 E . Implementation Arrangements and Financing Plan ..................................................... 14

Institutional and Implementation Arrangements.. ................................................... 14 Project Costs and Financing Plan ............................................................................ 15 Financial Management and Disbursement Arrangements ...................................... 16

Bank Supervision .................................................................................................... 16

G . Terms and Conditions for Project Financing ............................................................... 18

. .

Safeguard Policies ................................................................................................... 14

Procurement Arrangements ..................................................................................... 16

F . Project R i s k s and Mit igating Measures ........................................................................ 17

ANNEXES Annex 1 : Detailed Description o f Project Components .................................................... 19 Annex 2: Results Framework and Monitoring .................................................................. 32

Annex 4: Financial Management And Disbursement Arrangements ............................... 40 Annex 3: Summary o f Project Costs ................................................................................. 35

Annex 5: Procurement Arrangements ............................................................................... 53 Annex 6: Implementation and Monitoring Arrangements ................................................ 63 Annex 7: Project Preparation and Appraisal Team Members .......................................... 68 Annex 8: Environmental and Social Safeguards Framework., ......................................... 69 Annex 9: Economic and Financial Analysis ..................................................................... 71 Annex 10: Documents in Project Files ............................................................................. 75 Annex 1 1 : Statement o f Loans and Credits ...................................................................... 76 Annex 12: Country at a Glance ......................................................................................... 77 Annex 13: Map ................................................................................................................. 79

Republic of Uganda Avian and Human Influenza Preparedness and Response Project

Africa Region Emergency Project Paper Data Sheet

Date: M a y 28,2008 Country Director: John Murray McIntire Sector Managermirector: Karen M. Brooks / h g e r Andersen Lending instrument: Emergency Recovery Credit

Team Leader: Wilson Onyang Odwongo Sectors: Agriculture, Livestock & Health Themes: Avian & Human Influenza Environmental Category: B

Financing type: Loan [ ] Credit [ X Project ID(s): P110207 Proposed terms: Standard IDA Credit Expected effectiveness date: August 1,2008 Borrower: Republic o f Uganda

IDAGrantr 1 Other [ 1 Total Amount: US$lO mi l l ion Expected implementation period: Four years Expected closing date: June 30,2012 Responsible agencies: 1 .Office o f the Prime Minister, P.O. Box 341, Kampala, Uganda - Focal Point Officer - Apollo Kazungu; Tel. 256-4 1-345955; <[email protected]> 2. Ministry o f Agriculture, Animal Industry and Fisheries - Focal Point Officer, Chris Rutebarika; Tel. 256-772-664721, <crutebarika@yahoo. corn> 3. Ministry o f Health - Focal Point Officer- Winyi Kaboyo; Tel. 256-772-595792, <winyi.kaboyo@,health.go.ug>.

Development Objective: The overall development objective is to substantially reduce the threat posed to the poultry industry and humans in Uganda by HPAI infection and other zoonoses and to prepare for, control, and respond effectively to future AH1 pandemics and other infectious disease emergencies in livestock and humans. To achieve this, support wil l be provided in three main areas: (i) preparedness and prevention, (ii) outbreak response and recovery, and (iii) coordination, monitoring and evaluation. Short Description: The proposed AHIP has four components: (i) animal health; (ii) human health; (iii) communication; and (iv) coordination, monitoring and evaluation. Animal Health: The component wil l support: (i) overall institutional strengthening for animal disease prevention and control; (ii) national AH1 prevention and control strategies over the short- and medium-term; (iii) strengthening the capacity o f the National Veterinary Service (NVS) to cope with HPAI epidemic and new emerging infectious diseases; and (iv) increased monitoring and surveillance o f migratory and resident birds. Human Health: This component wil l support: (i) building the health system capacity to detect AI early, respond and contain the infection at source; (ii) adapting guidelines and training materials (including infection control guidelines); and (iii) training, activating and strengthening o f national and district Rapid Response Teams (RRTs), establishing isolation units, upgrading laboratories and pre-positioning Personal Protective Equipment (PPEs),

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I' ii

Source Borrower Total IBRD/IDA Avian & Human Influenza Trust Fund EC funded AU-IBAR SPINAP* USAID* Total “Parallel financing

Local Foreign Total 0.00

7.40 2.60 10.00

2.00 0.80 0.46

13.26

Total IBRD/IDA Trust Funds

F Y 0 9 F Y 1 0 FY11 F Y 1 2 FY13 F Y 1 4 3 6 8 10 0.6 1.1 1.6 2.0

I

Significant, non-standard conditions, if any: The AHITF Grant Agreement has been executed and delivered, and all conditions precedent to i t s effectiveness, or to the right o f the Recipient to make withdrawals under it (other than the effectiveness o f the Financing Agreement), have been fulfilled.

Does the emergency operation require any exceptions fiom Bank policies?

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Yes [I No [XI Yes [ ] N o [

Have these been approved by Bank management? Are there any critical r isks rated “substantial” or “high”?

1 Yes [ X ] No

What safeguard policies are triggered, if any? Environmental Assessment [I OP 4.01

A. INTRODUCTION

1. This Project Paper seeks the approval o f the Executive Directors to provide a credit in an amount o f US$lO.O mi l l ion equivalent to the Republic o f Uganda for the proposed Avian and Human Influenza Preparedness and Response Project (AHIP).

2. With the continuing reports o f outbreaks and spread o f Highly Pathogenic Avian Influenza (HPAI) in Asia, Africa, Europe and Middle Eastern Countries, Uganda i s among those countries in Sub-Saharan Afr ica at risk o f HPAI epidemic outbreak. The four key factors which put Uganda at high risk include:

The reported outbreak in 2007 o f HPAI in Juba, Southern Sudan, which i s close to Uganda’s northern border and with whom there i s considerable formal and informal cross-border trade;

The high prevalence o f backyard and/or free-range poultry rearing in the majority o f rural Ugandan households;

The legal or illegal movement o f poultry and/or poultry products as well as the unregulated trading in poultry in most rural and urban markets; and

The location o f the major routes for the wild migratory birds within the borders o f the country and the presence o f large masses o f water which facilitate close interaction between wild birds and domestic poultry.

3. The proposed credit would help finance the costs associated with substantially reducing the threat posed to the poultry industry and humans in Uganda by the HPAI infection and other zoonoses, and to prepare for, control, and respond effectively to future AH1 pandemics and other infectious disease emergencies in livestock and humans. The proposed financing wil l help respond to the situation by supporting the Government o f Uganda (GOU) in three main areas: (i) preparedness and prevention, (ii) outbreak response and recovery, and (iii) project coordination and monitoring and evaluation. The main outcomes will result in strengthening the capacities o f the Ministry o f Agriculture, Animal Industry and Fisheries (MAAIF) and the Ministry o f Health (MOH) in the following areas: coordination system for animal health surveillance and emergency disease control; strengthening the national veterinary services ( N V S ) ; strengthening coordination between health services l ine ministries for early detection and rapid response to emerging and re- emerging zoonotic diseases; and consolidating health facilities for prevention, containment and control o f AH1 and similar epidemic outbreaks.

4. Partnership arrangements: The total cost o f a comprehensive AH1 program in Uganda i s estimated in the Integrated National Action Plan (INAP or “the Plan”)) for Preparedness and Response to Avian and Human Influenza (February, 2008) at US$14.6 mi l l ion over five years. The Bank proposes to finance the INAP with US$12 mi l l ion (IDA credit o f US$lO mi l l ion and a grant o f US$2 million from the AH1 Trust Fund), whilst grants

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from other Development Partners (DPs - EC/EU and USAID) for INAP implementation are estimated at US$1.26 million. Furthermore, the preparation o f the INAP at an estimated cost o f about US$1.4 mi l l ion (which includes the cost o f training, sensitization, production o f AH1 posters, and supply o f laboratory reagents and kits for AI preparedness and prevention up to end December, 2007), was undertaken with the support o f several DPs and NGOs - CDC, Care International, DANIDA, DFID, EC/EU, FAO, HPF (Sweden), WHO, UNICEF, USAID, and the Bank.

B. EMERGENCY CHALLENGE: COUNTRY CONTEXT AND RATIONALE FOR PROPOSED BANK EMERGENCY PROJECT

COUNTRY CONTEXT

5. Whilst AH1 has not attracted wide spread media coverage in recent months, it continues to stir serious human health concerns world wide because o f the potential threat it poses if it mutates in ways that would allow sustained human to human transmission. While the strain o f the AH1 virus (known as H5N1) has been identified as the pathogen for the HPAI responsible for the large scale epidemic outbreaks and deaths in wild and domestic birds, no cases have yet been reported o f i t being transmitted from human to human. Nearly al l reports o f over 230 human deaths reported to date from H5N1 infections, have been caused through animal to human transmission. W h i l e an AH1 outbreak has not yet occurred in Uganda, there i s no doubt that the negative socio-economic impact o f an outbreak would be enormous and devastating. For instance in Asia , where the epidemic has persisted since the f i rs t outbreaks in 2003, over 200 mi l l ion domestic poultry have either died or been destroyed and over 300 people have contracted the infection o f which at least 190 have died as a result o f infections from H5N1 strain. Economic losses to the Asian poultry sector alone are already estimated at over US$10 bi l l ion with unprecedented adverse social and economic impact. In Nigeria, between February 2006 and October 2007, there were 920 suspected cases o f HPAI o f which 265 were confirmed positive. A total o f 1.3 mi l l ion birds were depopulated and about US$4.5 mi l l ion was paid out to farmers in compensation over the same period. There has been one confirmed case o f human fatality in Nigeria due to HPAI. Egypt has recorded 37 human cases with 15 fatalities and Djibouti one human fatality.

6. Since October 2005, the G O U has been actively working on prevention, preparedness and response to the AH1 threat. A comprehensive and multi-sectoral National Task Force on Avian Influenza (NTF/AI), co-chaired by MAAIF and M O H was established to develop a national strategy against the threat. The NTF/AI prepared the National Plan o f Action (NPA) for Preparedness and Response to Avian Influenza in Uganda (2006-2007), which was endorsed by the Cabinet in April 2006.

7. In April 2007, G O U requested the Bank to coordinate a Joint Rapid Assessment o f i t s action plan to bring i t in l ine with international technical standards o f the World Health Organization (WHO), Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE), and also assist i t in mobilizing resources necessary for implementing AH1 activities in Uganda from DPs. The Rapid Assessment was carried out in June/July 2007 by a team o f experts from WHO, OIE and FAO, working in collaboration

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with the NTF/AI, and coordinated by the Bank. The Rapid Assessment exercise resulted in the production o f INAP with a budget proposal o f US$14.6 mi l l ion for implementation o f AH1 activities in Uganda over the next five year period. The INAP was endorsed as the main working document for AH1 activities in Uganda by GOU, fol lowing a national workshop in February 2008.

8. In addition to the above process, G O U is actively involved in regional and sub- regional coordination and preparedness activities through the East Afr ican Community (EAC), Intergovernmental Authority on Development (IGAD), Afr ican Union-Inter-African Bureau o f Animal Resources (AU-BAR), FAO, and WHO.

9. The above processes undertaken by the GOU are consistent with key principles identified in the Bank’s Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI), which are l isted below:

Avian influenza control i s multi-sectoral in nature;

The risk o f human pandemic i s real;

The livelihoods o f the rural poor are particularly threatened;

Individual countries are central to any coordinated response;

An appropriate balance between short and long term actions need to be made; and

Global and regional aspects o f the response need to be addressed and coordinated.

10. Bank’s support to i t s AH1 activities very appropriate at this stage.

Uganda has, therefore, taken the necessary steps and preparations that make the

RATIONALE FOR BANK INVOLVEMENT

11. following:

The rationale for the Bank to support an AH1 project in Uganda includes the

The global public goods aspect o f controlling HPAI, in order to strengthen Uganda’s response capacity as part o f coordinated international and regional initiatives to minimize the risk posed by spreading o f any outbreak to neighboring countries and other parts o f the world. This requires the need to strengthen Uganda’s veterinary services, disease surveillance, and human health systems, as planned in this operation.

H P A I control programs require a multi-disciplinary approach to integrate technical, social, economic, political, policy, and regulatory issues in addressing a complex problem. In Uganda, therefore, the Bank can be helpful in bringing together the relevant ministries, government agencies and DPs, and in facilitating high level political coordination.

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The Bank’s main comparative advantage vis-&vis i t s partner agencies WHO, FA0 and OIE is its ability to provide significant funds to countries at risk, as a lender o f last resort. In Uganda, the Bank has already been requested by Government to leverage additional resources from other bilateral and international agencies. The grant resources being provided by DPs are not adequate for the basic needs o f the veterinary services and facilities required for AHI. Thus, there is a strong case for the provision o f resources from the World Bank’s GPAI.

The Bank i s also wel l placed to draw on i t s knowledge base concerning evidence and lessons already learned in various regions during emergency preparedness and response programs. The Bank can also contribute towards understanding and addressing the social and economic impact o f such emergency operations. The proposed project i s fully consistent with the Bank’s GPAI (which is an APL o f emergency operations) and draws heavily o n the global strategies developed by FAO, OIE and WHO.

C. BANK RESPONSE AND STRATEGY: THE PROJECT

BRIEF DESCRIPTION OF BANK’S STRATEGY OF EMERGENCY SUPPORT

12. Initially, a review o f the existing agriculture and health sector portfolio was undertaken to assess if funds were available for AH1 activities through reallocation or restructuring. The review determined that sufficient funds were not available for this emergency operation. In addition, the proposed AHIP was not included in the Country Assistance Strategy (CAS), 2004-2008. Therefore, at the request o f GOU, the Bank agreed to process AHIP as an Emergency Recovery Credit (ERC) under the Bank’s pol icy for emergency operations (OP/BP 8.00).

13. The AHIP will be co-financed by: (i) an IDA credit under the GPAI Adaptable Program Loan (APL), approved by the Executive Directors on January 12, 2006; and (ii) grant funds from the Avian and Human Influenza Trust Fund (AHITF)l, which i s being administered by the Bank. The AHIP wil l support the government’s INAP over a four year period. As indicated earlier, the project aims at building and consolidating al l GOU and DP initiatives related to HPAI in order to avoid any duplication and make the best use o f scarce resources. In addition to the resources from the Bank, E C and U S A I D will also provide grant resources, under parallel financing arrangements for the INAP/AHI activities.

PROJECT DEVELOPMENT OBJECTIVES

14. The overall development objective is to substantially reduce the threat posed to the poultry industry and humans in Uganda by H P A I infection and other zoonoses and to prepare for, control, and respond effectively to future AH1 pandemics and other infectious disease emergencies in livestock and humans. To achieve this, support wil l be provided in three

Contributors to the AHITF include the EC, DFID, Russia, Australia, China, South Korea, Iceland, Slovenia 1

and Estonia.

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main areas: (i) preparedness and prevention, (ii) outbreak response and recovery, and (iii) coordination, monitoring and evaluation.

SUMMARY OF PROJECT COMPONENTS

15. The proposed AHIP has four components: (i) animal health; (ii) human health; (iii) communication; and (iv) coordination, monitoring and evaluation. A summary o f the project components and activities is given below and more details are provided in Annex 1.

Component 1: Animal Health (US$5.66 million)

16. This component wil l be the primary focus o f the project as HPAI outbreaks must be addressed at source. The component aims at overall institutional strengthening for animal disease prevention and control, with emphasis on the emerging zoonoses including Transboundary Animal Diseases (TADs). I t wil l also support national prevention and control strategies proposed to cover the country’s needs over the short- and medium-term, based on detailed assessments o f the avian influenza epidemiological status, the capacity o f the National Veterinary Service (NVS) to cope with HPAI epidemic and the vulnerability o f the poultry industry to new emerging infectious diseases. The component will provide f inds for increased monitoring and surveillance o f migratory and resident birds.

Part I: Preparedness and Prevention (P&P)

Subcomponent 1: Strengthening Capacity for Animal Health Surveillance, Monitoring and Emergency Disease Control

17. The project will use the existing institutional framework for surveillance, monitoring and emergency disease control. The project wil l support: (i) MAAIF to strengthen i t s epidemiological unit: (ii) MAAIF to put in place a system in al l the districts to detect the appearance o f HPAI in migratory birds and domestic animals; (iii) strengthening the surveillance capacity o f MAAIF, HPAI Rapid Response Teams (RRTs), and Uganda Wildlife Authority (UWA) through training, provision o f PPEs and procurement o f necessary equipment and supplies for control o f H P A I and other emerging diseases.

Subcomponent 2: Strengthening of National veterinary Services (nVS)

18. This subcomponent will support activities to strengthen N V S to enhance animal disease surveillance, diagnosis and control. The support wil l cover the following: (i) upgrading knowledge and skills through training, equipping laboratories, provision o f transport; (ii) development and distribution o f Standard Operating Procedures (SOPS) for reporting between MAAIF and other l ine ministries; (iii) dissemination o f the OIE developed Performance Vision Strategy document; (iv) Sero-prevalence surveys to establish baseline data on the epidemiology o f re-emerging diseases; (v) review o f curricula o f the Faculty o f Veterinary Medicine, Makerere University (FVM-MUK) and Para-Veterinary schools to cater for HPAI and other TADs; and (vi) strengthening o f the regulatory framework.

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Subcomponent 3: prevention, early detection and rapid response

Improved Veterinary Technical Competence for emerging disease

19. The project will build capacity in risk analysis, through training and research in various areas o f specialisation (risk analysis, infectious disease epidemiology, wi ldl i fe surveillance). Simulation exercises for HPAI and other infectious diseases wil l also be undertaken.

Subcomponent 4: A Balanced Veterinary Epidemio-surveillance programme capable of early detection of emerging infectious diseases and other TADs

20. The project will support: (i) passive, active and targeted surveillance, (ii) improving animal health information f low among relevant agencies; (iii) early detection and timely reporting and follow-up o f suspected or positive cases; (iv) public and Community-Based Surveillance System (CBSS) by establishing a community-based early warning system; (v) routine serological surveys and epidemio-surveillance; and (vi) upgrading o f the laboratories earmarked to carry out diagnostics for HPAI including upgrading o f the MAAIF National Diagnostics and Epidemiology laboratory to Bio-Safety Level 3 (BSL-3). Animal disease surveillance will be strengthened through provision o f the necessary infrastructure, equipment, supplies and transport capacity.

Subcomponent 5: Infectious Diseases Preparedness, Detection and Control

Evidence-Based Veterinary Rapid Response Capacity for Emerging

21. To enhance the capacity for effective rapid response, the project will: (i) establish an Incident Command System (ICs) for animal HPAI outbreak response; (ii) develop national policies and SOPS for €€PA1 rapid response and control; (iii) procure rapid response supplies and equipment for a l l levels o f N V S , including PPEs, disinfection uni ts and culling equipment; (iv) improve commercial farm and backyard poultry production bio-security; (v) strengthen N V S quarantine capacity; and (vi) support preparation o f compensation pol icy and guidelines.

Subcomponent 6: Coordination, monitoring and evaluation

22. MAAIF will be responsible for coordination, monitoring and evaluation o f animal health activities planned under the project. The O P M will be responsible for the overall M&E activities. The project wil l provide funds to al l the implementing ministries responsible for their own coordination, monitoring and evaluation.

Part 11: Response and Recovery (R&R) 23. In case o f an outbreak, there will be additional costs to cater for immediate response, over and above the expenses related to P&P activities. However, the exact amount cannot be known for the time being because neither the timing nor the extent o f an eventual outbreak (or outbreaks) can be anticipated. This subcomponent will provide support for immediate reaction to the outbreak; implementation o f sanitary measures; quarantine and movement control; strengthening o f surveillance; initiation of recovery activities (compensation),

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improvement o f bio-security; strengthening o f public awareness; and re-enforcement o f active surveillance (e.g. border check posts).

Component 2: Human Health (US$2.06 million)

24. The AHIP will strengthen the human health strategy for the preparedness and response to Avian Influenza (AI) in Uganda by helping to build the health system capacity to detect early, respond and contain the infection at source. The project wil l provide hnds for adapting guidelines and training materials (including infection control guidelines), conducting training, activating and strengthening o f national and district RRTs, establishing isolation units, upgrading laboratories and pre-positioning PPEs, supplies and medicines.

Part I: Preparedness and Prevention (P&P) Subcomponent I: Strengthening of Surveillance of humans for influenza

25. Surveillance activities for human influenza wil l be strengthened in al l aspects and the number o f sentinel sites expanded from the present three sites to at least eight sites. The project wil l provide h n d s to strengthen MOH’s existing field disease investigation system and expand sentinel surveillance to cover at least the regional hospitals and community based surveillance in selected high risk districts

Subcomponent 2: Strengthening the Capacity of the Uganda National Health Research Organization

26. This wil l include: (i) strengthening o f the capacity o f U N H R O for developing policies to ensure effective coordination and to harmonise research in new and emerging infectious diseases including avian influenza (ii) upgrading the National Influenza Centre (NIC) laboratory at the Uganda Virus Research Institute (WRI) to BSL3, including provision o f laboratory diagnostic equipment and reagents; and (iii) training o f staff for quality control in AI diagnostics, field specimen collection, and testing for influenza viruses.

Subcomponent 3: Consolidation of preparedness for AHI Prevention, Containment and Control

27. This sub-component wil l support: (i) development o f infection control procedures and educational programs for the most vulnerable and at risk communities and health workers and (ii) establishment o f isolation facilities and procurement o f infection control materials and PPEs for at least six regional hospitals.

Subcomponent 4: Improving Food safety and Environmental Hygiene

28. The project wil l support activities and assessments aimed at improvement o f environmental, occupational and food safety o f poultry and poultry products in poultry markets and along major highway food vending points.

Subcomponent 5: Health Services and Systems Prepared to handle suspected cases.

29. Based on the lessons learnt from the Ebola outbreak, the implementation o f this subcomponent i s aimed at increase the surge capacity and flexible deployment o f both human

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and infrastructure resources. This wil l be achieved mainly by training o f health workers in case management and rapid response, development and conducting o f simulation exercises and the development o f a contingency plan o f human resource management in case o f an outbreak.

Subcomponent 6: Preparation for Effective Case Management.

30. The ultimate aim o f any outbreak management strategy is to ensure proper treatment o f a l l cases detected. The project will: (i) provide limited stock o f pharmaceuticals for emergencies (TamifluB and other antibiotics) while adequate budgetary provision should be made for additional supplies when the situation warrants; (ii) support preparation o f guidelines and SOPs; and (iii) procurement o f necessary accessories and medical supplies (including vaccines).

Part 11: Response and Recovery (R&R) Subcomponent 1: Response to Outbreak ofpandemic influenza of avian origin

3 1. The Project wil l help create and sustain a system that can rapidly contain the infection as this i s one o f the key elements which wil l drastically reduce human to human transmission, suffering and death. Support will be provided for activating RRTs to undertake active case investigations, intensify collaboration with the veterinary services in the areas o f disease surveillance, provision o f PPEs, prophylaxis to investigating teams and treatment o f human cases to control the spread o f the epidemic. In the pandemic phase support wil l be provided for exceptional measures l ike quarantine and restricting movement o f people, closure o f schools and markets.

Component 3: Communication (US$1.83 million)

Part I: Preparedness and Prevention (P&P) 32. The main challenges faced in fighting A I relate to lack o f motivation due to l ow risk perception and a general lack o f knowledge o f AI among the general public and a wide range o f stakeholders, especially the small-scale back-yard poultry farmers. To address these constraints, the Project will provide funds to: (i) brief pol icy makers on AI through development and presentation o f pol icy papers; (ii) enhance the communication skills o f key pol icy makers and spokespersons through training; (iii) establish a Communications center within the coordinatiodoperation centers at central and district levels, designate Communication Focal Points (CFPs) within them, and equip the CFPs with dedicated communication facilities, ready supply o f posters, and standard protocols for reporting any outbreaks; (iv) mount media campaigns using Information, Education and Communication (IEC) materials specially developed, and establish a national AH1 web-site; (v) train f m e r s and households with back yard poultry, local government officials, and religious and cultural leaders on the r isks o f AI; (vi) build strategic partnerships with the media through briefings and simulation exercises; and (vii) develop an M&E system..

Part 11: Response and Recovery (R&R)

33. outbreak.

The R&R strategy should be launched within the first 24 hours o f any report o f an To facilitate this, the project will support: (i) establishment o f SOPs for the

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outbreak communication strategy; (ii) dissemination o f IEC materials for outbreaks; (iii) activation o f media plan for outbreaks; (iv) Strengthened communication to the public at the outbreak foci or ‘ground zero’;(v) plan for off icial ly communicating the end o f the emergency phase; and (vi) the evaluation o f the impact o f the communication effort.

Component 4: Coordination, Monitoring & Evaluation (US$0.45 million)

34. Coordination: This component wil l support implementation costs associated with project planning, coordination, management, as wel l as overall monitoring and evaluation (M&E) at the national and district levels. This wi l l cover support for these functions for the OPM, MAAIF, and MOH. This support covers the operational costs for the National Project Steering Committee (NPSC), NTF/AI, Technical Working Groups (TWGs), Project Coordination Team (PCT), and the RRTs.

35. Monitoring and Evaluation: The OPM has in place a National Implementation, Monitoring and Evaluation System (NIMES). The project wil l support the development of, and integration o f an M&E system for AHIP activities into the NIMES. The project will also support the M&E aspects o f AHIP activities at MAAIF and MOH.

ELIGIBILITY FOR PROCESSING UNDER oP/BP 8.00

36. The proposed Uganda AHIP i s being processed under the GPAI framework, which was endorsed by the Bank’s Executive Directors. The GPAI framework recognizes the need to minimize the threat posed to humans by HPAI infection and the need to prepare for, control, and respond to influenza pandemics and other infectious disease emergencies in humans. The GPAI identifies three areas to be considered for Bank support: (i) prevention, (ii) preparedness and planning, and (iii) response and containment. These areas are fully consistent with the following objectives o f OP/BP 8.00: (i) assisting with the crucial ini t ial stages o f building capacity for longer-term disaster management and risk reduction; and (ii) supporting measures to mitigate or avert the potential effects o f imminent emergencies, or future emergencies, or crises in countries at high risk.

CONSISTENCY WITH COUNTRY ASSISTANCE STRATEGY (CAS)

37. The AHIP i s consistent with the 2005-2009 Uganda Joint Assistance Strategy (UJAS) discussed by the Board on December 14, 2005 - Report No. 34310-UGY which was aligned with Uganda’s development objectives as articulated in the 2004 Poverty Eradication Action Plan (PEAP). The AHIP will provide support mainly for strengthening livestock services, improving health services provision and build management and technical capacity within MAAIF, MOH and OPM. These interventions wil l support Pillars 2,3 and 5 o f the PEAP.

EXPECTED OUTCOMES

38. The results framework and the performance indicators adopted for the AHIP are consistent with the indicators included in the PEAP and UJAS. At the end o f the project the expected outcomes are: (i) the capacity o f the government ministries/agencies involved in HPAI containment, control and mitigation wil l be improved; (ii) the threat to human health in the high r i s k areas o f Uganda will be reduced; and (iii) the general public wil l be better

9

informed and wil l have adopted AH1 related human health, animal health and environmental safeguards. The results framework and the l i s t o f indicators are provided in Annex 2.

GAR Scenario I. 0.7 11. 1.0 111. 2.5

MONITORING AND EVALUATION OF OUTCOMES/RESULTS

Outbreak in year 2 Outbreak in year 4 11% 7% 20% 13% 70% 34%

39. The M&E unit in the O P M will, with assistance from MAAIF and MOH, continuously and systematically monitor project implementation activities, outputs and outcomes. The key indicators to be monitored include: extent o f animal surveillance and laboratory testing; training o f veterinary and health officers; readiness for outbreak containment; enactment o f containment plans (as and when necessary); changes to legislation; h l l y developed human surveillance systems and equipped laboratories; training o f health workers; weekly/monthly disease reporting; preparation o f communication material and communication strategy. Further details are provided in Annex 2.

40. An M&E specialist from OPM’s Coordination and Monitoring department wil l be assigned to work with the PCT for the entire project period. He/she would be responsible for preparing the M&E program at the beginning o f the project, in consultation with hisher counterparts in MAAIF and MOH, and for training central and district staff on how to record and report data, and for producing regular reports for the NPSC and the World Bank. He/she would work closely with the PCT in preparing quarterly progress reports.

41. carrying out independent impact evaluation o f the project at mid-term and end o f the project.

In addition, the PCT wil l select, using agreed procurement guidelines, consultants for

D. APPRAISAL OF PROJECT ACTIVITIES, BENEFITS AND R I S K S

ECONOMIC AND FINANCIAL ANALYSIS

42. There are several major difficulties in estimating .the economic impact o f AI in Uganda, most o f which would also be val id for other countries. First, scenarios for “gross attack rates” (GARS) o f AI in the case o f a pandemic, based mostly o n past events, are only approximate. There i s a lack of scientific knowledge on the primary factors affecting the spread o f the H P A I in humans and the probability o f i t s occurrence. Second, there i s no data to assist in predicting the probability o f any o f the scenarios for which a possible impact o f HPAI can be estimated.

43. Nevertheless, based o n reasonable assumptions, the economic and financial analysis, the details o f which are provided in Annex 9, provides considerable justification for this project. The internal rates o f return estimated for this project are summarized in the following Table.

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44. The results show that for minimal Gross Attack Rates (GARS), and depending on when the outbreak occurs during the project cycle, the I R R s are sufficiently high to justify the investment in AH1 preparedness and prevention.

TECHNICAL

45. The technical proposals for both the animal health and human health related AI activities o f the AHIP are based on a phased and multi-disciplinary approach. These proposals were formulated o n the basis o f a sound epidemiological approach to control and contain HPAI outbreaks, and are tailored to the prevailing conditions in Uganda. The technical proposals wil l address the weaknesses in, inter alia, the fol lowing areas: inadequate surveillance and diagnostic capacity o f the N V S to respond rapidly to an HPAI outbreak; inadequate laboratory facilities, insufficient finds for operating costs, and lack o f staff expertise; inadequate capacity to implement bio-security measures; scarce scientific expertise in epidemiological and epizoological areas linked to disease control programs; inadequate surveillance o f migratory birds, which have been a source for the transmission o f the H5N1 virus to domestic poultry; and, weak coordination among the public agencies, and weak linkages with the private sector.

INSTITUTIONAL

46. The INAP proposed the setting up o f a separate Project Coordination Unit (PCU). Taking into account the Paris Declaration, and the need to strengthen the capacities o f the implementing ministries and agencies, the AHIP will use the existing government structures to implement al l aspects o f the project. Given the multi-sectoral nature o f the project and the need to have high level political engagement, the AHIP design envisages using a multi- sectoral Project Coordination Team, led by the OPM. There are no major weaknesses in the Financial Management arrangements o f the three implementing institutions to note under this section.

FIDUCIARY

47. With increasing reliance on the country systems and shifting the focus from creating a parallel system to using the existing Public Financial Management (PFM) system, the AHIP will be implemented within the financial structures o f the implementing ministries. The animal heath component wil l be implemented by the MAAIF, while the human health component wil l be implemented by MOH and the overall coordination function wil l be implemented by OPM. To facilitate smooth implementation, each implementing agency wil l have access to project finds through i t s own designated (special) account. The communication component wi l l be implemented jo int ly by MAAIF and MOH with support from OPM, but the finding for this component will be placed in the account o f MOH. MAAIF, M O H and O P M will follow GOU’s existing financial management system.

Financial Management:

48. The Public Expenditure and Financial Accountability (PEFA) Report o f November 2005 (issued in July 2006) and Country Financial Accountability Assessment (CFAA)

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carried out by IDA in 2004 shows that the Government o f Uganda has made substantial progress in improving its Public Financial Management Systems since the last C F A A undertaken in 2001. The fiduciary r isks associated with poor budget formulation and budget preparation processes have been reduced. In terms o f appropriate legislation and regulatory frameworks, significant progress has been made to ensure that the risk associated with the lack o f clear rules and regulations has been reduced. Also, more useh l information is provided in the Report and Opinion o f the Auditor General to Parliament on the Public Accounts o f the Republic o f Uganda, which are up to date. However, risks remain in terms o f (i) Quality and timeliness o f in-year budget reports since budget reports only include information on budget releases and not actual expenditures; (ii) Stock and monitoring of expenditure payment arrears; (iii) Effectiveness o f internal audit; (iv) Oversight o f aggregate fiscal risk from other public sector entities; (v) Effectiveness o f measures for taxpayer registration and tax assessment; (vi) Legislative scrutiny o f external audit reports; (vii) Effectiveness o f payroll controls; and, (viii) Effectiveness in collection o f tax payments. Government o f Uganda (GOU) has prepared a Financial Management Accountability Program (FINMAP) to address the weaknesses in its Public Financial Management system. The FINMAP is supported by a number o f development partners, including the World Bank, that form the Public Financial Management Donor Group.

49. The project’s financial management transactions wil l be managed within the existing set-up in the three institutions o f which the overall accounting officer i s the Permanent Secretary (PS). All the three institutions’ accounting departments are adequately staffed with a Principal Accountant as head, senior accountants, accountants, and several accounts assistants. The Principal Accountants report to the Under Secretaries, who in turn report to the Permanent Secretaries. The three institutions have accounting policies and procedures that wil l be used for the project. These are documented in the government’s Treasury Accounting Instructions, 2003, issued under the Public Finance and Accountability Ac t 2003. These procedures, however, fa l l short on project requirements on external auditing and financial reporting, which wil l be documented in the Financing Agreement. The ministries are computerized on Integrated Financial Management Information Systems (IFMIS). However the IFMIS has not yet been configured to be utilized by projects, which implies that AHIP accounting wil l be done using other accounting software or excel spreadsheets. The institutions have internal audit units comprised o f the head o f internal audit and two internal auditors seconded from the Ministry o f Finance, Planning and Economic Development (MFPED), who wil l include the project activities in their work plan. The project’s financial statements will be audited in accordance with statutory requirements, and suitable Terms o f Reference wil l be developed.

50. Actions outlined in the Financial Management Action Plan wil l be undertaken by the three ministries to strengthen the financial management system. The formats o f the Interim Financial Reports (IFR) were agreed with IDA at the time o f the negotiations.

5 1. In order to ensure that the project i s effectively implemented, the three ministries wil l ensure that appropriate staffing arrangements are maintained throughout the l i fe o f the project.

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52. The conclusion o f the assessment i s that the financial management arrangements for the project have an overall residual r i sk rating o f moderate (Annex 4), which satisfies the Bank’s minimum requirements under OPL3P10.02. These arrangements are adequate to provide, with reasonable assurance, accurate and timely information on the status o f the project, as required by IDA. With the implementation o f the action plan, the financial management arrangements will be strengthened.

53. Procurement: Procurement for the proposed project would be carried out in accordance with: (i) the World Bank’s “Guidelines: Procurement under IBRD Loans and IDA Credits” dated M a y 2004, revised October 2006; (ii) “Guidelines: Selection and Employment o f Consultants by World Bank Borrowers” dated M a y 2004, revised October 2006; (iii) the Simplified Procurement Plan as permitted by the new OP 8.00; and (iv) the provisions stipulated in the Financing Agreement. The details o f the procurement arrangements are set out in Annex 5, whilst the procurement requirements by expenditure categories are summarized in Table 2 o f Annex 3.

SOCIAL

54. The main social concern i s the maintenance o f livelihoods for poultry producers, especially backyard producers, in the event o f future outbreaks o f HPAI. There are two main ways in which GOU can assist small producers. The first i s through the establishment o f a compensation program that operates in a transparent and agreed way. G O U and producers need to reach agreement on the amount o f compensation payable for each bird culled. Discussion i s needed between GOU and the industry to draw up compensation payment mechanisms. The second important thing is for al l stakeholders to develop and promote risk awareness messages that wil l avoid the creation o f panic so that people do not refuse to buy poultry just because o f an outbreak in some parts o f the country. Some progress has been made on this front, but more needs to be done, especially with regard to news media. The project wil l have significant positive social impact by protecting human lives through H P A I early warning, prevention and containment, improved poultry farming practices, increased public awareness o f HPAI, and improved hygiene and food preparation practices and waste management,

ENVIRONMENTAL

55. The project i s assessed as a Category B project, based on the type o f interventions proposed under the project and the nature and magnitude o f potential environmental impacts. The project i s l ikely to have limited adverse environmental impacts as the interventions are largely on public sector capacity building and improved readiness for dealing with outbreaks o f AI in domestic poultry. These prevention-focused activities are expected to have positive environmental impacts because project investments in facilities, equipment, laboratories and training will improve the effectiveness and safety o f existing AI handling and testing procedures by meeting international standards established by OIE. This would be reinforced by the mainstreaming of environmental safeguards into the protocols and procedures for culling and disposal o f animals in the event of an AI outbreak, decontamination o f production facilities and laboratory biosafety. However, adverse environmental health impacts, mainly inadvertent spread o f HPAI, could occur when an emergency operation

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involves containment o f HPAI outbreaks through quarantine, isolation and stamping out actions, and when relevant mitigation measures are not in place. Therefore, precautions have been taken under the project to avoid or minimize such impacts by integrating environmental and public health safety aspects in the preparation, design, and implementation o f the project. The potential adverse environmental impacts identified above will be mitigated by integrating environmental and public safety aspects in al l stages o f the project. The Government is preparing Guidelines for safe culling, transport and safe disposal o f carcasses, which wil l be supported under the project. The project wil l provide training to al l relevant staff for implementation o f the Guidelines as well as infrastructure needed in the event o f an outbreak.

SAFEGUARD POLICIES

56. Environmental Assessment i s the only safeguard pol icy triggered under this project, considering the scope o f activities financed under the project. There are no Social Safeguards triggered by the project because there wil l be no land acquisition, voluntary or involuntary. Therefore, there would be no displacement o f people. The Environmental Management Plan (EMP), that outlines the measures proposed to address al l potential adverse environmental and social impacts, wil l be prepared and wil l serve as a guide to ensure that the project wil l not result in any potential indirect and or long-term impacts (see Annex 8 for details). The preparation o f the Guidelines will involve an evaluation o f suitable alternatives for safe culling, transport and particularly for safe disposal o f carcasses. The project wil l finance the implementation o f the selected alternatives, according to the EMP. In the case o f the AI Component o f MOH, a Health Care Waste Management Plan already exists and will form the basis o f environmental management for avian influenza activities as wel l (no separate EMP will therefore be prepared for the Human Health component). Most o f these activities related to the safeguards wil l be undertaken in consultation with the National Environmental Management Authority (NEMA).

POLICY EXCEPTIONS AND READINESS

57. N o pol icy exceptions are required. The project meets the regional implementation readiness requirements. The INAP has been endorsed for implementation by the GOU. The project NPSC and NTF/AI are in place, and G O U has established the PCT. A simplified Procurement Plan for the f i rst six months and the implementation program for the f i rst year (year 1) have already been prepared. The draft Project Implementation Plan (PIP) i s under preparation, and a draft Compensation Policy has been prepared and awaits Cabinet approval. The National Communication Strategy for Avian Influenza and Human Pandemic Influenza has also been prepared and approved by GOU.

E. IMPLEMENTATION A R R A N G E M E N T S AND FINANCING PLAN

INSTITUTIONAL AND IMPLEMENTATION ARRANGEMENTS

58. Implementation of the Plan: The GOU has designated MAAIF and MOH to implement i t s national Plan (INAP), with appropriate coordination from the Office o f the

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Prime Minister (OPM) and support from the other ministriedagencies. A National Project Steering Committee (NPSC) comprising 22 Ministers, Permanent Secretaries, and representatives o f relevant GOU agencies and the private sector, and headed by the Minister for General Duties in the OPM, has been designated as the apex coordinating body. I t will meet quarterly. Below the NPSC, a multi-sectoral National Task Force o n Avian Influenza (NTF/AI) has been established with representation from a wide range o f public and private sector agencies to provide advice o n technical matters to the NPSC. The implementation o f the GOU Plan i s being facilitated through the AHIP.

59. Implementation of the Project: The IDA is supporting the AHIP under the framework o f the Global Program for the Avian Influenza and Human Pandemic Preparedness and Response (GPAI). The AHIP, an emergency project, i s designed to provide assistance for AI within the overall framework o f the GOU national Plan. The project wil l be implemented over a four year period through existing government structures. A Project Coordination Team (PCT) has been established to implement and coordinate the project activities, including the technical components, communication, financial management, procurement, safeguards, monitoring and reporting.

60. Project Coordination Team: The PCT wil l consist o f seven members - three Focal Point Officers (FPOs) from the O P M representing the Departments o f Disaster Management and Refugees (DDMWOPM), Information and National Guidance, and Coordination and Monitoring, one FPO each from MAAIF and MOH responsible for the technical components, and one nominee each from MAAIF and M O H responsible for the Communication aspects/component. The PCT wil l work closely together to achieve project objectives. The FPO representing the D D M W O P M will act as the Project Coordinator (PC), with responsibility for overall project coordination. The other PCT members from MAAIF and MOH will have the responsibility to coordinate implementation o f the project’s technical and communication components. Given the importance o f the Communication component, i t will be implemented joint ly by MAAIF and MOH, with support from OPM, as required. On project matters, the PCT members wil l send their work plans, budgets and progress reports to the PC through their heads o f departments. The PC wil l consolidate the annual work plans, budgets, and progress reports for the NPSC and IDA for approval, guidance, and information. The D D M W O P M will serve as the secretariat to the NPSC. On administrative, coordination, procurement, financial management, communications, safeguards and internal M&E matters, the PCT wil l be supported by the relevant sections/units from within OPM, MAAIF, and MOH, andor other relevant GOU ministries. The project will provide support for coordination, monitoring and evaluation, and implementation. Annex 6 provides details about project implementation and monitoring arrangements.

PROJECT COSTS AND FINANCING PLAN

61. As indicated earlier, the GOU’s INAP has been budgeted at US$14.6 million. However, based on commitments thus far, DPs are expected to finance about US$13.26 mi l l ion o f the GOU’s Plan as shown below:

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US$ Million AHIP - proposed IDA Credit Proposed grant financing from World Bank AHITF Facility

10.00 2.00

A U - B A R SPINAP (Supported by EC/EU) 0.80 Financing from U S A I D 0.46 Total financing available for INAP 13.26

62. The AHIP project cost o f US$10 mi l l ion would be financed by an IDA credit under the GPAI Adaptable Program Loan window, whilst the AHITF is largely expected to finance technical assistance and training under the INN. The financing by IDA and AHITF will be at 100%. The GOU may claim a small amount o f expenditures (estimated at US$ 100,000) under the IDA credit as retroactive financing. Furthermore, the project aims at building and consolidating al l GOU and DPs’ initiatives related to INAP and HPAI in order to avoid any duplication and make the best use o f resources. The funds from the EC/EU and U S A I D programs supporting the INAP would be available to G O U under parallel financing arrangements.

FINANCIAL MANAGEMENT AND DISBURSEMENT ARRANGEMENTS

63, The three implementing institutions have established effective financial management and accounting systems. These will facilitate the introduction o f report based disbursements where cash f low forecasts based on work plans are submitted for a period o f six months, along with IFRs, for each quarterly period. The IFRs wil l also be submitted for disbursement o n a quarterly basis. In order to continue using report based method, IDA will expect the project to: (a) sustain satisfactory financial management rating during project supervision; (b) submit IFRs consistent with the agreed form and content within 45 days o f the end o f each reporting period, and (c) submit a Project Audit Report by the due date. The details are provided in Annex 4.

PROCUREMENT ARRANGEMENTS

64. As in the case o f financial management, the procurement o f consulting services, goods, motor vehicles, equipment and c iv i l works relating to the AHIP activities wil l be undertaken by the Procurement units o f the implementing ministries - OPM, MAAIF, and MOH. Some o f the emergency procurements will be handled through the UNDP-IAPSO. The detailed procurement arrangements are given in Annex 5.

BANK SUPERVISION

65. The supervision, monitoring and evaluation o f AHIP will require an experienced multi-sectoral task team. The project wil l require three implementation review missions in the first year and at least two missions during each o f the following three years. It is estimated that, o n average, the supervision effort will require an input o f about 25 staff weeks per year. For the mid-term review o f the project, additional budgetary resources o f about 10 staff weeks would be required to field a mission covering al l aspects o f the project.

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F. PROJECT R I S K S AND MITIGATING MEASURES

66. Critical Risks: A summary o f critical r isks for the Project and the l ikely mitigation

Risk Rating

From Outputs to Objective

implementing agencies and insufficient agency authority, leadership and capacity to take a leading role in avian influenza prevention and control.

Intervention activities are not effective in containing the spread o f avian influenza from birds to the human population. .

Lack o f coordination among project

Insufficient commitment at local levels despite strong central commitment.

Risks that the disease might re-occur through porous borders.

H

S

M

- Financial resources not accessible in a timely manner; weak procurement management.

S

Overall Risk Rating: S

Mitigation Measure

AHIP w i l l facilitate coordination and linkages across relevant agencies and development partners wi th project support through NPSC, NTF/AI and TWGs. I t wil l also support the coordination functions o f the PCT.

The proposed project activities w i l l strengthen the response capacity in the event o f AH1 outbreak over the short and medium term. They w i l l also put in place strategies for prevention and control o f the epidemic. Implementation linkages between national and districtAoca1 levels will be strengthened and project's activities focus on building capacity at local levels. Quarantine measures w i l l be strictly enforced and movements o f birds across borders will be closely monitored. Quarantine stations w i l l also be strengthened. Procurement and financial management arrangements w i l l be handled by the experienced staff o f the relevant ministries; training w i l l be provided to enhance capacity.

fi :st Risk), N (Negligible or L o w Risk)

67. Possible Controversial Aspects: The project wil l support the implementation o f necessary actions to prevent, control and respond to possible influenza pandemic. Some o f the typical and necessary "social distancing measures" (such as quarantines, bans on mass gatherings and travel restrictions) may be socially and politically controversial. Culling for outbreak control among poultry i s also l ikely to be controversial. Intensive and continuous dialogue is needed among different stakeholders. This will be supplemented by a wel l designed communication strategy. A high degree o f political commitment i s needed for managing any controversies with respect to preventing and controlling influenza pandemic.

68. There are no controversial aspects in the Financial Management arrangements o f the three implementing institutions to note under this section. As noted in Annex 4, the mitigation measures proposed for the financial management arrangements are expected to reduce the critical risks considered as substantial to moderate.

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G. TERMS AND CONDITIONS FOR PROJECT FINANCING

69. maturity o f 40 years, including a grace period o f ten years.

Terms: The Emergency Recovery Credit would be on standard IDA terms, with a

70. Financial covenants are the standard ones as stated in the Financing Agreement Schedule 2, Section I1 (B) on Financial Management, Financial Reports and Audits and Section 4.09 o f the General Conditions.

Legal Covenants:

71, The conditions for project effectiveness are: (i) the receipt o f the Legal Opinion from GOU’s Attorney General; (ii) the AHITF Grant Agreement has been executed and delivered, and al l conditions precedent to its effectiveness, or to the right o f the Recipient to make withdrawals under it (other than the effectiveness o f the Financing Agreement), have been hlfilled; and, (iii) the Recipient has prepared and adopted a Project Implementation Plan (PIP), in form and substance acceptable to the Association.

Effectiveness Conditions:

72. Disbursement Condition: There i s an urgent need for GOU to finalize and approve the compensation pol icy and operational guidelines that would provide the basis on which compensation would be paid, including eligibility o f commercial as wel l as backyard poultry producers. A sample o f guidelines on Compensation for AI has been provided to the Government’s NTF/AI for consideration. These guidelines can be modified as deemed appropriate in the context o f the country environment. Finalization and approval o f the compensation pol icy and guidelines wil l be a condition for IDA to disburse any part o f the credit for compensation in the event that government will request withdrawal for such purpose.

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ANNEX 1

REPUBLIC OF UGANDA


Annex 1 : Detailed Description of Project Components

Component 1 : Animal Health (US$5.66 million)

1. This component wil l be the primary focus o f the project as H P A I outbreaks must be addressed at source; within the animal sector as the threat to human health wil l persist as long as the problem persists in livestock and poultry flocks. Preparedness for HPAI, and the capacity to prevent i t s introduction, depends directly on the policies, infrastructure, capacities and systems in place for animal disease surveillance and control. Strong institutional structures for the prevention and control o f emerging diseases minimize the risk o f HPAI introduction, and ensure appropriate responses in the unfortunate case o f introduction. Therefore, this component aims at overall institutional strengthening for animal disease prevention and control, with emphasis o n the emerging zoonoses including Transboundary Animal Diseases (TADs). The project wil l therefore support national prevention and control strategies proposed to cover the country’s needs over the short, medium and long term, based on detailed assessments o f the avian influenza epidemiological status, the capacity o f N V S to cope with HPAI epidemic and the vulnerability o f the poultry industry to new emerging infectious diseases. It is, therefore, important that the primary focus o f attention in the prevention o f the introduction and perpetuation o f the virus in the country i s initiated from the animal health perspective to ensure that any introduction o f the HPAI virus in poultry i s quickly detected and contained within the outbreak areas.

2. Uganda Wildl i fe Authority (UWA) officials wil l perform increased monitoring and surveillance in sites recognized as a principal landing sites for migratory bird populations in Uganda. The project wil l provide finds for hiring o f boats for surveillance for migratory and resident.

Part I: Preparedness and Prevention Subcomponent 1: Strengthening Capacity for Animal Health Surveillance, Monitoring and

Emergency Disease Control

3. The project wil l use the existing institutional framework for surveillance, monitoring and emergency disease control. The project wil l support the MAAIF to strengthen i t s epidemiological unit to improve data management and f low within MAAIF and other institutions. MAAIF will put in place a sufficiently sensitive system in al l the districts in order to detect the appearance o f HPAI in migratory birds and domestic animals. To prevent entry o f HPAI virus into the country, the capacity o f HPAI rapid response teams wil l be strengthened through training and provision o f PPEs. District Rapid Response teams wil l be supported to undertake disease surveillance and monitoring. Systems for rapid investigation and response to rumors by MAAIF teams will be strengthened through procurement o f equipment and supplies. UWA’s surveillance capacity wil l be strengthened through

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procurement o f bird capture equipment and hiring o f surveillance boats. SOPs for rapid response and control o f emerging diseases in other species wil l be developed, printed and disseminated. Specific targeted research wil l be carried out for H P A I and other emerging diseases.

Subcomponent 2: Strengthening of National Veterinary Services (NVS)

4. As part o f the control strategy for H P A I and other emerging diseases, this subcomponent wil l support activities to strengthen N V S , including the private sector operating under i t s authority, to enhance animal disease surveillance, diagnosis and disease control. This activity wil l enable the N V S to respond adequately not only to HPAI but also to other trans-boundary animal diseases.

5. Based on the recently concluded evaluation o f N V S and related services, support will be provided to strengthen N V S to make it compliant with OIE standards. Emphasis will be in upgrading knowledge and sk i l ls o f the staff o f veterinary services through training and providing the necessary infrastructure for provision o f services including equipped laboratories, transport capacity. For HPAI preparedness and control, the current short fal l in human resources wil l be met by hiring personnel on a contractual basis.

6. ministries wi l l be developed, pre-tested, printed and distributed.

Standard Operating Procedures (SOPs) for reporting between MAAIF and other l ine

7. Funds wil l be provided for dissemination o f the Performance Vision Strategy Document that was developed by the OIE after the evaluation o f the N V S . Public private partnership wil l be enhanced by involving the private sector in participatory planning and monitoring.

8. Sero-prevalence surveys wil l be undertaken to establish baseline data on the epidemiology o f re-emerging diseases. The curricula o f the Faculty o f Veterinary Medicine, Makerere University (FVM-MUK) and Para-Veterinary schools wil l be reviewed to include HPAI and other TADs. The FVM-MUK will be facilitated to undertake f ield exercises for HPAI and other TADs surveillance.

9. The project wil l support strengthening o f the regulatory framework to address key pol icy issues to ensure that the recommended disease control, prevention and eradication measures are implemented in a uniform and effective way and in accordance with OIE standards and guidelines. In addition, support will be provided to review the existing regulations and policies and pol icy studies that focus on trans-boundary animal diseases.

Subcomponent 3: Improved Veterinary Technical Competence for emerging disease prevention, early detection and rapid response

10. Successfd prevention o f and an appropriate response to emerging diseases depends on the human capacity o f N V S . Risk analysis is an increasingly important tool for disease preparedness and prevention. The project will build capacity in risk analysis, design o f effective disease control programmes and understanding o f infectious disease epidemiology as the main areas o f focus to enhance national capacity for preparedness and response for

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H P A I and other TADs. This wil l be achieved through training and research in various areas o f specialisation (risk analysis, infectious disease epidemiology, wi ldl i fe surveillance). Simulation exercises for HPAI and other infectious diseases wil l be undertaken. The project will not only focus o n AI but also on other diseases.

11, the need for timely and accurate reporting o f a l l suspected outbreaks.

Personnel from al l districts wil l be trained and sensitized on HPAI recognition and

Subcomponent 4: A Balanced Veterinary Epidemio-surveillance programme capable of early detection of emerging infectious diseases and other TADs

12. Rapid response to, and successful control and eradication o f emerging infectious diseases depends directly on early detection. The capacity for early detection is a product o f an effective, balanced integrated animal health surveillance system that is directly linked to rapid response plans for disease emergencies. An effective surveillance system i s sensitive, specific, representative, timely, simple, flexible and acceptable to stakeholders. To achieve this, a system must be balanced to include passive and active elements that produce disease intelligence about al l livestock and wildl i fe systems, in a way that brings the animal health priorities o f producers to the national decision making level and allows disease prevention and control programs to meet the multi-faceted needs o f al l consumers o f surveillance information. The objective i s to strengthen Uganda’s veterinary surveillance system by helping the N V S improve its surveillance program by adding active surveillance elements, a Monitoring and Evaluation System (ME), and ensuring an integrated internationally compliant animal health database.

13. The activity wil l support: (a) passive, active and targeted surveillance, supported by sound epidemiological principles, (b) improving animal health information f low among relevant agencies; (c) early detection and timely reporting and follow-up o f suspected or positive cases; (d) public and community-based surveillance system by establishing a community-based early warning system, utilizing existing human health infrastructures at the village level, and (e) routine serological surveys and epidemio-surveillance.

14. An active HPAI surveillance program wil l be implemented in al l high risk areas, live bird markets and at the border areas. Epidemiological mapping o f high risk areas wil l be undertaken in collaboration with MOH. Epidemiological mapping protocols’ wil l be developed and discussed with other stakeholders.

15. infrastructure, equipment, supplies and transport capacity.

Animal disease surveillance wil l be strengthened through provision o f the necessary

16. The activity will support the upgrading o f the laboratories earmarked to carry out diagnostics for HPAI. The MAAIF National Diagnostics and Epidemiology laboratory will be upgraded to contain a Bio-Safety Level 3 (BSL-3) facility and wil l be expected to carry out HPAI confirmatory diagnosis at molecular level using Polymerase Chain Reaction (PCR) and Real Time PCR (RT PCR) after screening samples using Rapid Antigen Detection kits. Surveillance wil l be carried out by antibody detection tests. The MAAIF laboratory as a national referral laboratory wil l collaborate and coordinate with regional and international

21

reference laboratories for quality assurance. Capacity at the Central Diagnostic Laboratory wil l be strengthened through training and provision o f laboratory equipment and supplies.

17. The laboratory network wil l be strengthened to ensure proper coordination o f diagnostic activities in the country. The district laboratories wil l be provided with rapid detection kits to enable them screen samples for routine surveillance and rapid response.

Subcomponent 5: Infectious Diseases Preparedness, Detection and control

Evidence-Based Veterinary Rapid Response Capacity for Emerging

18. detection. The aim o f this output i s to undertake the following:

Effective rapid response to infectious disease emergencies depends directly on early

a. Establish an Incident Command System (ICs) for animal HPAI outbreak response. The N V S will establish an I C s for disease control, and ensure that the necessary equipment and supplies are available at the field level.

b. Develop national policies and SOPs for HPAI rapid response and control, including culling, compensation, livestock insurance, movement control, bio-security, vaccination, quarantine. Indicators o f completion are Minimum o f 7 SOPs for HPAI rapid response and control activities; a vaccine(s) to be used in case o f vaccination program identified, and a supplier(s) identified who can have stock available at the district or lower level within 3 weeks o f an outbreak report. Provisions for procuring o f vaccines and for carrying out vaccination campaigns have been included in the proposal. Vaccine procurement through subscribing to vaccine banks will guarantee availability o f vaccines if and when needed.

c. Procure rapid response supplies and equipment for all levels of NVS, including PPEs, disinfection units and culling equipment (burdizzos for all field staf for smaller numbers of animals, asphyxiation systems at district level for larger culls. Rapid response equipment and supplies will be procured and stored at the central level. These wil l be made available within 24 hours to the affected districts. Indicators o f completion are sufficient stocks o f PPE, disinfection units, burdizzos and asphyxiation systems available in every district.

d. Improve commercial farm and backyard poultry production bio-security . This component wil l support; improved public hygiene in poultry slaughter facilities, poultry product outlets and live-bird markets; b io security protocols for commercial farms and backyards poultry production systems; devising rural poultry sector restructuring strategies to promote poultry housing systems; and training o f people likely to be in contact with l ive virus.

e. Strengthen NVS quarantine capacity. This subcomponent supports the fol lowing activities; development o f SOPs, training and procurement o f limited equipment and infiastructure (quarantine facilities) to achieve reliable internal movement control and border quarantine.

f. Preparation of compensation Policy and Guidelines. The national AH1 preparedness strategy recognizes that a comprehensive compensation pol icy and guidelines are prerequisites o f effective control o f AH1 outbreaks. Consequently a pol icy and guidelines

22

have been developed and a compensation fund wil l be established to handle a possible outbreak o f HPAI in the country. The pol icy consequently focuses on four key issues:

Subcomponent 6: Coordination, monitoring and evaluation

19. MAAIF will be responsible for coordination, monitoring and evaluation o f Animal Health component activities planned under the project. The OPM will be responsible for the overall M&E activities. The project wil l provide funds to al l the implementing ministries responsible for their own coordination, monitoring and evaluation.

Part 11: Response and Recovery

20. In case o f an outbreak, there will be additional costs to cater for immediate response, over and above the expenses related to P&P activities. However, the exact amount cannot be known for the time being because neither the timing nor the extent o f an eventual outbreak (or outbreaks) can be anticipated. For this reason, a provision o f funds has been earmarked to activities related to the R&R stage to ensure that funds are available in the programme and in the government budget to make immediate interventions in the affected districts and regions in the eventuality o f an outbreak.

21. Cost estimates are based on an outbreak scenario which has been described at length in the Animal Health Sector Background paper. I t i s related to two outbreaks in Mbale district and one outbreak in a commercial farm with 10,000 poultry in the same district. Additional costs wi l l be incurred in terms o f need for strengthening the immediate reaction, increasing sanitary measures and improving bio-security. In the event o f an outbreak, o f HPAI and government wishes to apply part o f the credit for compensation, up to US$120,000 o f the credit may be used for that purpose. The purpose o f the proposed scenario is to make a calculation o f the R&R budget based on assumptions that are as realistic as possible, e.g. distance and time needed for interventions (for transport and per diem costs). Compensation cost has been calculated based on the poultry density population o f Mbale district. The scenario also provides simple basic data and information that wil l serve as a multiplier factor in case o f a real outbreak.

22. This subcomponent will provide support for immediate reaction to the outbreak; implementation o f sanitary measures; quarantine and movement control; strengthening o f surveillance; initiation o f recovery activities (compensation), improvement o f bio-security; strengthening o f public awareness; and re-enforcement o f active surveillance (e.g. border check posts).

Component 2: Human Health (US$2.06 million) 23. The AHIP will strengthen the Human Health strategy for the preparedness and response to Avian Influenza in Uganda by helping to build the Health System Capacity to detect early, respond and contain the infection at source in case o f a highly pathogenic avian influenza. In case o f a human influenza pandemic, the MOH will build on existing surveillance and response mechanisms established together with partners such as WHO, CDC and others. The process will include adapting guidelines and training materials, conducting training, activating and strengthening o f national and district Rapid Response Teams (RRTs), establishing isolation units and pre-positioning personal protective materials

23

and medicines. In order to confirm a working diagnosis early, the National Influenza Center (NIC) laboratory will be remodeled and equipped to Biosafety Level 3 (BSL3) and laboratory staff trained. Spread o f infection in the community wil l be detected and contained through health education, community based surveillance and confinement o f cases. Infection control guidelines will therefore be among the key activities to be implemented.

2. Sentinel surveillance

3. In-service Training ,

4. Epidemiological mapping

5.Strengthening national and district rapid response teams

6. Investigation o f outbreak threats

7. Provide regular feedback

8. Respond to private sector information

9. Community Based Disease Surveillance

Part I: Preparedness and Prevention Subcomponent I : Strengthening of Surveillance of Humans for Influenza

24. Surveillance activities for human influenza will be strengthened in al l aspects and the number o f sentinel sites expanded from the present three sites to at least eight sites. The MOH has in place the Integrated Disease Surveillance & Response (IDSR) which i s a weekly reporting system for priority diseases including human influenza o f avian origin. The aim o f this subcomponent i s to strengthen the existing field disease investigation system and expand sentinel surveillance to cover at least the regional hospitals and community based surveillance in selected high risk districts. The project wil l ensure that surveillance tools reach the desired end users. This will be achieved through training, ensuring data collection and reporting. The broad functions and activities under this subcomponent are presented below:

Select districts in high risk areas to capture data on human & animal health events

Training at national level to strengthen technical capacity and at district level to strengthen AI surveillance activities

Mapping o f high r i s k areas for AI

Purchase o f vehicles, equipment and logistics for easy and rapid access to high risk areas and outbreak areas.

Threats identified f rom increased threshold f rom sentinel surveillance data

Outbreak investigations & surveillance reports

Work with poultry farmers, media, etc to respond to information o n sick and dead confined andor backyard chickens.

Develop reporting forms, train members o f the DHT,DVO and Vil lage Health Teams to report suspected sickness and deaths f rom severe acute respiratory infections and influenza like illnesses

I Remarks Function

1. Case detection & reporting Case definition, Reporting forms for human and animal health events

24

Subcomponent 2: Strengthening Capacity of Uganda National Health Research Organization (UNHRO) 25. The project will support UNHRO to ensure effective coordination o f stakeholders and development o f harmonized policies and strategies for active surveillance and laboratory investigations at national and regional levels. I t will also build capacity for integrated research and management o f new emerging infections e.g. avian influenza, Ebola, Marburg, monkey pox and others. The project wil l also support UNHRO to coordinate the establishment o f the Centre for Infectious Diseases ecology and upgrading o f the National Influenza Centre (NIC) laboratory at WRI to BSL 3 and provision o f laboratory diagnostic equipment and reagents. Training o f staff and quality control in AI diagnostics, field specimen collection, and testing for influenza viruses including HPAI will also be supported

Subcomponent 3: Consolidation of Preparedness for AHI Prevention, Containment and Control

26. Infection control procedures and educational programmes wil l be developed for the most vulnerable and at risk communities and health workers while at the same time isolation facilities and infection control materials and PPEs will be set up at least at six regional hospitals from where they can be easily accessible to health centres within their catchment areas.

Subcomponent 4: Improving Food Safety and Environmental Hygiene

27. In view o f a potential risk o f an outbreak o f Avian Influenza from occupational and environmental exposure to infected poultry and poultry products, the project will support a number o f activities and assessments aimed at improving on the level o f preparedness and prevention o f Avian Influenza in the food industry. The main focus wil l be on improvement o f the environmental, occupational and food safety o f poultry and poultry products in the country. The main activities will be carried out in poultry markets in a sample o f towns and along major highway food vending points where chickens are slaughtered, roasted and openly sold to the traveling public. These places can be potential sources o f unsafe poultry and poultry products and an ideal medium for the rapid spread in case o f an avian influenza epidemic.

Subcomponent 5: Health Services and Systems Prepared to Handle Suspected Cases

28. The experiences with Ebola Haemorrhagic fever outbreaks in northern and western Uganda shows that the health systems need to be ready for a surge in case o f an outbreak. The implementation o f this subcomponent wil l increase the surge capacity and flexible deployment o f both human and infrastructure resources. This will be achieved mainly by training o f health workers in case management and rapid response, development and conducting o f simulation exercises and the development o f a contingency plan o f human resource management in case of an outbreak. In due course the private health practitioner sector will be included as part of the M O H /Public Private Partnership for Health (PPPH).

25

Subcomponent 6: Preparation for Effective Case Management

29. The ultimate aim o f any outbreak management strategy i s to ensure proper treatment o f al l cases detected. In addition to the treatment, the project wil l ensure availability o f a limited stock o f pharmaceuticals for emergencies (Tamif luB and other antibiotics) while adequate budgetary provision should be made for additional supplies when the situation warrants. Guidelines, SOPS and other accessories and medical supplies used in treatment wil l also be provided. These drugs and supplies including vaccines (once they become available); wil l be positioned in a location that makes them easily available to those in need. The project will also provide operational expenses such as those related to mobilization o f health teams, allowances and technical assistance.

Part 11: Response and Recovery Subcomponent 1: Response to Outbreak of Pandemic Influenza of Avian Origin

30. Previous outbreaks o f pandemic influenza have shown how rapidly it can spread and the mortality i t can bring upon a community. The Project wil l help create and sustain a system that can rapidly contain the infection as this is one o f the key elements which wil l drastically reduce human to human transmission, suffering and death. Rapid response teams wil l be activated immediately to undertake active case investigations, detection and provide situation analysis reports. There wil l be need to intensify collaboration with the veterinary services in the areas o f disease surveillance, provision o f PPEs, prophylaxis to investigating teams and treatment o f human cases to control the spread o f the epidemic. In the pandemic phase exceptional measures l i ke quarantine and restricting movement o f people, closure o f schools, markets etc wil l be taken by the central government in consultation with WHO. In the recovery phase the project wil l support restocking o f equipment and drugs used by RRT, health facilities and the laboratories.

Component 3: Communication (US$1.83 million)

Part I: Preparedness and Prevention 3 1. The main challenges faced in fighting avian influenza relate to lack o f motivation due to l o w risk perception and a general lack o f knowledge o f avian influenza among the general public and a wide range o f stakeholders, especially the small-scale back-yard poultry fanners. To address these constraints, the Project wil l identify lines o f communication, social beliefs, practices and perceptions and habits o f stakeholders by improving public awareness and information aimed at fostering positive behavior change.

32. Project aims at achieving the following objectives:

The communication interventions as elaborated in the Communication Strategy o f the

(i) To increase the number o f pol icy makers and community leaders who are aware o f AI and actively advocate for AI prevention, preparedness and control.

(ii) To increase the number o f ‘at risk’ people who are aware o f the signs and symptoms o f AI in animals, and the bio- security measures needed to prevent infection; and to

26

increase the number o f people who promptly report sick and dead birds that might be suspected as cases o f HPAI.

(iii)To increase the numbers o f people who are aware o f the signs and symptoms o f AH1 in humans and also know the proper action to take in case o f suspected human infection such as seek prompt treatment at a health centre.

(iv)To increase the number o f relevant fiont line workers (veterinarians, para-veterinarians, extension workers, teachers, health workers, border officials and key religious and community leaders including local council members, and district media representative, particularly the FM radio stations) who have a comprehensive understanding o f AH1 prevention and who can actively train others to take appropriate protective measures.

Subcomponent 1: Achieve Advocacy with Key Policy Makers at the National and District Levels

33. This wil l be done to ensure the support o f key local and national pol icy makers to AI prevention and control efforts. The project wil l support the development o f pol icy papers on the evolution o f AH1 globally and in Africa, on the latest information on the science o f the outbreaks in birds and o n the threat to human beings as wel l as on the likely damage to the national economy and to family finances and food security. Brief ing to pol icy makers with video support will also be undertaken to help achieve the expected result.

Subcomponent 2: To Enhance the Communication Skills of Key Policy Makers and Spokespersons

34. Strengthening the communication capacity and media dealing skills o f senior pol icy makers and spokespersons through small-group trainings, would be an asset in any outbreak situation. The spokespersons and policy makers need to apply the principles o f Outbreak communications and maintain trust and transparency in order to secure the trust and compliance o f the public especially so during an outbreak. Media training for senior spokespersons wil l be conducted to enable them to deal more effectively with the media which play a very important role in the control o f any outbreak.

Subcomponent 3: Establishment of a Communications Center within the Coordination/Operation Center at Central and District Levels

35. Communication Focal Points (CFPs) for AI wil l be located at the central and district AI Coordinatiodoperation centers. The project wil l equip the CFPs with dedicated communication facilities, e.g. hotlines and computers with internet connectivity. The CFPs wil l also be provided with a ready supply o f posters and handouts o n the basic information on AI for poultry and human health, as wel l as standard protocols for reporting any outbreaks. The project will ensure availability o f the SOPS for the communication chain o f command, for urgent passage o f information, both up to the central command centre and down to the sub-district and L C levels.

27

Subcomponent 5: Development, Production and Evaluation of Relevant Communications Messages and Materials.

36. The public at a l l levels wil l need to be kept informed, o f the situation in the country, the potential risk from neighbouring countries, and the risk during an actual outbreak. This wil l involve mounting media campaigns using I E C materials specially developed, pre-tested and prepared to inform people about the risks to their poultry and the associated risk to human health. At the same time a national AH1 web-site wil l be developed for posting and updating in fomat ion o n AHI.

Subcomponent 6: Inform and Mobilize a Critical Mass of Communication and Social Mobilization Teams at National and Sub-national Levels

37. The project wil l inform and mobilize farmers and households with back yard poultry and support their efforts to build partnerships with the district and sub district officials, technical people, religious and cultural leaders and the media. T o bring them o n board, the project will undertake training at various levels, and this will require development o f training modules and training o f trainers to ensure quality training.

Subcomponent 6: Build Strategic Partnership with the Media

38. The project wil l support building o f strong partnership with the key national and district level media since any local outbreak o f AI has the potential o f becoming international news. This wil l be done through regular meetings with news editors and senior journalists and also by including journalists in simulations and table top exercises which reveal the complex nature o f outbreaks. A well-informed set o f journalists would be able to report responsibly and with a greater understanding o f the subject.

Subcomponent 7: Develop a Monitoring and Evaluation (M&E) matrix

39. To study the effectiveness o f the communications activity and to make mid-course corrections as necessary, the project wil l support the development and application o f an M&E matrix. This would be developed under the supervision o f the AH1 Communication TWG with the help o f a consultant, who wil l develop the matrix and start the evaluation in the second year. The consultant wil l also train two M&E staff from MAAIF and MOH. These staff wil l j o in the evaluation process from the start, and will continue it further in collaboration with other technical staff in the two ministries.

Part 11: Response and Recovery

40. The outbreak response strategy should be launched within the f i rst 24 hours o f any report o f an outbreak and by 48 hours to have the full response in position. However, to ensure this state o f readiness, the following outputs are essential to be developed for a six month response strategy, and must be finalized in the next 6 months, as a priority.

41. SOPS for the outbreak communication strategy established. Activities planned include:

Chain of command for movement o f information from the field (outbreak site) to the central AH1 command established;

28

Procedure for chain o f clearance for al l ‘Talking points’ and press releases established and published;

e List o f authorized spokespersons, including the specific role o f the Ministry Communication officers, at centre and districts designated; Key spokespersons provided training in Outbreak Communications and in media skills and dealings.

42. , I E C materials for outbreaks in poultry and in humans readied and disseminated particularly to borders and districts at risk. Activities planned include:

e e

e

e

e

e

43.

44.

Prevention and containment messages developed, pre-tested and produced: Posters/ material on quarantine and movement control to be widely disseminated at pre-designated sites Information about compensation pol icy to be clearly communicated to the community to encourage compliance with culling measures. Experts/Spokespersons to appear on Television and radio explaining the actual situation, without over reassuring the public and maintaining transparency in al l measures being taken. In case o f infection in a human, ready posters and I E C materials to be intensively disseminated in the affected area. Inform the public through press releasedmedia talk shows about the dangers to their health and the steps to self protection. In case self- isolation i s necessary, the measures would have to be explained in messages from high level political leadership. Specific posters/ material on quarantine outbreak in humans.

Media plan for outbreaks i s activated.

Schedule o f regular media briefings established and media informed. Principles o f Outbreak communications applied. Activate media surveillance to obtain feedback on rumors and public perceptions and concerns about AI. Ensure the next communication messages address these concerns. Press releases and Fact Sheets drafted and disseminated. Web site regularly updated with latest information. Prepare K e y “talking points” for and regular briefings o f the spokespersons on the outbreak situation and the response measures. Professional photographers and videographers wil l be commissioned to document the situation.

45. Strengthened communication to the public at the outbreak foci or ‘ground zero’.

46. Ground level, frontline workers for social mobilization activated. Community mobilization teams activated. Rapid training in correct practices provided to farmers in affected areas.

47. restockinghecovery measures clearly communicated to the media and the public.

Plan for officially reaching the end o f the emergency phase clearly demarcated and

48. strategy for future use.

Evaluate the impact o f the communication effort and make necessary revision in the

29

Component 4: Coordination, Monitoring & Evaluation (US$0.45 million) 49. This component will support implementation costs associated with project planning, coordination, management, as wel l as overall monitoring and evaluation (M&E). The Project will therefore support strengthening the effectiveness and quality o f project management and operations at the national and local levels o f government for overall project coordination and supervision. The project will be implemented at the grassroots level. Therefore, the OPM, as leader o f Government Business, wil l provide overall pol icy coordination and project M&E at national level, while MAAF and MOH will coordinate, monitor and evaluate the district offices and health units on the technical aspects o f the project to ensure effective implementation, reporting and backstopping.

Subcomponent 1: Coordination at National Level

50. This h c t i o n will be undertaken by the Project Coordination Team (PCT) which wil l be led by the Project Coordinator/Focal Point Officer in the Disaster Management Department o f OPM. The later office wil l also serve as the secretariat o f the National Project Steering Committee (NPSC). The main goals o f coordination are three fold:

a To ensure that the various sectors (human and animal health and the communication sectors) work effectively and efficiently in developing and implementing prevention, preparedness and response policies and strategies for AHI; To facilitate the exchange o f and access to al l information necessary for the development, adjustment, and implementation o f strategies by al l actors/players at a l l levels.

a To increase the synergies derived from sharing resources, information and experiences.

51. The project wil l strengthen and support strong inter-linkages among the various sectors o f intervention (animal health, human health and communication) to avoid overlaps in the implementation o f the different components o f the AHP. The coordination mechanisms wil l be both multi-ministerial and multi-sectoral partnerships o f the NPSC, NTF/AI and TWGs and the wider stakeholders involving DPs and international and local NGOs. The project will also support the inclusion o f private human and animal health practitioners and farmers groups and facilitate their participation in the prevention, preparedness and response to AH1 and the promotion o f public private partnership (PPP) projects on AH1 to private companies and investors through PPP fora.

a

Subcomponent 2: Coordination at District Level

52. The project wil l strengthen coordination between the NTF/AI and district Rapid Response Teams (RRTs) which wil l play a key role in the preparedness and response to AH1 outbreaks. On the coordination point o f view, district RRTs wil l be set up in al l 80 districts and district operational plans developed based on the strategies set at central level. The project wil l support districts to have reliable ways o f communicating regularly with the central, counties, sub-counties levels, and with each other.

30

Subcomponent 3: Expanded Coordination and Collaboration across Borders

53. The government through the NPSC and PCT in OPM, the NTF/AI and TWGs will maintain its active participation in regional, sub-regional and key international meetings on AHI. The government wil l therefore increase i t s involvement in the region and sub-regional prevention and preparedness activities and proactively expand, strengthen i t s collaboration with al l neighboring countries and partners involved in the import-exports o f poultry and poultry products.

Subcomponent 4: Regular Coordination with DPs

54. I t i s important to strengthen coordination with DPs to ensure buy-in and additional mobilization o f resources for the INM. To this end the project wil l ensure that the DPs are regularly kept abreast o f proj ect implementation progress.

Subcomponent 5: Monitoring and Evaluation

55. Overall M&E by OPM at national level: The OPM has in place a National Implementation, Monitoring and Evaluation System (NIMES). An effective and comprehensive system o f monitoring and evaluation for the AHIP activities at al l levels and for al l sectors needs to be developed and integrated into the NIMES. The data for this system wil l be provided to the O P M by MAAIF and MOH who are responsible for technical monitoring aspects at both the national and district levels. This would help the NSC to accurately measure progress and achievements, and identify gaps and obstacles so that timely corrective actions can be taken.

31

5

0 s

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3 C 0 0 C

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ANNEX 3

Project Cost by Component

REPUBLIC OF UGANDA


Local Foreign Total YO of total

SUMMARY OF ESTIMATED PROJECT COSTS

Animal Health Human Health Communication Coordination, M&E

Annex 3: Summary of Project Costs (In US$ million equivalent)

4.28 1.38 5.66 56.6% 1.16 0.90 2.06 20.6% 1.62 0.21 1.83 18.3% 0.34 0.11 0.45 4.5%

Table 1: Project Cost by Component

Total Project 7.40 I costs 2.60 I I 10.00 100% I

Figures may not add up due to rounding

Table 2: Project Cost by Category

Category

(1) Animal Health: (Works, goods and equipments, consultants’ services, Training and Workshop, and Operating Costs for Part A o f the Project)

(2) Human Health and Communication: (Works, goods and equipments, consultants’ services, Training and Workshops, and Operating Costs for

Amount o f the Financing Allocated

(expressed in SDR million equivalent)

3,500.0

Amount o f the Financing Allocated

(expressed in US$ million equivalent)

5,657.2

Percentage of

Expenditures to be

Financed (inclusive of

Taxes)

100%

35

Parts B and C o f the Project)

(b) Communication

(3) Goods and equipments, consultants’ services, Training and Workshops, and Operating Costs for Part D o f the Project

TOTAL AMOUNT

(a) Human Health

1,100.0

300.0

6,200.0

I 1,300*0

I

2,066.8

1,826.0

100%

100%

450.0 100%

10,000.0 I

36

I I I z $1 3

- z m N

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- z $1

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-

z m m

z m 3

- z 00 3

C W c 7

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9 3 3

I

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- 9 m

8 Q\ N

- 8 rn

8 Q\ m

- 8 2

C C C 7-

-

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- 0

8 d

-

8 m

2 rn

- 9 3 rn

8 2

- 8 2

I

ANNEX 4

REPUBLIC OF UGANDA


Annex 4: Financial Management And Disbursement Arrangements

Introduction

1. This report is a record o f the results o f the assessment o f the proposed financial management arrangements for Avian and Human Influenza Preparedness and Control Project (AHIP) implemented by the Ministry o f Health (MOH) and Ministry o f Agriculture, Animal Industry and Fisheries (MAAIF) and overseen by the Office o f the Prime Minister (OPM). The objective o f the assessment i s to determine: (a) whether the three implementing entities have adequate financial management arrangements to ensure AHIP funds wil l be used for purposes intended in an efficient and economical way; (b) AHIP financial reports will be prepared in an accurate, reliable and timely manner; and (c) the project’s assets will be safeguarded. The financial management (FM) assessment was carried out in accordance with the Financial Management Practices Manual issued by the Financial Management Sector Board on November 3,2005.

Country Issues

2. The Public Expenditure and Financial Accountability (PEFA) Report o f November 2005 (issued in July 2006) and Country Financial Accountability Assessment (CFAA) carried out by IDA in 2004 shows that Government o f Uganda has made substantial progress in improving its Public Financial Management Systems since the last C F A A undertaken in 2001. The fiduciary r isks associated with poor budget formulation and budget preparation processes have been reduced. In terms o f appropriate legislation and regulatory frameworks, significant progress has been made to ensure that the r isk associated with the lack o f clear rules and regulations has been reduced. Also more useful information i s provided in the Report and Opinion o f the Auditor General to Parliament on the Public Accounts o f the Republic o f Uganda. However r isks remain in terms of: (i) Quality and timeliness o f in-year budget reports since budget reports only include information on budget releases and not actual expenditures; (ii) Stock and monitoring o f expenditure payment arrears; (iii) Effectiveness o f internal audit; (iv) Oversight o f aggregate fiscal risk from other public sector entities; (v) Effectiveness o f measures for taxpayer registration and tax assessment; (vi) Legislative scrutiny o f external audit reports; (vii) Effectiveness o f payroll controls; and, (viii) Effectiveness in collection o f tax payments. Government o f Uganda (GOU) has prepared a Financial Management Accountability Program (FINMAP) to address the weaknesses in i t s Public Financial Management system. The FINMAP is supported by a number o f development partners, including the World Bank, that form the Public Financial Management Donor Group.

40

Risk Assessment and Mitigation

3. The objectives o f the project’s financial management system are:

0 to ensure that funds are used only for their intended purposes in an efficient and economical way;

0 to ensure that funds are properly managed and f low smoothly, adequately, regularly and predictably in order to meet the objectives o f the project;

0 to enable the preparation o f accurate and timely financial reports; 0 to enable project management to monitor the efficient implementation o f the project;

and 0 to safeguard the project assets and resources.

4. system:

Furthermore, the following are necessary features o f a strong financial management

0

0

e

0

0

5.

an adequate number and mix o f skilled and experienced staff; the internal control system should ensure the conduct o f an orderly and efficient payment and procurement process, and proper recording and safeguarding o f assets and resources; the accounting system should support the project’s requests for funding and meet i t s reporting obligations to fund providers including Government o f Uganda, IDA, other donors, and local communities; the system should be capable o f providing financial data to measure performance when linked to the output o f the project; and an independent, qualified auditor should be appointed to review the Project’s financial statements and internal controls.

The table below identifies the key risks that the project management may face in achieving these objectives and provides a basis for determining how management should address these risks.

government PFM systems and they are

41

I Entity Level

I Budgeting I Accounting

I Project Level

L L Accounting systems are satisfactory in al l

the three ministries. Staffing i s satisfactory and there are accounting policies and procedures in place being adhered too.

The IFMIS i s used as the computerized accounting system for the three ministries but i s not configured to be used for projects. As such, AHIP accounts wil l be

Control Risk

AAIF and OPM that wil l ensure funds are spent for purposes intended and

42

I Internal Control

H FundsFlow

Reporting

r Auditing

Overall Risk Rating

S The three ministries have qualified and experienced internal auditors who have included the project within their work plan to ensure the internal audit unit carries out i t s role within the project. Accounting policies and procedures are satisfactory.

However, in the Auditor General’s report o f 30 June 2006, OPM and MAAIF audited accounts were qualified on an ‘except for’ basis and MOH had a disclaimer audit opinion. In al l the three ministries, issues o f lack o f accountability were raised in the report hence making the risk o f their internal control system substantial. In order to mitigate this risk, the funds for this project have been ring fenced within these ministries and their use will be closely monitored by thc Accounting Officer, Internal Audit Unit, Auditor General’s Office and the Bank to ensure they are used for purposes intended.

M There i s a l ikelihood o f challenges being faced by the implementing institutions l ike ministries, districts, private companies and investors, regional, sub regional and international organizations in financial reporting. This will be mitigated by constant and continuous training and monitoring by the accountants in the three ministries during project implementation.

The three ministr ies have produced formats of Inter im Financial Reports (IFRs) that will be used for NIP. These formats were agreed with the Bank at the negotiations.

udits for the project will be done by the uditor General using International

les- condition If negotiation n regard to IPM, MOH, YlAAIF roducing onnats o f IFRs.

H - High S - Substantial M - Modest L - L o w

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6. r isks in the risk assessment and mitigation table above.

The overall residual r isk i s expected to be moderate upon the mitigation o f identified

7. financial management system and the dates that they are due to be completed by.

The action plan below indicates the actions to be taken for the project to strengthen i t s

Production o f formats o f interim financial reports (IFRs) that will be used for AHIP and agreeing them with IDA. The Auditor General’s audit report in the three ministries identified accountability issues which, implies that al l these implementing institutions will have to improve on their internal control systems to ensure that the project’s fimds are used for purposes intended. In order to mitigate this risk, the funds for this project have been ring fenced within these ministries and their use will be closely monitored by the Accounting Officer, Internal Audit Unit, Auditor General’s Off ice and the Bank to ensure they are used for purposes intended.

Date Due Before negotiations

To be done during Project implementation.

Strengths and Weaknesses of the Financial Management System

OPM. MOH and MAAIF /IDA

OPM. MOH, M M ’ Auditor General’s Office and IDA

The project financial management i s strengthened by the following salient features:-

The accounting personnel within the three ministries are adequately qualified and experienced. The project being under the ministries will use the Treasury Accounting Instructions 2003, issued under the Public Finance & Accountability Act 2003 as i t s accounting policies and procedures. Budgeting arrangements are adequate; External and internal auditing arrangements are adequate; Funds f low arrangements are adequate; and The IFMIS i s used as the computerized accounting system for the three ministries but i s not configured to be used for projects. As such, AHIP accounts will be prepared manually using excel spread sheets or other accounting packages. The three ministries have adequate financial reporting requirements. They have developed formats for IFRs that have been agreed with the Bank.

The project financial management i s weakened by the following salient features:-

The Auditor General’s audit report for 30th June 2006 for the three ministries identified accountability issues which, implies that al l these implementing institutions wil l have to improve on their internal control systems to ensure that the project’s h d s are used for purposes intended. In order to mitigate this risk, the funds for this

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project have been ring fenced within these ministries and their use will be closely monitored by the Accounting Officer, Internal Audit Unit, Auditor General’s Office and the Bank to ensure they are used for purposes intended.

Institutional and Implementation Arrangements

10. No Project Coordination Unit (PCU) i s envisaged but there wil l be a multi-sectoral, sustainable, robust coordination system at central level. A multi sectoral Project Coordination Team (PCT) wil l be set up. The PCT wil l be chaired by the office o f the Prime Minister (OPM), which i s responsible for disaster management and will serve as the secretariat to the Project Steering Committee. The project wil l largely be implemented by the Ministry o f Agriculture, Animal Industry and Fisheries (MAAIF- Animal health component) and ministry o f health (MOH-Human health component). The communication and M&E components wil l be coordinated by the PCT and implemented by the relevant ministries for areas pertinent to their responsibilities, with OPM maintaining the consolidated project data.

11. During project execution the ministries shall individually coordinate project implementation and manage:

(a) procurement, including purchases o f goods, works, and consulting services; (b) project monitoring, reporting and evaluation; (c) contractual relationships with IDA and other co-financiers; and (d) financial management and record keeping, accounts and disbursements.

12. Government o f Uganda on matters related to the implementation o f the project.

The three ministries will also constitute the operational link to the IDA and

13. The Permanent Secretaries (PSs), o f the three ministries, wil l be the “Accounting Officers” for the project, assuming the overall responsibility for accounting for the project funds.

14. The project wil l have a number o f implementing units that include ministries, districts, private companies and investors, regional, sub regional and international coordination organizations. Memorandums o f Understanding (MoUs) will be entered between the ministries and these implementing institutions. The MoUs should include the following in order to ensure the implementing institutions have adequate financial arrangements acceptable to the Bank.

(a) They should have a designated qualified and experienced accountant to budget, account and prepare financial reports in regards to the use o f AHIP funds or alternatively submit their accountabilities to the three ministries.

(b) They should open a designated AHIP bank account for the funds sent from the ministries.

(c) They should have satisfactory accounting policies and procedures in place. (d) They should provide quarterly unaudited interim financial reports (IFRs) to the

These reports should be ministries in regard to the utilization o f AHIP funds.

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submitted within thirty (30) days after the end o f the quarter in order for the ministries to consolidate AHIP IFRs to be submitted to Bank within forty five (45) days after the end o f the quarter.

(e) They should provide access to both internal and external auditors and the Bank to information in relation to the utilization o f AHIP funds.

Budgeting Arrangements

15. In all the three implementing institutions, Government planning and budgeting procedures which are documented in the government’s Treasury Accounting Instructions, 2003 are followed. These arrangements have been found to be adequate. There is a planning unit that i s responsible for budgeting in the ministry. There i s also a budget officer responsible for budgeting. All other departments are involved in the budgeting process. The capacity o f the accounting staff to fulfill budgeting needs o f the project i s adequate.

Accounting Arrangements

16. Books of Accounts and List of Accounting Codes: All the three implementing institutions will maintain similar books o f accounts to those for other IDA funded projects. The books o f accounts to be maintained specifically for AHIP should thus be set up and should include: a Cash Book, ledgers, journal vouchers, fixed asset register and a contracts register. A l i s t o f accounts codes (Chart o f Accounts) for the project should be drawn upon finalization o f the accounting computerization process. This should match with the classification o f expenditures and sources and application o f funds indicated in the Financing Agreement. The Chart o f accounts should be developed in a way that allows project costs to be directly related to specific work activities and outputs o f the project.

17. Staffing Arrangements: All the three implementing institutions are adequately staffed with qualified and experienced accounting staff. The project’s accounts wil l be prepared by a designated staff in each o f these institutions who wil l report to the Principal Accountant who reports to the Under Secretary and ultimately to the Permanent Secretary. The designated accountant wil l be assisted by an accounts assistant. Otherwise the O P M has 1 Principal Accountant, 2 Senior Accountants, 3 Accountants while MOH has 1 Principal Accountant, 1 Senior Accountant, 3 Accountants and 5 accounts assistants and M A A I F has 1 Principal Accountant, 1 Senior Accountant, 4 Accountants and a number o f senior accounts assistants as wel l as accounts assistants.

18. In order to ensure that the project i s effectively implemented, the three implementing institutions will ensure that appropriate staffing arrangements are maintained throughout the l i fe o f the project.

19. Information System: All the three implementing institutions are connected to the Integrated Financial Management System but i t has no project module and wil l not be used to account for the project’s funds. However, OPM will prepare the accounts for the project manually using excel spreadsheets, MOH will use i t s Sun Accounting software and MAAIF will use i t s Navision Accounting software. The accounting staff in MOH and MAAIF are conversant in preparing the accounts using their accounting software. The r isk o f O P M using

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excel spreadsheets to prepare accounts i s minimal given that few accounting transactions are expected to be processed by OPM.

Internal Control & Internal Auditing

20. Internal Controls and Financial Management Manual: The existing Financial Management Manual (FMM) in the three implementing institutions i s the Government’s Treasury Accounting Instructions 2003 issued under the Public Finance and Accountability Act 2003. These procedures, however, fa l l short on project requirements on external auditing and financial reporting which wil l be documented in the Financing Agreement.

21. major transaction cycles o f the project; funds f low processes; the accounting records, supporting documents, computer files and specific accounts in the financial statements involved in the processing o f transactions; the l i s t o f accounting codes used to group transactions (chart o f accounts); the accounting processes from the initiation o f a transaction to i t s inclusion in the financial statements; authorization procedures for transactions; the financial reporting process used to prepare the financial statements, including significant accounting estimates and disclosures; financial and accounting policies for the Project; budgeting procedures; financial forecasting procedures; procurement and contract administration monitoring procedures; procedures undertaken for the replenishment o f the Special Account; and auditing arrangements.

The FMM describes the accounting system i.e.

22. In the Auditor General’s report o f 30 June 2006, OPM and MAAIF audited accounts were qualified o n an ‘except for’ basis and MOH had a disclaimer audit opinion. In al l the three ministries, issues o f lack o f accountability were raised in the report hence making the risk o f their internal control system substantial. In order to mitigate this risk, the funds for this project have been ring fenced within these ministries and their use wil l be closely monitored by the Accounting Officer, Internal Audit Unit, Auditor General’s Office and the Bank to ensure they are used for purposes intended.

23. Internal Audit: All the three implementing institutions have qualified and experienced internal auditors. OPM and MOH have 2 internal auditors i.e. a Senior Internal Auditor and an Internal Auditor while MAAIF has 3 internal auditors i.e. a Senior Internal Auditor and 2 Internal Auditors. The Senior Internal Auditor in al l the three implementing institutions reports to the Accounting Officer who i s the Permanent Secretary although reforms are underway to ensure internal audit reports to an Audit Committee. The internal audit unit issues out reports on a quarterly basis based on their review o f the internal control system o f the ministry and the management at the ministry takes action on the report. The commissioner Internal Audit in the MFPED also receives copies o f the audit reports for monitoring purposes. The qualification and experience o f the staff in the unit i s adequate and their quality assurance i s monitored by the Ministry o f Finance, Planning and Economic Development (MFPED) under the Commissioner Internal Audit. In this regard, the internal audit arrangements at the three implementing institutions are adequate.

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Funds Flow Arrangements

Bank Accounts

24. institutions for the purposes o f implementing the project:

The following bank accounts wil l be maintained by each o f the three implementing

0

0

Designated Account: Denominated in U S dollars, disbursements from the IDA will be deposited on this account. Project Account: This wil l be denominated in local currency. Transfers from the Designated Account (for payment o f transactions in local currency) wil l be deposited on this account in accordance with project objectives.

25. Financing Agreement.

These bank accounts shall be opened at Bank o f Uganda in accordance with the

26. The signatories for the project wil l be in accordance with the Treasury Accounting Instructions/ Public Finance and Accountability Act, 2003. Payments wil l be approved and signed by The Accounting Officer (Permanent Secretary) as the principal signatory and the person designated by the Accountant General who in this case is the Principal Accountant.

Flow of Funds

27. The three implementing institutions wil l be using the report-based disbursement method. Funds f low arrangements for the project (through the two bank accounts above) wil l be as follows:

The ministries wil l prepare a six monthly cash f low forecast for AHIP based on the work plan and submit the Withdrawal Application to the Bank after the effectiveness o f the project. Subsequent withdrawal applications should be submitted quarterly with IFRs within 45 days after the end o f the quarter. The quarterly periods fol low the calendar year quarters hence IFRs should be prepared as o f end o f March, June, September and December. IDA will make an advance disbursement from the proceeds o f the hnding based on the cash f low forecast by depositing into a Borrower-operated Designated Account held at Bank o f Uganda denominated in U S Dollars. Funds can be transferred from AHIP designated account to the project Account denominated in Uganda Shillings to make payments in the local currency. The project expenditure can be paid from either the designated account or the project account. These wil l include transfers to other implementing units under an MoU such as ministries, research institutions, NGOs and international organizations, private sector agencies, local govemment/district entities and community facilitation teams who will have to account for the funds before receiving the next transfer.

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FIGURE 1 : AHIP FUNDS FLOW CHART (For each of the implementing institutions)

............. .................. Designated Account

(USD) in BOU

Transactions paid in either USD or UGX including transfers under an MoU to implementing units e.g. NGOs and international organizations, private sector

agencies, investors, etc government/district entities and community facilitation teams

Disbursement Arrangements

28. The three implementing institutions have established effective financial management and accounting systems, which will facilitate the introduction o f report based disbursement where cash f low forecasts based on work plans are submitted for a period o f six months every quarterly period along with IFRs. The IFRs will be submitted for disbursement’on a quarterly basis. In order to continue using report based method, we will expect the project to, (a) sustain satisfactory financial management rating during project supervision; (b) submit IFRs consistent with the agreed form and content within 45 days o f the end o f each reporting period, and (c) submit a Project Audit Report by the due date. Another acceptable method o f withdrawing funds from IDA i s the direct payment method, involving direct payments from the Credit/Grant to a third party for works, goods and services upon the Borrower’s request. Payments may also be made to Bank o f Uganda for expenditures against IDA special commitments covering Bank o f Uganda’s Letter o f Credit. IDA’S Disbursement Letter will stipulate a minimum application value for direct payment and special commitment procedures,

29. The three implementing institutions wil l be expected to submit within six months after effectiveness a six months cash f low forecast based on their work plan using the report based method o f disbursement to IDA for disbursement. IDA will then deposit funds into the Designated Account and these funds will be used by the Borrower to finance the project.

30. Upon effectiveness, the three implementing institutions wil l be required to submit an IFR with the six month cash flow forecast to IDA in order to make a deposit to the

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designated (Special) Account. Replenishment o f funds from IDA to the Special Account wil l be made upon receipt o f the quarterly IFRs which wil l contain the 6 monthly cash f low forecast for the subsequent period. If ineligible expenditures are found to have been made from the Designated Account, the Borrower will be obligated to refund the same. If the Designated Account remains inactive for more than six months, the Borrower may be requested to refund to IDA amounts advanced to the Designated Account.

31. disbursement o f the Funds if reporting requirements are not complied with.

IDA will have the right, as reflected in the Financing Agreement, to suspend

Financial Reporting Arrangements

32. Formats o f the various periodic financial monitoring reports to be generated from the financial management system wil l be developed. There wil l be clear linkages between the information in these reports and the Chart o f Accounts. The financial reports wil l be designed to provide quality and timely information to the project management, implementing agencies, and various stakeholders monitoring the project’s performance.

33. The following quarterly IFRs will be produced by the three ministries; . . A statement o f Sources and Uses o f Funds for the reported quarter and cumulative period

(from project inception) reconciled to opening and closing bank balances; and A statement o f uses o f funds (expenditure) by project activity/component comparing actual expenditure against the budget, with explanations for significant variances for both the quarter and cumulative period.

34. were agreed with the Bank during the negotiations.

The three implementing institutions have prepared the formats for the IFRs which

35. submit to the Bank the following information in order to support report-based disbursement:

In addition to the above IFRs, the three implementing institutions wil l also have to

. . DA Bank Statements. . . Designated Account (DA) Activi ty Statement.

Summary Statement o f DA Expenditures for Contracts subject to Prior Review. Summary Statement o f DA Expenditures for contracts not subject to Prior Review.

36. The financial statements should be prepared in accordance with International Public Sector Accounting Standards (which inter alia includes the application o f the cash basis o f recognition o f transactions). The IDA Financing Agreement wil l require the submission o f audited financial statements to the Bank within six months after the financial year end.

37. These Financial Statements wil l comprise of:

(i) A Statement of Sources and Uses of Funds / Cash Receipts and Payments which recognizes al l cash receipts, cash payments and cash balances controlled by the entity; and separately identifies payments by third parties on behalf o f the entity.

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(ii)

(iii)

(W

A Statement of Affairs/ Balance Sheet as at the end o f the financial year showing al l the assets and liabilities o f the project.

The Accounting Policies Adopted and Explanatory Notes. The explanatory notes should be presented in a systematic manner with items on the Statement o f Cash Receipts and Payments being cross referenced to any related information in the notes. Examples o f this information include a summary o f fixed assets by category o f assets, and a summary o f SOE Withdrawal Schedule, listing individual withdrawal applications; and

A Management Assertion that Bank funds have been expended in accordance with the intended purposes as specified in the relevant World Bank legal agreement.

38. requirements and agreed with the Country Financial Management Specialist.

Indicative formats o f these statements wil l be developed in accordance with IDA

External Auditing Arrangements

39. The Auditor General i s primarily responsible for the auditing o f al l government projects. Usually, the audit may be subcontracted to a firm o f private auditors, with the final report being issued by the Auditor General, based on the tests carried out by the subcontracted firm. The private f i r m s to be sub-contracted should be among those that are acceptable to the Bank, following a review o f audit firms in Uganda. In case the audit is subcontracted to a firm o f private auditors, IDA funding may be used to pay the cost o f the audit. The audits are done in accordance with International Standards on Auditing.

40. The three implementing institutions wil l each submit an audit report to the Bank within six months after the end o f each financial year for the project components they handle.

41. The arrangements for the external audit of the financial statements o f the project should be communicated to IDA through agreed terms o f reference. Appropriate terms o f reference for the external auditor should be developed by the three ministries and agreed with the Country Financial Management Specialist. A format o f the TOR will be shared by the Bank with The three ministries in order to complete the TOR.

42. In the Auditor General’s report o f 30 June 2006, OPM and MAAIF audited accounts were qualified on an ‘except for’ basis and MOH had a disclaimer audit opinion. In al l the three ministries, issues o f lack o f accountability were raised in the report hence making the risk o f their internal control system substantial. In order to mitigate this risk, the issues raised by the Auditor General should be addressed and internal control systems strengthened. In addition, the other mitigation measure to be adopted wil l be ring fencing the project’s funds within these ministries and ensuring their use wil l be closely monitored by the Accounting Officer, Internal Audit Unit, Auditor General’s Office and the Bank to ensure they are used for purposes intended.

43. GOU does not have a pol icy that allows public disclosure o f audit findings but Article 41 (1) o f the Constitution o f Uganda allows the public to access this information. The Access

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to Information Bill, No. 7 o f 2004 has been drafted to complement the clause in the constitution and i s currently with Parliament. The media under the Press and Journalist Act also has access to information such as audit findings. In addition, the public i s allowed to attend the Public Accounts Committee o f Parliament when it is addressing audit issues.

44. institutions and the due dates for submission are:

The audit reports that will be required to be submitted by the three implementing

Audit Report pue Date after the end o f

Statements submitted by each implementing year i.e. by 3 lSt December iven that the accounts wil l be prepared for

1) AHIP audited project Financial

institutions (OPM, MOH and MAAIJ?).

Supervision plan

45. A supervision mission wil l be conducted at least twice every year based on the risk assessment o f the project. The mission’s objectives wil l include that o f ensuring that strong financial management systems are maintained for the project throughout its life. Reviews will be carried out regularly to ensure that expenditures incurred by the project remain eligible for IDA hnding. The Implementation Status Report (ISR) will include a financial management rating for the components. This will be produced by the World Bank Country Financial Management Specialist after an appropriate review.

Conclusion of the assessment

46. A description o f the three implementing institutions financial management arrangements above assesses the financial management risk as substantial, but based on the improvements envisaged under the financial management plan (detailed above), the residual risk i s considered as moderate. Thus, the project satisfies the Bank’s minimum requirements under OP/BP10.02, that with the planned improvements, the financial management system wil l be adequate to provide, with reasonable assurance, accurate and timely accountshnformation o n the status o f the project, as required by the Bank.

.

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ANNEX 5

REPUBLIC OF UGANDA


Annex 5: Procurement Arrangements

A. General

1. Procurement for the proposed project would be carried out in accordance with (i) the World Bank’s “Guidelines: Procurement under IBRD Loans and IDA Credits” dated M a y 2004, revised October 2006; (ii) “Guidelines: Selection and Employment o f Consultants by World Bank Borrowers” dated M a y 2004, revised October 2006, (iii) the Simplified Procurement Plan as permitted by the new OP 8.00, and (iv) the provisions stipulated in the Financing Agreement and Legal Agreement or any other method accepted by the Bank. For each contract to be financed by the Avian and Human Influenza Preparedness and Response Project (AHIP), the different procurement and consultant selection methods, estimated costs, prior review requirements, and time frame are agreed between the Recipient and the Bank project team in the Procurement Plan. The Procurement Plan wil l be updated at least annually or as required to reflect the actual project implementation needs and improvements in institutional capacity.

2. Procurement of Goods: Goods procured under this project would include; resettlement items, vehicles, motorcycle, bicycles, office equipment and accessories, stationery, furniture as well as vehicle and motor-cycle tyres. The procurement wil l be done using Bank’s SBD for al l I C B and National SBD satisfactory to the Bank. Framework Contracts for common small value supplies wil l be procured annually so as to enable the implementing agency to place orders for urgently needed supplies at short notice, at a competitive price.

3, Procurement of non-consulting services: Procurement o f non-consulting services will be done using the Bank’s sample SBD for non-consulting services for al l I C B and N C B agreed with or satisfactory to the Bank and for shopping, the PPDA solicitation template will be used.

4. Standard Bidding Documents (SBDs) for Works and Goods: The use o f World Bank Standard Bidding documents (SBDs) i s mandatory for a l l ICB/LIB procurement o f works and goods. All contracts following National Competitive Bidding, and other lower procurement procedures (shopping, and selective tender for smaller works contracts) will follow the national public procurement law (PPDA 2003 Act and i t s Regulations). These procedures have been reviewed by the Bank and found to be acceptable, except for the following provisions which will not be applicable under this project. (i) Negotiations with the best evaluated bidder is inappropriate, except for consulting services contracts, and for contracts procured through direct contracting; (ii) the merit point system for bid evaluation shall not be applied for goods and works contracts. (iii) Any Direct Contracting, or Single

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Source Selection, should be used on exceptional basis with adequate justification and with the Bank’s prior approval.

5. Procedure for Shopping: For clarity and removal o f doubt, the following procedures will be followed for shopping. Request for quotations shall be from as many suppliers or contractors as practicable, but from at least three. The request for and quotations shall be in writing and the quotations shall be submitted and opened at the same time. The request for quotations shall contain al l required specifications (and drawings, if needed, in case of works); standards etc. to enable the supplier or contractor provide a complete quotation. Invited bidders shall be required to acknowledge receipt o f the RFQ and copies o f this acknowledgement shall be kept on the respective procurement files. Each supplier or contractor from whom a quotation i s requested shall be informed o f the place, time and method o f submission o f quotations and whether any elements, apart from the charges for the goods or services themselves, such as transportation and insurance charges, customs duties and taxes, are to be included in the quotations or not. Each supplier or contractor may only give one price quotation and may not change this quotation, once the quotations are submitted and opened. N o negotiations shall take place with respect to a quotation submitted by the supplier or contractor.

6. Selection of Consultants: Consultancy services will be required as indicated in the procurement plan. For al l contracts to be awarded following QCBS, LCS and FBS, the Bank’s Standard Request for Proposals will be used.

7. Training and Workshops: These wil l be carried out on the basis o f approved programs o n a yearly basis. The programs wil l identify the general framework o f training and similar activities for the year, including the nature and objectives o f training, conferences, workshops, institutions where training/ workshops would be conducted (selection o f institutions and justification thereof), cost estimates and contents o f the course, the number o f participants, cost estimates, and the translation o f the knowledge gained in the actual implementation o f project components.

8. Incremental Operating Costs: This wil l cover project implementation-related expenditures such as in-country travel and per-diem, office supplies, office rentals, utilities, vehicle and equipment maintenance, communication costs, etc. They wil l be procured using the implementing agency’s administrative procedures reviewed and found acceptable to the Association.

9. Procurement through IAPSO: Procurement o f specialized equipment required for this emergency project (e.g. PDAs, GSI mappers and 4WD vehicles for specimen collection and rapid response) wil l be undertaken through the UN IAPSO as indicated in the procurement plan.

10. Assessment of the Agencies’ Capacity to Implement Procurement: The Project wil l be implemented by the Ministry o f Agriculture, Animal Industry and Fisheries (MAAF) and Ministry o f Health (MOH) and coordinated by the Office o f the Prime Minister (OPM). The O P M will have the overall responsibility to: (a) assure steady progress o f the procurement in accordance with an implementation schedule reviewed and approved by the

54

World Bank; and (b) ensure satisfactory implementation o f procurement activities included in al l contracts. A capacity assessment was carried out by Ms. Grace Nakuya M. Munanura, Procurement Specialist, Uganda Country Office, o f the Ministry o f Agriculture, Animal Industry and Fisheries o n April 25, 2008 and for the Ministry o f Health on April 29, 2008, and completed on M a y 06,2008.

B. MAAIF

11. MAAIF has a Procurement and Disposal Unit (PDU), which has 3 Procurement staff - a Principal Procurement Officer (PPO) and 2 Procurement Officers (PO). The Officers are al l conversant with procurement using the Country System. Although none o f the staff in the P D U have received any training in Wor ld Bank Procurement procedures, the PPO worked as a Procurement Officer on an IDA funded project - Primary Education and Teacher Development Project in the Ministry o f Education from 1998 - 2002. The PDU reports to the Permanent Secretary.

12. MAAIF has a fully functional Contracts Committee) in accordance with the Procurement Act. The Committee has been fully involved in the review and approval o f Procurement Documents (Bidding Documents, Evaluation Reports and Contracts award) and therefore has experience in the review o f these documents using the PPDA Act.

13. Although the Ministry has 6 projects funded by ADB, the projects have Implementation units which prepare their own documentation, which are then forwarded to the PDU for presentation to the Contracts Committee. The PDU workload therefore consists o f the Government o f Uganda funded procurements only.

14. The Ministry maintains an acceptable Procurement Records management system. The storage space and equipment available i s fully occupied. The Bidding documents (using PPDA SBD 's) viewed were wel l prepared with clear evaluation criteria and detailed technical specifications.

15. The Evaluation reports reviewed indicated that the evaluations were not well conducted - there was an instance o f using criteria not specified in the solicitation documents and another o f elimination o f qualified bidders for not presenting documents that they had in fact presented - this points to a case o f negligence by the P D U or Contracts Committee in failing to review the evaluation reports thoroughly, or possible collusion to eliminate some bidders, or insufficient internal controls to note such errors. A member o f the PDU should participate in al l Evaluation processes and guide the evaluation teams to ensure correct evaluation

16. A procurement plan based on the Country System templates was in place. The plan however doesn't adequately cover the key stages o f the procurement process and the duration and would therefore not be a good tool for planning purposes.

17. Considering the volume of Procurement to be conducted under the Project and the capacity o f the agency, the overall risk for procurement o f MAAIF to the Project i s Average.

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C. MOH

18. MOH has a Procurement and Disposal Unit (PDU) which has 4 Procurement staff - a Principal Procurement Officer (PPO also Head o f Procurement Unit (HPDU)), a Senior Procurement Officer (SPO), and 2 Procurement Officers (PO). The Officers are al l conversant with the use o f the Country Systems.

19. The HPDU has not received training in IDA funded procurement procedures but has experience including working on 2 IDA funded projects. H e also previously worked in the Supply Chain in the WFP. The SPO has had training in Goods, works and Consultancies under IDA funded projects as a Procurement Officer on an IDA funded project. The rest o f the staff in the PDU have not received any training in World Bank Procurement procedures training but are proficient in the use o f the country systems.

20. MOH has a fully fimctional Contracts Committee consisting o f 5 members in accordance with the Procurement Act. The Committee has been fully involved in the review and approval o f Procurement Documents (Bidding Documents, Evaluation Reports and Contracts award) and therefore has experience in the exercising oversight over the procurement process.

2 1. The Ministry maintains an acceptable Procurement Records management system - each procurement i s kept in a well marked procurement f i le with most o f the records on file. Payment records should also be included in the file. The Bidding documents (using PPDA SBD’s) viewed were wel l prepared with clear evaluation criteria and detailed technical specifications. The Evaluation reports were also o f acceptable quality.

22. A procurement plan based on the Country System templates was in place. The plan however doesn’t adequately cover the key stages o f the procurement process and the duration and would therefore not be a tool for planning and monitoring purposes.

23. The Ministry, however, needs to address the following challenges: (i) lack o f storage space - the storage space and equipment available i s fully occupied, (ii) recruitment o f storekeeper to ensure deliveries are recorded when made and to keep track o f the distribution o f the goods/equipment , and (iii) Use o f the Goods Received Note on receipt o f goods.

24. capacity o f the agency, the overall risk for procurement o f M O H to the Project i s Average.

Considering the volume o f Procurement to be conducted under the Project and the

D. OPM

25. Howard Centenary, Procurement Specialist, Uganda Country Office.

A Procurement Capacity Assessment o f the OPM was conducted in July 2007 by

26. The O P M has a PDU headed by a Principal Procurement Officer, who is supported by a Procurement Officer. Both officers have very l imited experience in IDA procurement; they however have some experience in the use o f the Country system under which most o f their procurements are handled.

56

27. I t was established that: (i) the solicitation documents are well prepared, (ii) the bidding process well managed, (iii) The Bid evaluation reports were o f fair quality, (iv) the Ministry Contracts Committee reviews al l the key stages o f the procurement process and wards contracts, and (v) the PDU has a good records keeping system.

Contract Value Threshold (US$) 1.2 Above U S $ 500,000 1.3 1.4 Below US$ 500,000 1.5 1.6 Below US$ 100,000 1.7 1.8 Above US$200,000 1.9 1-10 Below US$200,000 1.11 1.12 Below US$ 30.000

28. In light o f (i) the very limited experience o f the Procurement Officers under the project, and (ii) the limited procurement to be done under the project, the risk to procurement management by the O P M i s Average.

Procurement Method

ICB

NCB

Shopping / selective bidding ICB

NCB

Shopping

E. OVERALL PROJECT R I S K ASSESSMENT

29. In light o f (i) the experience o f the HDPU o f MAAIF and MOH; (ii) the limited procurement to be done under the project; and (iii) that there are no reports o f political interference in al l the ministries, the r isk to procurement management for this project i s Average.

F. ACTIONS TO MITIGATE OVERALL R I S K

30. Considering the multi-agency nature o f the project, the Project Coordinator in liaison with IDA, shall organize a project launch upon effectiveness o f the project. In addition to confirming readiness for implementation, the launch shall be used to; (i) explain the responsibilities and roles o f each o f the entities, (ii) to update al l PDU, CC members and user departments o f the applicable procedures and (iii) to review key elements o f the Project Implementation Manual.

G. PROCUREMENT THRESHOLDS

Expenditure Categorv 1. Works

2. Goods

Review

Prior

Post

Post

Prior

Post

Post

57

Expenditure Category

3. Consulting Services and Training

4. Non Consulting Services

5. All Types o f contracts

Contract Value Threshold (us9 1.13

1.14 1.15

1.16 1.17

1.18 1.19

1.20 1.21 1.22 1.23 1.24 1.25

With f i r m s above US$ 100,000

With individuals above US$50,000

With Firms below U S $ 100,000

With Individuals below US$50,000

Above US$ 100,000

Below U S $ 100,000

Below U S $ 30,000

All Contracts

Procurement Method

QCBS/LCS

Individual

Qualifications/Other

Individual

ICB

NCB

Shopping

Sole source / Direct Contracting and TORS

Review

Prior

Prior

Post

Post

Prior

Post

Post

Prior

H. PROCUREMENT PLAN

31. The Recipient, at appraisal, developed the procurement plan below for the f i rst 6 months o f project implementation. This plan covers goods, works and services to be procured for project implementation and the procurement methods to be used. The Procurement Plan wil l be updated in agreement with the Bank annually or as required to reflect the actual project implementation needs and improvements in institutional capacity.

I. FREQUENCY OF PROCUREMENT SUPERVISION

32. In addition to the prior review supervision to be carried out from Bank offices, the Bank will carry out supervision missions at least three times a year to conduct post review o f contracts which are not subject to prior review requirements. The procurement post-reviews should cover at least 20% o f contracts subject to post-review.

58

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f n

ANNEX 6 REPUBLIC OF UGANDA

AVIAN & HUMAN INFLUENZA PREPAREDNESS AND RESPONSE PROJECT

Annex 6: Implementation and Monitoring Arrangements

Overall Project Organization and Management

1. General Considerations: In considering the institutional arrangements for this multi- sectoral project, due regard has been paid to the lessons learned over the past several years. Experience shows that the following aspects need to be considered, and fulfil led as much as possible, for multi-sectoral projects to be successfully implemented: (i) high level o f support at the political and policy level; (ii) a sizeable level o f autonomy for the sectoral ministries; (iii) stakeholder participation; (iv) sustainable funding mechanism; and, (v) coordinated implementation o f projects and programs. Further, consistent with the agreements reached under the Paris Declaration (March 2005), a stand-alone project coordination unit wil l not be set-up. Instead, the project will be implemented under regular government structures, through the key technical ministriedagencies - MAAIF, MOH, and the OPM. Apart from providing strong linkage at the political level, the OPM is directly responsible for disaster management.

2. Project Organization: At the apex, the project will have a National Project Steering Committee (NPSC), comprising Ministers and Permanent Secretaries o f the implementation ministries and a number o f other relevant ministries/agencies. The NPSC wil l report to the Cabinet though the OPM. Below the NPSC, the project wil l have a National Task Force on Avian Influenza (NTF/AI), comprising senior technical officials nominated by the Permanent Secretaries and Heads o f relevant G O U ministries and agencies. Both the NPSC (previously referred to as the NSC) and the NTF/A I are already in place. They were set up in 2006 at the time when the NTF/AI was asked to prepare the National Plan o f Action for Preparedness and Response to Avian Influenza in Uganda. At the implementation level, the project wil l have a Project Coordination Team (PCT) comprising senior and experienced officials from the OPM, MAAIF, and MOH. The organization chart for the project i s shown in Appendix 1, whilst details relating to the above bodies are discussed below. The AH1 focal point officer in the Department o f Disaster Management, OPM, would serve as the Project Coordinator for the project.

Institutional Arrangements

3. National Project Steering Committee (NPSC): The NPSC is chaired by the Minister for General Duties in the OPM, and comprises the Ministers and Permanent Secretaries o f the following ministriedagencies: (i) OPM; (ii) MAAIF; (iii) MOH; (iv) Ministry o f Foreign Affairs; (v) Ministry o f Internal Affairs; (vi) Ministry o f Local Government (MOLG); (vii) Ministry o f Tourism, Trade and Industries (MTTI); (viii) Ministry o f Finance, Planning and Economic Development (MFPED); (ix) Deputy Secretary o f the Treasury, MFPED; (x) Representatives of Uganda Revenue Authority (URA), FAO, WHO, Chairperson o f the

63

Poultry Association o f Uganda; and (xi) the Director o f Information, OPM. The NPSC will be convened by the Chair on a quarterly basis. The Department o f Disaster Management, in the O P M will serve as secretariat to the NPSC, whilst the Project Coordinator wil l serve as the Secretary to the NPSC.

4. The NPSC wil l be responsible for the following: 0 To provide pol icy direction and strategic planning, including approval o f the project’s

annual work plans and budgets; 0 To ensure accountability from al l sectors participating in the project; 0 To provide an enabling environment and allocation o f necessary resources for

effective implementation o f the AH1 INAP and the project; 0 To provide high level political support;

To provide linkages with other relevant sectors, institutions, and stakeholders; and, To mobilize resources for the implementation o f INAP from development partners, government, and other stakeholders.

5. National Task Force on Avian Influenza: To provide technical advice to the NPSC for sound pol icy making, the government has set up a National Task Force on Avian Influenza (NTF/AI). The key responsibilities o f the NTF/AI are to: provide technical backup to the NPSC; plan the technical preparedness and response actions (surveillance, prevention, containment, health system’s response and communication) for AHI; and, to monitor and evaluate performance as required by the NPSC. The NTF/A I is co-chaired by the MOH Commissioner for Health Services and the MAAIF Commissioner for Livestock Health and Entomology, and includes members from OPM, MAAIF, MOH, Uganda Virus Research Institute (UVRI), Livestock Research Institute (LIRI), Uganda Wildl i fe Authority (UWA), Uganda Wildl i fe Education Center (UWEC), MOLG, MTTI, FAO, UNICEF, WHO, NGOs such as Nature Uganda and Uganda Media for Health, International Committee o f the Red Cross and Red Crescent (ICRC), and the Poultry Association o f Uganda (representing the private sector). G O U also invites DPs such as DFID, EC/EU, Japan Embassy, USAID, and the World Bank, to meetings o f the NTF/AI.

6. Technical Working Groups (TWGs): Six TWGs, reporting to the NTF/AI, have also been set up. These TWGs work on further development and implementation o f key strategies in the following areas: (i) Surveillance; (ii) Public Awareness and Advocacy; (iii) Food Hygiene and Safety, Containment, Culling, Compensation, and Vaccination for poultry; (iv) Drugs and Supplies; (v) Case Management o f human cases; and (vi) Resource Mobilization. All the relevant ministries/agencies are wel l represented in the TWGs. In particular, MAAIF and M O H have already established close collaboration, and have conducted jo int awareness and sensitization activities, and joint surveillance.

7. Project Coordination Team (PCT): As indicated earlier, the project design embraces the use o f existing country systems and structures. The three ministries responsible for project implementation - OPM, MAAIF, and MOH - have each nominated senior and experienced technical staff from amongst their ranks as the Focal Point Officers for the project, who wil l serve on the PCT. These focal point officers would be responsible for the day-to-day coordination and management of implementation matters relating to their respective ministry

64

or department, to ensure that they are implemented effectively and in accordance with approved work plans and budgets. The PCT officers wil l carry out their tasks in close collaboration with the implementation staff, both at the national level and in the field. Within their relevant ministries, the focal point officers would continue to report on project progress through thekdepartmental structures. Three departments from OPM will be represented on the PCT. These are Department o f Disaster Management and Refugees, Department o f Information, and the Department for Coordination and Monitoring and Evaluation. MAAIF and M O H have each nominated one Focal Point Officer. In addition to the above five members o f the PCT, two other nominees (one each from MAAIF and MOH) representing the key Communication aspects o f the project, wil l complete the PCT. Whilst the team is expected to work closely on a collegial basis, to achieve project objectives and for practical reasons, the focal point officer from the Department o f Disaster Management (OPM) would serve as the Project Coordinator. To facilitate i t s work, including for reporting purposes, the PCT would be able to co-opt other colleagues involved in project implementation (e.g. financial management, procurement, M&E). The MAAIF and MOH focal point officers would be responsible for compiling their sector's progress report on project activities on a quarterly basis, and sharing it with the Project Coordinator. The Project Coordinator will consolidate the progress reports from' the three ministries for presentation to the NPSC.

Animal Health Component

8. The Animal Health Component o f the Project wil l be implemented in the Department o f Livestock Health and Entomology (DLH&E) under the overall supervision o f the Permanent Secretary o f the MAAIF, who i s the Accounting Officer o f the ministry. The Focal Point Officer in DLH&E will oversee the day-to-day running o f the project, under the guidance o f the Commissioner, Livestock Health and Entomology, who is the Co-chairperson o f the NTF/AI. The Commissioner reports directly to the Director o f Animal Resources, who in turn reports to the Permanent Secretary (PS) MAAIF. The project wil l utilize the existing c iv i l service structure under the Directorate o f Animal Resources.

9. Activities associated with wild birds wil l be undertaken by UWA. The latter has an existing Memorandum o f Understanding with MAAIF for purposes o f wildlife disease surveillance and reporting.

10. At the district level, district veterinary staff headed by the District Veterinary Officer (DVO) wil l be responsible for the implementation and coordination o f project activities in al l the districts under the technical supervision o f the Commissioner, Livestock Health and Entomology.

11. Private veterinarians will supplement the activities o f the district veterinary staff and participate in project activities under the coordination o f the Uganda Veterinary Association and professional supervision o f the Uganda Veterinary Board.

65

Human Health Component

12. The Human Health Component o f the Project will be implemented in the Ministry of Health under the overall supervision o f the Permanent Secretary o f the Ministry, who i s also the Accounting Officer. The project wil l utilize the existing c iv i l service structure under the Directorate o f Clinical and Community Health and will be operationalized in the Department o f Community Health. The Focal Point Officer o f MOH, who wil l be responsible for day to day implementation and coordination o f the human health component, wil l report to the Commissioner for Health Services (CHS/CH).

13. At the district level, District Health Officers (DHOs) and Medical Superintendents wil l be responsible for the implementation and coordination o f project activities in al l districts and hospitals, respectively, under the technical supervision o f the CHS/CH.

14. Responsibility for Preparation of Annual Work Plans: The relevant government departments wil l be responsible for the preparation o f annual work plans and budgets as wel l as quarterly and annual project management reports. The O P M will be responsible for consolidating the annual work plans and budgets for submission to the NPSC and the World Bank.

15. Compensation Arrangements: With respect to al l cash transfers or other forms o f compensation, an adequate operational review will be in place to confirm the validity and legitimacy o f the said transfers. In addition, the external auditors wil l provide an opinion on the soundness o f accounting, reporting, and internal controls in respect o f cash compensation activities.

16. pr ior to effectiveness to facilitate the management and implementation o f the project.

Project Implementation Plan: A Project Implementation Plan (PIP) i s to be prepared

66

UGANDA AHIP - APPENDIX TO ANNEX 6

Project Coordination Team: OPM [Disaster Management & Refugees,

Coordination & Monitoring, and Directorate of Information]; MAAIF &

MOH

Rt. Hon. Prime Minister

I I I I I I

. - - - - - - - I

Project Coordination Framework

( - _ _ - - - _ - - - - - ~

I

National Project Steering Committee

OPM, MAAIF, MOH, MTTI, URA, MOIA, MOLG, Uganda

Poultry Association I

t

67

Annex 7

Name Wilson Onyang Odwongo

REPUBLIC OF UGANDA AVIAN & HUMAN INFLUENZA PREPAREDNESS AND RESPONSE PROJECT

Title Unit Rural Development Specialist / AFTAR Task Team Leader

Annex 7: Project Preparation and Appraisal Team Members

Madhur Gautam

Edith Mwenda Mohammed Taqi Sharif

TIME TABLE FOR PROJECT PREPARATION

Lead Economist AFTAR Consultant AFTAR Senior Counsel LEGAF

Milestone Available Date

Appraisal

Negotiations

April 22 - May 9,2008

May 19 - 20,2008

VP’s Approval May 27,2008

Board Approval (indicative) June 12,2008

Expected Date o f Effectiveness August 1,2008

Credit Closing June 30,2012

I t i s proposed that this project be processed using streamlined procedures.

IDA TASK TEAM

68

ANNEX 8

REPUBLIC OF UGANDA


Annex 8: Environmental and Social Safeguards Framework

Environmental assessment: Environmental Category B

1. The project falls under the Bank’s Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI). Most o f the activities under the proposed project are not expected to generate any adverse environmental effect, since a large part o f the project is geared to supporting prevention activities. The project will, overall, have positive environmental and social impacts. Since the Project supports investments for the disposal o f carcasses and laboratory wastes, an Environmental and Social Safeguards Assessment Framework (ESSAF) and an Environmental Management Plan (EMP) for carcass disposal facilities wil l be necessary. The ESSAF would provide guidance on the approach to be taken during implementation for the selection and design o f proposed investments and planning o f mitigation measures, including consultation and disclosure requirements. The EMP will address the clean up o f animal wastes o f infected and culled poultry. The scope o f this EMP will be specified during the init ial period o f project implementation. The EMP will include guidelines for carcass disposal facilities; i t wil l summarize the potential negative impacts o f disposals, as well as provide measures for mitigating and monitoring those impacts.

2. W h i l e the EMP i s being prepared, the project wil l follow interim guidelines and operating procedures to manage and monitor potential negative impacts o f carcass disposal. Precautions have been taken under the project to avoid or minimize such impacts by integrating environmental and public health safety aspects in the preparation, design, and implementation o f the project. However, adverse environmental health impacts, mainly inadvertent spread o f HPAI, could occur when an emergency operation involves containment o f HPAI outbreaks through quarantine, isolation and stamping out actions and when relevant mitigation measures are not in place. The potential adverse environmental impacts identified above wil l be mitigated by integrating environmental and public safety aspects in al l stages o f the project. The Government i s preparing Guidelines for safe culling, transport and safe disposal o f carcasses, which wil l be supported under the project. These interim guidelines and procedures wil l be formulated by a technical expert to the PCT. These provisions wil l be included in the PIPPIM, to be finalized prior to disbursement. The PIPPIM will be updated as necessary to reflect any modifications or additions to the procedures that are recommended in the EMP.

3. The proposed investments in laboratory facilities, equipment and staff training wil l improve the effectiveness and safety o f avian influenza handling and testing procedures by meeting international standards established by OIE. In the case o f the AI Component o f

69

MOH, a Health Care Waste Management Plan already exists, and this wil l form the basis o f environmental management for avian influenza activities as well (no separate EMP will therefore be prepared for the Human Health component). The Project will also support updating o f these guidelines, training o f healthcare workers to manage medical wastes according to these guidelines and, if necessary, the purchase o f equipment for the proper handling and disposal o f medical waste in participating facilities. These provisions wil l be included in the PIPPIM.

4. The Project wil l assist the government in developing a strategy for managing future emerging and re-emerging zoonotic and infectious disease outbreaks. Such a strategy would improve environmental and social safeguards in three areas: (i) mainstreaming environmental safeguards into protocols and procedures for the stamping out and disposal o f animals during an outbreak, in particular by adopting OIE standards; (ii) improving bio-medical waste management systems in health facilities and laboratories; and (iii) developing policies on compensation for poultry farmers affected by future outbreaks.

5. As an emergency operation under O P B P 8.00, the safeguard documents are not required to be prepared and disclosed prior to appraisal. However, it i s expected that the medical waste management plan and the EMP for the carcass disposal facilities wil l need to be prepared and disclosed within six months o f project effectiveness.

6. Assessment, as shown in the table below.

Safeguard Policies: The only pol icy which applies to the AHIP is Environmental

Table: List o f safeguard policies

Safeguard Policies Triggered by the Project Yes No Environmental Assessment (OP/BP/GP 4.01) [XI [ I Natural Habitats (OPBP 4.04) [ I [XI

Pest Management (OP 4.09) [ I [XI Cultural Property (OPN 11.03, being revised as OP 4.1 1) [ I [XI

Involuntary Resettlement (OP/BP 4.12) [ I [XI Indigenous Peoples (OD 4.20, being revised as OP 4.10) [ I [XI

Forests (OP/BP 4.36) [ I [XI

Safety o f Dams (OP/BP 4.37) [ I [XI

Projects in Disputed Areas (OP/BP/GP 7.60) [ I [XI

Projects on International Waterways (OP/BP/GP 7.50) [ I [XI

70

ANNEX 9

REPUBLIC OF UGANDA


Annex 9: Economic and Financial Analysis

A. Introduction

1. This annex presents the results o f economic analyses o f the proposed Uganda AHIP. The analyses examine economic impacts o f AI in terms o f costs incurred without the AHIP and economic impacts o f AI in terms o f benefits and costs accruing with the AHIP.

B. Background

2. Outbreaks of the H5N1 strain o f AI in birds have now been registered in more than 60 countries in Asia, Europe, Afr ica and the Middle East, spreading from what was init ial ly (in late 2003) an East Asian phenomenon. This has been accompanied by an increase in human cases from less than 100 deaths in the period 2003 to over 230 deaths by the end o f 2007. Moreover, the virus has been extremely deadly on those infected with an estimated death rate o f 57% o f al l human cases detected since 2003.

3. Globally the primary concern, in terms o f economic impacts o f AI, relates to the possibility o f a future human pandemic through human-to-human transmission o f the H5N1 virus. To date, transmissions have been bird-to-bird with some cases o f bird-to-human transmissions. The main economic impact has been on poultry and related sectors, particularly in South East Asia.

4. Empirical evidence o n the economic impacts o f AI points to two important conclusions. First, the overall impact on national GDP and GDP growth i s rather small (most countries affected in Asia continued to grow approximately at the same pace). The reason for this is that the poultry sector accounts, on average, for only a very small share o f GDP (normally in the range o f slightly below 1% to a little over 2% o f GDP) and even a large drop in sector output (e.g. 20% in Vietnam) would result in a small overall effect. Second, evidence seems to suggest that the impact o f AI can actually be quite significant for certain segments o f the population and for specific regions in a country. For example, despite less than 1% o f the national poultry population being affected with AI, commercial poultry producers in the capital o f L A O PDR lost as much as 40% o f their layer flock due to deaths and culling.

5. The probability o f a future human pandemic i s difficult to assess, as would be the nature and severity o f the disease in the event o f a future outbreak. Most infections and death scenarios have been established through simulation models based on pre-defined probability distributions for key variables based on historical date. Data has been drawn from Spanish flu (1918-19), the Asian flu of 1957 and the Hong Kong Flu of 1968-69. Some o f the

71

economic models also used inputs and data available f rom the S A R s outbreak in Asia. In an attempt to illustrate the order o f the magnitude o f a possible human pandemic, the World Bank Prospects Group estimated a decline in World GDP in the range o f 0.7% and 4.8% o f GDP. Moreover the impact would be greater in developing countries (between 0.6% and 5.3% o f GDP) because o f greater population density, poverty and lower quality o f health care services. Countries most open to trade and in particular large net exporters o f services, would be most hit by a human pandemic, because o f the movement o f people in and out o f the country.

C. Economic Impacts of AI without AHIP

6. The status, performance and dynamics o f the poultry sector in Uganda between 2003 and 2007 are summarized in Tables 1 and 2 below. The total bird population (chickens, ducks and turkeys) was 36.8 in 2007; with the bulk o f the population being made up o f backyard poultry. Average annual growth in the bird population in the last 5 years has been about 2.2%. The meat production and bird population ratio was 1.2 (in terms o f number o f kilograms) in 2007. The egg production and bird population ratio was 10 (in terms o f eggs) in 2007.

7. There are several major difficulties in estimating the economic impact o f AI in Uganda, most o f which would also be valid for other countries. First, scenarios for “gross attack rates” (GARS) o f AI in the case o f a pandemic, based mostly on past events, are only approximate. There i s a lack o f scientific knowledge on the primary factors affecting the spread o f influenza and scenarios are based o n a small number o f past observations for which data i s o f differing quality and i s also quite heterogeneous. Second, there is no data to assist in predicting the probability o f any o f the scenarios for which a possible impact o f AI can be estimated.

Table 1: Poultry Sector in Uganda

Table 1: Poultry Sector in Uganda

Poultry Population (million birds) Poultry Sector 2003 2004 2005 2006 2007 Chickens

Backyard 28.9 28.0 Commercial 3.7 8.6

Total 35.9 31.6 32.6 27.4 36.6 Growth (%) -12.0 3.2 -16.0 33.6

72

Table 2: Estimates of Ratios o f Meat and Egg Production Relative of Bird Populations in Uganda

Population Poultrv

Item 2003 2004 2005 2006 2007 Total bird population (million birds) 35.9 31.6 32.6 27.4 36.6

Total egg production (million) 359 316 326 274 366 Meat productionhird (kg) Egg productionhird population (egg)

Total meat production (mil l ion kg) 43.1 37.9 39.1 32.9 43.9

I I1 I11 0.7 1 .o 2.5

8. A fair degree o f sophistication can be adopted in estimating the economic impact on AI by, example, differentiating between age groups, for likelihood o f a medical visit, hospitalization or death (allowing for better use o f data from past pandemics since there i s differential impact across age groups). However, given the limitations o f data in Uganda and the uncertainty surrounding any estimates for the present economic analysis, only three possible “Gross Attack Rate” (GAR) scenarios were considered. More sophisticated and higher attack rates, including on human population could be considered, but not done so here for lack o f reliable data. By nature, these estimates are difficult to estimate and hence arbitrary. Besides, the lower bound benefits estimated from even these limited and minimal scenarios are sufficiently large to justify the current levels o f investment. These are described below and a summary o f the scenarios and their assumptions are reported in Table 3.

Table 3: Possible GAR Scenarios Considered for Economic Impact

9. Scenario (i) i s the case o f countries such as Cambodia or Lao PDR where less than one percent o f the poultry population has been infected by AI. Scenarios (ii) and (iii) are st i l l very modest impacts in comparison to these experienced by some counties such as Indonesia and Thailand, where poultry GARs were about 10% together with a small number o f the human population being infected by the disease (essentially bird-to-human transmission). Clearly, higher poultry GARs and any human GARs would produce significantly greater impacts.

10. Thus, focusing only o n the poultry sector, the economic impact considered is the value o f production lost, which depends o f the GAR and assumptions concerning selling prices and average meat and egg production per bird. Additional impacts due to a reduction in selling prices due to consumer fears about the disease could also be considered, in which case the benefits would be further increased. Because o f lack o f information o n elasticities and sector details, the impact on other protein producing sectors, as consumers shift demand away from

73

poultry products, can not been taken into consideration. The impact on trade f i om any restrictions imposed, in the event o f A I outbreaks, i s also not been taken into consideration, as Uganda i s not a net exporter o f poultry products.

GAR Scenario I. 0.7

11. The main assumptions for estimating the economic impact o f AI on the poultry sector are: (i) the impact i s on the init ial bird population and there is 2.2.% annual growth rate; (ii) two possible AI shock scenarios are considered - one assumed to occur in the second year o f the four year project, and the second in the fourth year o f the project (clearly, the benefits are estimated to be even higher were it to occur in the f i rs t year itself); (iii) the impact i s assessed over a 15 year horizon f i om year 1 o f project implementation; (iv) there is an average o f 1.2kg o f meat per bird and 10 eggs a year per bird at a price o f UShs. 7,000 per kg o f meat and UShs. 150 per egg, and (v) prices used are the market prices in 2007.

Outbreak in year 2 Outbreak in year 4 11% 7%

13. Based o n these assumptions and the presumed shock, the internal rate o f return (IRR) i s estimated, using the project investments spread out over the 4 year period as given in the cost tables. The I R R s calculated under the different scenarios are presented in table 4.

Table 4: Estimated Internal Rates o f Returns to AHP Investment in Uganda

14. The results show that the project impact wil l be considerable under reasonable assumptions o f GARs on poultry alone. Only if the GARs are extremely l ow and are delayed in the lifespan o f the project are the returns l ikely to be lower. In the event that the GARs are anywhere close to those experienced in South-East Asia, the returns would be extremely high. In addition, if there is any transmission to the human population, the economic benefits would be higher still.

74

ANNEX 10

REPUBLIC OF UGANDA


Annex 10: Documents in Project Files

a. The Republic o f Uganda: National Plan o f Action for Preparedness and Response to Avian Influenza in Uganda, April 7,2006.

b. The Republic o f Uganda: Progress Report on Avian Influenza Preparedness and Response, October 2005- March 2007.

c. The Republic o f Uganda: Integrated National Action Plan (INAP) for Preparedness and Response to Avian and Human Influenza, February 2008.

d. The Republic o f Uganda: Technical Annex for the Proposed IDA Credit for the Proposed Avian and Human Influenza Project, April 2008

e. The World Bank: Financial Management Assessment Report on the Project Implementing Agencies

f. The World Bank: Procurement Assessment Report on the Project Implementing Agencies

75

REPUBLIC OF UGANDA


P101231

PO90867

PO78382

PO69208

PO50440

PO86513

PO83809 PO74079

PO79925

PO65437 PO02952

PO69996

PO65436

PO50439 PO70627

PO44695

PO73089

PO59127

PO02970

2008

2008

2008

2007

2006 2006

2005 2005

2004

2003 2003

2002

2002 2001

2001

2001

2001

1999

1999

0.00

0.00

0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00

0.00

0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00

0.00

0.00

0.00 0.00

0.00 0.00 0.00

0.00

0.00

0.00 0.00

0.00

12.14

0.00

0.00 0.00 0.00 0.00

202.48

55.82

34.99

232.20

76.81

29.07

66.43

96.85

19.16

8.72

10.53

19.58

3.06

14.08

8.78

33.08

2.48 12.74

8.53

0.00 0.00 0.00 0.00 2.03 0.00

56.50 0.00 0.00 0.00

0.80 0.00

52.98 0.00

50.85 61.54

14.14 7.39

4.46 0.00 -9.98 -9.98

9.56 -8.50

-8.14 -8.14

17.22 11.72

5.62 0.00 21.28 0.00 -0.58 -0.35 -0.73 4.72 2.04 2.04

Annex 11: Statement of Loans and Credits UGANDA: Avian and Human Influenza Preparedness and Response Project

Difference between expected and actual

disbursements Original Amount in US$ Millions

Project ID FY Purpose IBRD IDA SF GEF Cancel. Undisb. Orig. Frm. Rev’d

UG-PRSC 7 (FY08) 0.00 200.00 0.00

UG-Local Govt Mgt Svc Del Pjt (FY08)

UG-Kampala Inst & Infrast Dev Prj (FY08) UG - Power Sector Dev. Project (FY07)

UG-Pub Sew Perform Enhance (FY06) UG-Millennium Science Init (FY06)

UG-Priv Sec Competitiveness 2

UG-Road Dev APL 3 (FY05)

UG-Natl Re Dev TAL (FY04)

UG-PAMSU SIL (FY03) UG-N Uganda SOC Action Fund (FY03)

UG-Energy for Rural Transform (FY02)

UG-Road Dev Phase 2 APL (FY02) UG-Priv & Utility Sec Reform (FYOI)

Regional Trade Fac. - Uganda

UG-Nat Agr Advisory SNCS S I L (FYO1)

UG-EMCBP SIL 2 (FYOl)

UG-Agr Rsrch & Training SIL 2 (FY99)

UG-Roads Dev APL (FY99)

0.00 0.00

0.00 0.00

0.00

0.00

0.00

0.00

0.00 0.00 0.00

0.00

0.00

0.00 0.00 0.00

0.00 0.00

55.00 33.60

300.00

70.00

30.00

70.00

107.60

25.00

27.00 100.00

49.15

64.52

48.50

20.00

45.00

22.00 26.00

90.98

0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00

0.00 0.00 0.00 0.00 0.00 0.00

Total: 0.00 1,384.35 0.00 0.00 12.14 935.39 218.05 60.44

UGANDA STATEMENT OF IFC’s

Held and Disbursed Portfolio In Millions of U S Dollars

Committed Disbursed

IFC IFC

FY Approval Company Loan Equity Quasi Partic. Loan Equity Quasi Partic.

1996 AEF Agro Mgmt 0.26 0.00 0.00 0.00 0.26 0.00 0.00 0.00 1992 AEF Clovergem 0.84 0.00 0.00 0.00 0.84 0.00 0.00 0.00 1999 AEF Gomba 0.45 0.00 0.00 0.00 0.45 0.00 0.00 0.00 1998 AEF White Nile 0.10 0.00 0.00 0.00 0.10 0.00 0.00 0.00 2005 DFCU 10.00 0.00 0.00 0.00 10.00 0.00 0.00 0.00 1998 Tilda Rice 0.48 0.00 0.00 0.00 0.48 0.00 0.00 0.00 2005 UMU 1 .oo 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total portfolio: 13.13 0.00 0.00 0.00 12.13 0.00 0.00 0.00

76

REPUBLIC OF UGANDA


Annex 12: Country at a Glance

2/20/08

Sub- Key Development Indicators

(2006)

Population, mid-year (millions) Surface area (thousand sq. km) Population growth (%) Urban population (% of total population)

GNI (Atlas method, US$ billions) GNI per capita (Atlas method, US$) GNI per capita (PPP, international S)

GDP growth (%) GDP per capita growth (%)

Saharan Low Uganda Africa income

(mast recent estimate, 200&2006)

Poverty headcount ratio at $1 a day (PPP, %) Poverty headcount ratio at $2 a day (PPP, %) Life expectancy at birth (years) Infant mortality (per 1,000 live births) Child malnutrition (%of children under 5)

Adult literacy, male (% of ages 15 and older) Adult literacy, female (% ofages 15 and older) Gross primaryenrdlment, male (% of age group) Gross primary enrdlment, female (% of age group)

Access toan improved water source (% of population) Access to improved sanitation facilities (% of population)

27.8 770 241 24,265 3.3 2.3 13 36

9.0 648 320 842

1,490 2,032

5.4 5.6 2.1 3.2

Net Aid Flows

(US$ millions) Net ODA and official aid Top 3 donors (in 2005):

United States Netherlands Denmark

Aid (% of GNI) Aid per capita (US$)

Long-Term Economic Trends

Consumer prices (annual % change) GDP implicit deflator (annual % change)

Exchange rate (annual average, local per US$) Terms of trade index (2000 = 100)

Population. mid-par (millions) GDP (US$ millions)

Agriculture Industry

Services

Household final consumption expenditure General gov't final consumption expenditure Gross capital formation

Exports of goods and services Imports of goods and services Gross savings

Manufacturing

1980

113

13 4 2

72.0 4.5 4.3

23.5

88.9 77.2

6.2

19.4 26.0

31

47 75

77 58

120 115

67

2,403 29,215

1.8 30

1,562 650

2,698

8.0 6.1

41 72 47 59 96 75 29

69 72 50 50 98 108 86 96

56 75 37 38

1990 2000

663 817

30 58 4 43

25 60

15.7 14.0 41 36

45.6 5.8 44.4 3.8

319.6 1,511.4 116 100

16.3 23.0 4,304 5,929

(% of GDP) 56.6 37.1 11.1 20.0 5.7 9.4

32.4 42.9

91.9 77.7 7.5 13.7

12.7 20.0

7.2 11.2 19.4 22.5 0.6 9.6

2006

1,198

242 80 64

14.0 45

6.6 7.3

1,625.1 97

27.8 9,419

31.7 21.5 9.1

46.6

76.8 14.3 23.4

14.9 29.5 13.3

Age dlstrlbutlon, 2006

Female

I 7 0 7 4 I 60-U 5054 4044

3034 20-24 I014

0-4 I 30 20 I O 0 10 20 30

oercent

Jnderd mortality rate (per 1.000)

2w , I80 I80 I40 I20 I W 80 80 40 20 0 1 0 Uganda 0 Subsahatan Africa

I 3rowth of GDP and GDP per capita (Oh)

1980-90 199C-2000 2000-06 (average annual growth %) 2.7 3.4 3.1 3.3 7.1 5.6

3.3 3.5 2.1 6.8 12.1 7.6 4.8 13.4 5.9 3.9 8.4 7.5

2.6 6.9 4.2 2.2 6.8 5.9

11.2 9.3 9.9

2.0 11.1 9.9 5.2 10.8 7.0

Note: Figures in italics are for years other than those specified. 2006 data are preliminary. .. indicates data are not available. a. Aid data are for 2005.

Development Economics, Development Data Group (DECDG).

77

Uganda

I

Balance of Payments and Trade

US% millions) 'otal merchandise exports (fob) 'otal merchandise imports (cifl let trade in goods and services

:urrent account balance as a % of GDP

Norkers' rernlttances and compensation of employees (receipts)

teserves, including gold

Eentral Government Finance

% of GDP) :urrent revenue (induding grants) Tax revenue

:unent expenditure

herall surplus/deficit

iighest marginal tax rate (%) Individual Corporate

External Debt and Resource Flows

US% millions) 'otal debt outstanding and disbursed 'otal debt service )ebt relief (HIPC, MDRI)

'otal debt (% of GDP) 'otal debt service (% of exports)

:oreign direct investment (net inflows) 'odfoiio equity (net inflows)

Composltlon of total external debt, 2006

2000

460 954

-703

-644 -10.9

238

719

11.3 10.4 10.9

-13.8

30 30

3,604 181

1,282

60.8 25.7

177 0

2006

890 1,991

-1,486

-933 -9.9

476

1,408

13.2 12.5 13.0

-7.1

30 30

4,315 305

1,705

45.8 16.3

261 0

IDA 3.085

iovernance Indicators, 2000 and 2006

Voice and accountability

Political stability

Regulatory quality

Rule of law

Contml of corruobon

0 25 50 75 I W

-3 2006 Country's percenele rank (0-100) 02000 hqher values m@y bene, r&ngrr

ource Kaufmann-Kraav-MaStNUm worn Bank

Technology and Infrastructure 2000 2005

Paved roads (% of total) Fixed line and mobile phone

High technology exports subscribers (per 1,000 people)

(% of manufactured exports)

.. 23.0

22.5 14.0

Environment

Agricultural land (% of land area) Forest area (% of land area) Nationally protected areas (% of land area)

Freshwater resources per capita (cu. meters) .. 1,353 Freshwater withdrawal (% of internal resources) 0.8

C02 emissions per capita (mt) 0.06 0.06

GDP per unit of energy use (2000 PPP $ per kg of oil equivalent)

Energy use per capita (kg of oil equivalent)

I uss millions

Private Sector Development 2000 2006

Time required to start a business (days) - 28 Cost to start a business (% of GNi per capita) - 96.0 Time required to register property (days) - 227

Ranked as a major constraint to business (% of managers Surveyed who agreed)

Electricity .. 63.3 Tax rates .. 11.0

Stock market capitalization (% of GDP) 0.6 7.2 Bank capital to asset ratio (%) 9.8 70.3

Note: Figures in italics are for years other than those specified. 2006 data are preliminary. 2/20/08 .. indicates data are not available. -indicates observation is not applicable.

(US% milhons)

IBRD Total debt outstanding and disbursed Disbursements Principal repayments Interest payments

IDA Total debt outstanding and disbursed Disbursements Total debt service

IFC (fiscal year) Total disbursed and outstanding porlfoiio

Disbursements for IFC own account Podfolio sales, prepayments and

repayments for IFC own account

of which IFC own account

MlGA Gross exposure

0 0 0 0

2.098 150 31

36 36 0

6

43

0 0 0 0

3.085 262

43

12 12 10

0

43 New guarantees 0 43

I Development Economics, Development Data Group (DECDG).

78

BundibugyoBundibugyo

BushenyiBushenyi

IbandaIbanda

KiruhuraKiruhura

NtungamoNtungamo

HoimaHoima

IgangaIgangaBusiaBusia

SironkoSironko

BugiriBugiri

KabaleKabale

KamuliKamuliKaliroKaliro

ButalejaButaleja

BudakaBudaka

KayungaKayungaKyenjojoKyenjojo

KapchorwaKapchorwa

BukwoBukwo

KaseseKasese

KisoroKisoro

KitgumKitgum

KumiKumi

KaberamaidoKaberamaido

LiraLira

LuweroLuwero

NakasekeNakaseke

NakasongolaNakasongola

MasakaMasaka

KamwengeKamwenge

KalangalaKalangala

MasindiMasindi

MbararaMbarara

KanunguKanungu

MorotoMoroto

NakapiripiritNakapiripiritKatakwiKatakwiAmuriaAmuria

MoyoMoyo

KibaleKibale

PallisaPallisa

SorotiSoroti

FortFortPortalPortal

AruaArua

JinjaJinja

BubuloBubulo

MbaleMbale

TororoTororo

GuluGulu

NebbiNebbi

ApacApac

AmolatarAmolatar

MubendeMubende

RukungiriRukungiri

IsingiroIsingiro RakaiRakai

SembabuleSembabule

MpigiMpigi

MukonoMukonoMityanaMityanaWakisoWakiso

KibogaKiboga

KotidoKotido

KaabongKaabongAdjumaniAdjumani

YumbeYumbeKobokoKoboko

KilakKilak

MarachaMaracha

OyamOyam

DokoloDokolo

BusikiBusiki

BulisaBulisa

AbimAbim

KAMPALAKAMPALA

MO

YO

ADJU

MANI

SIRONKOSIRONKO

KA

YUN

GAA

KABA

ROLE

SEMBABULE

KISOROKISORO

KANUNGUKANUNGU

RUKUUN

GIRRI

KAPCHORWAKAPCHORWA

BUKWOBUKWO

MASINDIMASINDI

HOIMAHOIMA

KASESEKASESE

KABALEKABALE

KIBOGAKIBOGA

MITYANAMITYANA

KIBAALEKIBAALE

MUBENDEMUBENDE

MPIGIMPIGI

MBARARAMBARARA

IBANDAIBANDAKIRUHURAKIRUHURA

ISINGIROISINGIRORAKAIRAKAI

MASAKAMASAKA

NTUNGAMONTUNGAMO

BUSHENYIBUSHENYI

APACAPAC

AMOLATARAMOLATAR KABERA-KABERA-MAIDOMAIDO

KAMULIKAMULI

GULUGULU

NEBBINEBBI

LUWEROLUWERO

NAKASEKENAKASEKE

IGANGAIGANGA

KALIROKALIRO

KALANGALAKALANGALA

MUKONOMUKONO

JINJAJINJA

KUMIKUMI

KATAKWIKATAKWIAMURIAAMURIA

MOROTOMOROTO

SOROTISOROTI

PALLISAPALLISA

MBALEMBALEBUDAKABUDAKA

MANAPWAMANAPWA

LIRALIRA

K I T G U MK I T G U M

ARUAARUA

KOTIDOKOTIDO

KAABONGKAABONG

TOROROTORORO

KAMPALAKAMPALA

YUMBEYUMBEKOBOKOKOBOKO

PADERPADER

MAYU

GE

MAYU

GE

BUG

IRIBU

GIRI

WAKISOWAKISO

KAMWENGEKAMWENGE

KYENJOJOKYENJOJO

NAKAPIRIPIRITNAKAPIRIPIRIT

NAKASONGOLA

BUNDIBUGYOBUNDIBUGYO

BUSIABUSIA

MARACHAMARACHA

AMURUAMURU

OYAMOYAM

DOKOLODOKOLO

ABIMABIM

BULISABULISA

NAMU-NAMU-TUMBATUMBA

BUTALEJABUTALEJA

Ora

Alb

ert

Nile

Achwa

Victoria Nile

Oko

k

Locho

man

Siti

Nkusi

Kafu

Katonga

To To FaradjeFaradje

To To JubaJuba

To To LodwarLodwar

To To BeniBeni

To To BuniaBunia

To To BeniBeni

To To NyakanaziNyakanazi

To To KisumuKisumu

To To NakuruNakuru

To To KigaliKigali

To G

oma

To G

oma

G r e a t R i f t Va l l e y

Margherita PeakMargherita Peak(5110 m)(5110 m)

Mt. Elgon (4321 m)Mt. Elgon (4321 m)

DEM. REP. DEM. REP. OF CONGO OF CONGO

S U D A N S U D A N

K E N Y A K E N Y A

K E N Y A K E N Y A

TANZANIA TANZANIA TANZANIA TANZANIA

RWANDA RWANDA

To To Faradje Faradje

To To Juba Juba

To To Lodwar Lodwar

To To Beni Beni

To To Bunia Bunia

To To Beni Beni

To To Nyakanazi Nyakanazi

To To Kisumu Kisumu

To To Nakuru Nakuru

To To Kigali Kigali

To G

oma

To G

oma

Margherita Peak Margherita Peak (5110 m) (5110 m)

Bundibugyo

Bushenyi

Ibanda

Kiruhura

Ntungamo

Hoima

IgangaBusia

Sironko

Bugiri

Kabale

KamuliKaliro

Butaleja

Budaka

KayungaKyenjojo

Kapchorwa

Bukwo

Kasese

Kisoro

Kitgum

Kumi

Kaberamaido

Lira

Luwero

Nakaseke

Nakasongola

Masaka

Kamwenge

Kalangala

Masindi

Mbarara

Kanungu

Moroto

NakapiripiritKatakwiAmuria

Moyo

Kibale

Pallisa

Soroti

FortPortal

Arua

Jinja

Bubulo

Mbale

Tororo

Gulu

Nebbi

Apac

Amolatar

Mubende

Rukungiri

Isingiro Rakai

Sembabule

Mpigi

MukonoMityanaWakiso

Kiboga

Kotido

KaabongAdjumani

YumbeKoboko

Kilak

Maracha

Oyam

Dokolo

Busiki

Bulisa

Abim

KAMPALA

MO

YO

ADJU

MANI

SIRONKO

KA

YUN

GA

KABA

ROLE

SEMBABULE

KISORO

KANUNGU

RUKUN

GIRI

KAPCHORWA

BUKWO

MASINDI

HOIMA

KASESE

KABALE

KIBOGA

MITYANA

KIBAALE

MUBENDE

MPIGI

MBARARA

IBANDAKIRUHURA

ISINGIRORAKAI

MASAKA

NTUNGAMO

BUSHENYI

APAC

AMOLATAR KABERA-MAIDO

KAMULI

GULU

NEBBI

LUWERO

NAKASEKE

IGANGA

KALIRO

KALANGALA

MUKONO

JINJA

KUMI

KATAKWIAMURIA

MOROTO

SOROTI

PALLISA

MBALEBUDAKA

MANAPWA

LIRA

K I T G U M

ARUA

KOTIDO

KAABONG

TORORO

KAMPALA

YUMBEKOBOKO

PADER

MAYU

GE

BUG

IRI

WAKISO

KAMWENGE

KYENJOJO

NAKAPIRIPIRIT

NAKASONGOLA

BUNDIBUGYO

BUSIA

MARACHA

AMURU

OYAM

DOKOLO

ABIM

BULISA

NAMU-TUMBA

BUTALEJA

DEM. REP.OF CONGO

S U D A N

K E N Y A

K E N Y A

TANZANIATANZANIA

RWANDA

Ora

Alb

ert

Nile

Achwa

Victoria Nile

Oko

k

Locho

man

Siti

Nkusi

Kafu

Katonga

Lake Vic tor ia

LakeEdward

LakeGeorge

LakeKwania

Lake Kyoga

LakeSalisbury Lake

Opeta

Lake

Albe

rt

To Faradje

To Juba

To Lodwar

To Beni

To Bunia

To Beni

To Nyakanazi

To Kisumu

To Nakuru

To Kigali

To G

oma

G r e a t R i f t Va l l e y

Margherita Peak (5110 m)

Mt. Elgon (4321 m)

30°E

4°N

2°N

0°

4°N

2°N

0°

32°E 34°E

32°E 34°E

UGANDA

0 25 50 75

0 25 50 75 Miles

100 Kilometers

IBRD 33504R2

OCTOBER 2007

UGANDA

DISTRICT CAPITALS

NATIONAL CAPITAL

RIVERS

MAIN ROADS

RAILROADS

DISTRICT BOUNDARIES

INTERNATIONAL BOUNDARIES

This map was produced by the Map Design Unit of The World Bank. The boundaries, colors, denominations and any other information shown on this map do not imply, on the part of The World Bank Group, any judgment on the legal status of any territory, or any endorsement or acceptance of such boundaries.