Additional Financing for Afghanistan COVID-19 Emergency Response and Health Systems Preparedness Project

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The PDO of the parent Project, “to respond and mitigate the threat posed by COVID-19 in Afghanistan and strengthen national systems for public health preparedness”, and the Project’s component structure remain unchanged. The AF will cover the procurement of vaccines, cold chain cost, logistic arrangement to delivery vaccine to up to provincial level, risk communication, mass communication activities for vaccine uptake, capacity development of health professionals involved in vaccine delivery and management, administration of the vaccines to the target populations by the SPs and monitoring and evaluation.• Component 1: Emergency COVID-19 Response (current allocation – US$15 million from COVID-19 FTCF, US$22 million from IDA; proposed AF allocation US$ 89.5 million)o Continuation: supports efforts in surveillance, testing, contact tracing, infection prevention and control, and behavior change communication. o Proposed new activities: will include assistance in the urgent efforts to respond to the COVID-19 pandemic through: (a) supporting Afghanistan’s health sector in the purchase of Project COVID-19 Vaccine and vaccine-related cold chain equipment; and (b) strengthening Afghanistan’s institutional framework to enable safe and effective vaccine deployment designed for Project COVID-19 Vaccines including development of (i) national policies surrounding prioritization of vaccine allocation; (ii) national policies ensuring voluntary vaccinations; (iii) regulatory standards for vaccination; (vi) standards and protocols surrounding cold chain, supplies, storage, logistics, and training.• Component 2: Health Care Strengthening (current allocation - US$46 million from IDA; proposed AF allocation US$16 million). o Continuation: strengthens essential health care service delivery to be able to provide the best care possible, through contracts with existing Sehatmandi Service Providers. o Proposed new activities: The Sehatmandi service providers, contracted by the parent project for incremental tasks related to COVID-19 to date, will also be utilized for targeting beneficiaries and delivering the vaccines. The Government of Afghanistan has identified priority target populations to be vaccinated and aims to achieve a 40 to 60 percent population coverage. . • Component 3: Mitigation of Social Impacts (current allocation - US$5.4 million from COVID19 FTCF, US$7 million from IDA; proposed AF allocation US$4 million).o Continuation: aims to address significant negative externalities expected in the event of a widespread COVID-19 outbreak and include comprehensive communication strategies.o Proposed new activities: will support will of the programs designed for Project COVID-19 Vaccines including: (i) development of explicit, contextually appropriate and transparent criteria for identification of priority populations for vaccination and supporting implementation plans; (ii) communication to address vaccine hesitancy to improve demand generation through mass and interpersonal communication especially targeting female considering their lower access to information; (iii) Social and Behavior Change Communication to address and manage COVID-19 risks and health promotion; (iv) outreach interventions; (v) citizen engagement for feedback and grievance redressal mechanisms; (vi) development of targeted training programs for managers, SPs and evaluators of vaccine deployment; and (vii) knowledge management and learning. These social communications will be carried out through UNICEF - in collaboration with the MoPH - who has been contracted in the parent project for similar COVID-19 related mass-media campaigns targeting specific groups which might resist COVID-19 activities including vaccinations. UNICEF has a wide experience using diverse and appropriate social media in Afghanistan to convey health, education and social benefit related information.• Component 4: Implementation Management and Monitoring and Evaluation (current allocation - US$5 million IDA; proposed AF allocation US$3.5 million).o Continuation: supports the strengthening of public structures for the coordination and management of the project.o Proposed new activities: will support development of information systems towards (i) impact of vaccination program through disease surveillance; (ii) assessment of coverage, effectiveness and safety of vaccination deployment; (iii) outbreak investigation and control; (iv) sero-surveillance studies; and (v) operational and management costs in implementation of the project. • Component 5: Contingent Emergency Response Component (CERC) (US$0 million): In the event of an Eligible Crisis or Emergency, the project will contribute to providing immediate and effective response to said crisis or emergency. This will remain as is.