Azerbaijan COVID-19 Emergency Response Project

dropped

Failure

The Project will support the government to curb the spread of COVID-19 pandemic and strengthen the health system to detect andtreat cases, and to mitigate some of the social consequences of the pandemic. BackgroundAzerbaijan’s response to the first waveof COVID-191. Azerbaijan was relatively successful in containing the first wave of the pandemic. Between March and May 2020,Azerbaijan experienced less than 5,000 cases and 58 deaths. The first wave was contained because of the GoA’s’s swift action: thefirst confirmed COVID-19 case was reported on February 28, 2020. Between March 2020 and January 2021, three lockdowns wereinitiated. The lockdowns brought restrictions on the opening of schools, public transportation, shopping malls, and other publicservices. In response to the immediate health needs, the GoA swiftly mobilized a health sector response and worked with multiplepartners to secure emergency supplies. Medical supplies were purchased and brought to Azerbaijan by the MoH, SAMHI, TABIB, UNagencies, the EU, and private donors. Countries such as Turkey, China, South Korea, Poland and United Arab Emirates also providedother forms of support. Coordination through the UN helped the country maintain access to international epidemiological expertiseand risk communication guidance. These collective efforts averted a shortage of personal protective equipment (PPE). Azerbaijan’sresponse to subsequent waves of COVID-192. Azerbaijan has been less successful at containing subsequent waves of the pandemic andsupport is needed to sustain much-needed public health measures. Overall, as of May 11, 2021, there were more than 327,000confirmed cases of COVID-19 and 4,698 deaths. The country has experienced three surges. Between October 2020 and January 2021, thecountry experienced a pronounced rise in cases, with a peak of 411.7 daily new confirmed cases per million people on December 14,2020. The third wave, which started in March 2021, reached its peak on April 13, 2021, with 221.7 daily new confirmed cases permillion people. Despite the efforts taken by the country at the outset of the pandemic, recent experience highlights the need forsustained support to avoid further surges, particularly as compliance with public health measures becomes harder to secure and moreeconomically challenging for vulnerable populations. 3. The demands of the last two surges have strained the health system andprompted the need to mobilize exceptional surge response and address structural weaknesses at the primary healthcare level.Following the April 2021 peak, as of April 29, 2021, 26,125 patients were receiving care in hospital settings and resulting in theneed for the GoA to provide exceptional top-up compensation for healthcare workers. COVID-19 has also exposed the fragmentation ofthe health sector’s information management systems at the primary healthcare level. These have limited the system’s ability toengage in NCD risk prevention and management, consequently reducing the overall vulnerability to severe COVID-19. 4. Theprolonged duration of the crisis and the triple shock, of conflict, recession, and a pandemic, are limiting public compliance withsocial distancing and other COVID-related guidance, further weakening Azerbaijan’s capacity to contain the pandemic. The April 2021surge corresponds with “superspreading” events following the March 2021 Nowruz celebration and, when compared with 2020, reflectwaning public compliance with social distancing measures. Mass gatherings, household celebrations and absence of social distancingand mask wearing, despite continued messaging from the authorities to adhere to the preventative measures. “Pandemic fatigue” andincreased politicization of the decision-making process around tightening or loosening restrictions is adding to Azerbaijan’sdifficulties in containing the spread of COVID-19. Previous measures to enforce public health measures have proved to be lesseffective during the third wave, especially among vulnerable populations and in the context of more infectious and deadly variants.5. Strengthening Azerbaijan’s health system, both during and following the COVID-19 pandemic, requires improving how patientswith NCDs are managed in primary care settings. Evidence from COVID-19 infections shows a two-way relationship between NCDs andCOVID-19. Firstly, COVID-19 patients with NCDs are more vulnerable to severe disease, particularly for men over 60. Secondly,COVID-19 stands to exacerbate the progression of NCDs. In addition, access to elective care and preventive programs have beenlimited due to the pandemic. As a result, a longer-term upsurge in morbidity and mortality is likely, which makes enhancedmonitoring in primary care settings, through digital technologies, a cost-effective and appropriate health systems strengtheningmeasure.The additionality of World Bank support to Azerbaijan’s COVID-19 response 6. Unless emergency needs, poor compliance w ith pandemic control measures and underlying health system weaknesses are urgently addressed, the country will remain incapableof definitively responding to the on-going pandemic. Critical investments are now needed to put the health system in a position toprevent, detect, and respond to the pandemic effectively and sustainably. These include: mobilizing surge response capacity, on anexceptional basis, in hospital settings; improving risk communication and community engagement to overcome the public’s “pandemicfatigue”; financing unemployment benefits and cash transfers to vulnerable populations to enable social distancing; improvingcapacity at the primary healthcare level to monitor, track and facilitate integrated care for patients with NCDs, who are atincreased vulnerability for severe COVID-19 and improving protocols and guidelines for healthcare workers, so that they are wellplaced to manage COVID-19 cases and NCD co-morbid patients, who are more vulnerable to severe COVID-19. 7. The GoA has requestedthe World Bank’s support for an emergency COVID-19 response project, which will focus on health and social protection measures tofacilitate required public health measures until vaccines are widely available. In 2020, Azerbaijan experienced the triple shock ofa pandemic, a military conflict and a recession. The conflict with Armenia in the autumn of 2020 resulted in 2,783 military deathsas well as civilian deaths and displacement. National security and the safety of the population was thus a key imperative for theGoA at the same time as other Governments were able to devote their focus and resources on combatting the pandemic. As a result,COVID-19 rates escalated. Following the end of the conflict and resumption of peace in the region, the GoA approached the WorldBank, in March 2020, for support in addressing the ongoing health security threat posed by COVID-19. The ongoing health emergencyis reflected in the December 2020 surge and continues to be apparent, as indicated by the April 2021 surge. Moreover, ashighlighted by the 2020 World Bank Group’s (WBG) Fragility, Conflict and Violence (FCV) Strategy, countries emerging from conflictwill continue to feel its effect on the capacity of national institutions, systems and services long after the end of hostilities.With Azerbaijan likely to meet the criteria for inclusion in the FY22 World Bank Classification of Fragile and Conflict-AffectedSituations (FCS List), WBG support to COVID-19 health and social protection needs in the immediate aftermath of the conflict willcontinue to strengthen the social contract and is strongly in line with the Helping Countries Transition out of Fragility pillar ofthe FCV Strategy. Having secured resources for COVID-19 vaccines and vaccines deployment from other sources, the GoA sees value inthe Bank’s involvement as a strategic support to address system weaknesses that became apparent and aggravated during the pandemic.The project will strengthen the healthcare system for management of COVID-19 cases a

World Bank Group

Project

Residential, Hospital, Commercial, Government