Togo, Additional Financing to the COVID-19 Emergency Response and System Preparedness Strengthening Project

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The proposed Additional Financing will support the implementation of Togo COVID-19 National Vaccine and Deployment Plan (NDVP). The parent project structure will be maintained with complementary sub-components and additional funds under Component 1, Component 2 and Component 3. This will allow to continue to support mitigation measures and contain the spread of the pandemic in the country under Component 1 which provides immediate support to Togo to prevent COVID-19 from expanding or to limit local transmission through containment strategies; Component 2 which provides assistance to all levels of the health care system for preparedness planning, maintaining essential community services and optimal medical care, and minimizing risks for patients and health personnel, as well as developing intra-hospital infection control measures and strengthening the national laboratory system; and Component 3 which consists of Project Implementation Management and Monitoring and Evaluation, including support for procurement, financial management (FM), environmental and social safeguards, M&E, and reporting as well as the training of the project management unit and technical consultants; and operating costs. These components were designed to support the Government in implementing activities presented in their 2020 COVID-19 National Action Plan and to complement activities that were already being financed by the REDISSE (P154807) Project., to continue support to mitigation measures and contain the spread of the pandemic in the country. In fact, out of the US$25 million of proposed IDA project financing for vaccination, an estimated amount of US$14 million will be for vaccine purchase and US$11 million for selected vaccine deployment activities, in addition to US$4.5 million from Health Emergency Preparedness and Response Trust Fund. The AF will support investments to bring immunization systems and service delivery capacity to the level required to successfully deliver COVID-19 vaccines at scale. The component 1 will increase in scope and cost to complement the activities that are being implemented through Regional Disease Surveillance Systems Enhancement II (REDISSE). The original activities under parent Component 1 will be maintained and merged into a new “Sub-Component 1.1: Strengthening capacities for COVID-19 case detection and clinical management which will continue to provide support to (i) strengthen disease surveillance systems, public health laboratories, and epidemiological capacity for early detection and confirmation of cases; (ii) combine detection of new cases with active contact tracing; (iii) support epidemiological investigation; (iv) strengthen risk assessment; and (v) provide on-time data and information for guiding decision-making and response and mitigation activities. Furthermore, it will finance the (vi) purchase and installation of a fuel-efficient mobile P2/P3 laboratory; and (vii) acquiring prefabricated isolation and treatment centers in Lome and equipping them with medical supplies and furniture and network installation.. Complementary interventions will be added as “Sub-Component 1.2: COVID-19 Vaccine Planning, Procurement and Distribution” to support the purchase and delivery of vaccine according to the Togo NVDP operational plan including: (i) upgrading regulatory standards at the national level to ensure there is no forced vaccination, including pharmacovigilance, and authorization mechanisms; (ii) preparation of appropriate minimum standards for vaccine management, including cold chain infrastructure (with financing for the investment to meet the standards); and (iii) operational costs during the vaccine campaign (per diem, travel, fuel etc.); (iv) creation of accountability, grievances, and citizen and community engagement mechanisms. “Sub-component 1.3: COVID-19 vaccines service delivery” to support the enhancement of preparation and operationalization of COVID-19 vaccines deployment in the country including : (i) procurement of needed monitoring and evaluation (M&E) softwares to allow interoperability with existing system DHIS2, IT equipment and capacity building for vaccine campaign roll-out; (ii) Training and Supervision of health workers at all level of the health system, training materials development and distribution, jobs aids adaptation, internet connection and training equipment for efficient virtual capacity building; (iii) demand generation and risk communication campaign through in country renowned communication agency; (iv) Assessment of the vaccine supply chain at all levels of the health pyramid according to the Effective Vaccine Management (EVM) procedure; (v) procurement of fuel-efficient vehicles for the supervision and distribution of vaccines from the central, regional, district and to vaccine sites level; and (vi) vaccine safety and management of adverse events following immunization (AEFI) through technical assistance for the development of protocol for vaccination safety, health workers training in detecting, reporting, data analysis, and investigation. Component 2: Supporting National and Sub-national, Prevention and Preparedness. The component 2 will also increase in scope and cost. The original activities under the parent Component 2 will be maintained and merged into a new “Sub-Component 2.1: Strengthening capacities for COVID-19 prevention, coordination and management” will finance : (i) provision of more emergency medical and non-medical supplies including PPEs such as gloves, surgical mask, respirator, eye protection and isolation gowns to health workers for their safety; (ii) provision of drugs, medical equipment and supplies to public health facilities and for intensive care facilities within hospitals; (iii) provision of two more fuel-efficient medical ambulances; (iv) provision of additional laboratory equipment, containers for specimen handling and transportation, diagnostic reagents and commodities, including kits for regional hospitals; (v) the training of health facilities staff and front-line workers on risk mitigation measures and providing them with the appropriate hygiene materials (such as detergents and disinfectants, and safety/sharp boxes); (vi) elaboration of Standard Operating Procedures (SOPs), guidelines and Terms of Reference on sample collection, packaging, transportation and testing of samples at the WHO recommended laboratories for COVID-19; (vii) operation of the Health Emergency Coordination Center (HECC) (including sub-national coordination and support for preparedness that include training, and supervision); and (viii) operating costs and other administrative-related costs for supportive supervision and monitoring; and (ix) procurement and instalment of a medical fluid system with conduits and accessories (oxygen production generator, vacuum unit and medical air unit) for the CHR Lome-commune. Complementary interventions will be added as “Sub-Component 2.2: Communication, social mobilization and community engagement to enhance demand for the COVID-19 vaccine” including (i) social mobilization; and (ii) demand creation communication. Component 3: Project Management and Monitoring and Evaluation (M&E). The component 3 will increase in scope and cost as well. The original activities under Component 3 will be maintained. The AF will support capacity building of local immunization stakeholders on new tools and strengthening of existing data and monitoring systems (immunization and public health) to enable monitoring of deployment of COVID-19 vaccines and continued monitoring of routine vaccination.COVID-19 Vaccination campaign has started on March 11, 2021 with priority groups as planned in the NDVP, including 82 percent of health workers vaccinated throughout the country (33,090 vaccinated out of 40,520), and people over 50 years of age (56,334 vaccinated) in the Grand-Lome. One month later, vaccination was extended to people over 30 years old (51,578 vaccinated) nationwide.