Cambodia: GMS: Regional Communicable Diseases Control Project

Sovereign Project | 36672-012

Summary

Project impact:

(i) Contained spread of epidemic diseases at local level and

(ii) reduced burden of common endemic diseases in CLV countries.

Project outcomes:

(i) Timely and adequate control of epidemics likely to have a major impact on public health and the economy in the region;

(ii) Improved coverage of prevention and care of communicable diseases in vulnerable populations, in particular poor women and children living in border areas; and

(iii) Improved know-how, policies, standards, and coordination among countries to improve CDC, including for HIV/AIDS, through intergovernmental cooperation.

Project outputs:

(i) Comprehensive national surveillance and response systems, including institutional structures; preparedness, surveillance, and response; laboratory services; and human resource development (HRD);

Latest Project Documents


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Project Name GMS: Regional Communicable Diseases Control Project
Project Number 36672-012
Country Cambodia
Project Status Closed
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 0025-CAM: GMS: Regional Communicable Diseases Control Project
Asian Development Fund US$ 9.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change
Sector / Subsector Health - Disease control of communicable disease
Gender Equity and Mainstreaming
Description

Project impact:

(i) Contained spread of epidemic diseases at local level and

(ii) reduced burden of common endemic diseases in CLV countries.

Project outcomes:

(i) Timely and adequate control of epidemics likely to have a major impact on public health and the economy in the region;

(ii) Improved coverage of prevention and care of communicable diseases in vulnerable populations, in particular poor women and children living in border areas; and

(iii) Improved know-how, policies, standards, and coordination among countries to improve CDC, including for HIV/AIDS, through intergovernmental cooperation.

Project outputs:

(i) Comprehensive national surveillance and response systems, including institutional structures; preparedness, surveillance, and response; laboratory services; and human resource development (HRD);

(ii) Expanded and integrated CDC for vulnerable groups in 26 provinces (5 in Cambodia, 6 in Lao PDR, and 15 in Viet Nam) along borders or transport corridors; and

(iii) Productive regional coordination for CDC through capacity building of MOH, regional policy dialogue, support for regional institutions in operations research, and project management.

Project Rationale and Linkage to Country/Regional Strategy

Project rationale:

(i) CLV countries need to make more effort to achieve health-related MDGs, in particular by providing PHC to remote populations suffering from a high burden of infectious and reproductive diseases, and improving the affordability and quality of health care;

(ii) CLV countries need community action to contain emerging diseases like avian influenza (AI), severe acute respiratory syndrome (SARS), Dengue, and HIV/AIDS, facilitated by increased regional integration;

(iii) At the GMS summit, leaders proposed stronger regional collaboration in CDC in view of emerging and other diseases of regional relevance, as part of national health systems development;

(iv) Regional cooperation in CDC is justified as its benefits exceed what countries acting on their own can achieve in terms of (a) control of communicable diseases, (b) know-how for disease control; (c) economies of scale and greater leverage, and (d) regional public goods for health;

(v) In recent years, globalization has transformed borders from barriers to bridges, and this transformation has shifted attention to cross-border matters that localities have in common;

(vi) SARS and AI have had high economic impact through declining tourism, reduced foreign investment, and export restrictions on products.

Link to Global and Regional Strategies:

(i) The International Health Regulations (IHR) and the Asia Pacific Strategy for Emerging Diseases (APSED) approved in 2005 serve as the strategic framework to contain diseases internationally. Countries will be expected to report public health threats and maintain core capacities;

(ii) Regional CDC is a priority of the GMS HRD Working Group; and

(iii) The Project is aligned to the Regional Country Partner Strategy.

Impact Contain the spread of epidemic diseases at local level, and reduce the burden of common endemic diseases by about 15% in the targeted provinces, and more for certain specific infections, in the CLV countries. This will help these countries progress toward their health-related MDGs for 2015 of reducing the child mortality rate and containing the spread of HIV/AIDS and other infections
Project Outcome
Description of Outcome

Timely and adequate control of epidemics that are likely to have a major impact on the region's public health and economy.

Improved coverage of prevention and care of communicable diseases in vulnerable populations, in particular poor women and children living in border areas.

Improved know-how, policies, standards, and coordination among countries to improve CDC, including HIV/AIDS control.

Progress Toward Outcome

(i) Contributed to containment of outbreaks of AI, Cholera, Dengue and other infectious diseases of regional relevance.

(ii) Contributed to improved provincial capacity for CDC in targeted provinces, Dengue prevention and outbreak control, control of NTDs in high risks populations, and improved coverage of HIV/AIDS testing and treatment;

(iii) Contributed to modest improvement in MOH capacity for CDC and regional cooperation.

Implementation Progress
Description of Project Outputs

Expanded and integrated CDC for vulnerable groups in 26 provinces (five in Cambodia, six in Lao PDR, and 15 in Viet Nam).

Comprehensive national surveillance and response systems, including institutional structures; preparedness; surveillance and response; laboratory services; and HRD in all three countries nationwide.

Productive regional coordination for CDC through capacity building of MOH, regional policy dialogue, support for regional institutions in operations research for HIV/AIDS control and other fields in support of this dialogue, and project management.

Status of Implementation Progress (Outputs, Activities, and Issues)

(i) Improved policy framework and guidelines, more field epidemiologists, better prepared provincial outbreak response teams and hospitals, provincial emergency funds, improved laboratory services, and better community preparedness. However, hospitals have limited surge capacity; hospital and laboratory staff need more training and operations support; community prevention, preparedness and reporting still insufficient in particular in border areas. Provincial emergency funds less sustainable and insufficiently covers outbreak reporting costs (e.g., sms, free phone).

(ii) Improved provincial annual operational plans (AOP) with more attention to targeting, CDC, and operations. Targeted support for the control of Dengue and neglected tropical diseases (NTDs). However, provincial planning and budgeting capacity varies considerably and needs clear purpose, formats, and reliable information. Due to a lack of sustainable funding, Dengue outbreaks are reoccurring. Strategies for community prevention of Dengue are less sustainable. Provinces need to make more effort to reach remote communities in border areas.

(iii) Regional cooperation in CDC has improved in terms of creating a conducive environment for dialogue and exchange of views. CLV institutions have completed several epidemiological studies. Cross-border cooperation is also increasing with support of partners. However, MOH capacity for regional cooperation remains limited. While there is an overall cooperation agreement, formal cooperation arrangements, institutional structures, and domestic resources budget need to be improved. Actual regional cooperation is slow to emerge, such as for implementation of regional strategies and KM products.

Geographical Location The Project will target 5 provinces in Cambodia, 6 in Lao PDR, and 15 in Viet Nam).
Summary of Environmental and Social Aspects
Environmental Aspects No negative aspects
Involuntary Resettlement No resettlement
Indigenous Peoples Positive, but more efforts needs to be made to reach very poor communities
Stakeholder Communication, Participation, and Consultation
During Project Design

(i) Consultations of core ministries, health officials, partners, managers, staff, village leaders, potential beneficiaries; and

(ii) Three regional and three national workshops;

During Project Implementation

(i) Regional and national steering committees and workshops;

(ii) Consultations with targeted institutions, provinces and communities during implementation;

(iii) Regional public health forums and websites;

(iv) Participation in regional events of partners.

Business Opportunities
Consulting Services About 238 person-months international and 1,176 person-months domestic consulting services will be required. Of the international consultants, the regional project coordinator (36 person-months), the health system development expert (16 person-months), and the HIV/AIDS Chief Technical Adviser (16 person-months) will be directly engaged by ADB as individual consultants for a total of 68 person-months. International experts for surveillance and response, outbreak preparedness, virology, dengue control, control of endemic diseases, legislation, and health information system will be contracted as individual consultants for a total of 170 person-months by WHO as implementing agency according to WHO rules and regulations for administrative procedures and practices. ADB-funded experts to be engaged by WHO must have the prior approval of ADB and MOH. Each MOH will engage domestic consultants as individual consultants according to procedures acceptable to ADB.
Procurement Equipment will be procured by international competitive bidding for contracts valued at $1,000,000 or more; international shopping for contracts below $1,000,000, and local competitive bidding or direct purchase for items valued at less than $100,000. Civil works are scattered and limited to repair and upgrading of existing facilities and will be carried out through local competitive bidding. Procurement of equipment and supplies will be managed by the EA who may delegate this to the provinces for items valued at less than $20,000.
Responsible ADB Officer Vincent De Wit
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Human and Social Development Division, SERD
Executing Agencies
Ministry of HealthProf. Eng Huotdghhuot@online.com.khMinistry of Health, No. 151-153, Kampuchea Krom Street, Phnom Penh, Cambodia
Timetable
Concept Clearance 15 Mar 2005
Fact Finding 29 Apr 2005 to 05 May 2005
MRM 08 Jun 2005
Approval 21 Nov 2005
Last Review Mission -
PDS Creation Date 28 Feb 2006
Last PDS Update 28 Sep 2012

Grant 0025-CAM

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
21 Nov 2005 27 Dec 2005 07 Mar 2006 30 Jun 2010 30 Jun 2011 17 Oct 2012
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 11.25 Cumulative Contract Awards
ADB 9.00 21 Nov 2005 8.77 0.00 97%
Counterpart 2.25 Cumulative Disbursements
Cofinancing 0.00 21 Nov 2005 8.77 0.00 97%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating Satisfactory Satisfactory Satisfactory - - Satisfactory

Safeguard Documents

See also: Safeguards

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Evaluation Documents

See also: Independent Evaluation

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