Lao People's Democratic Republic: Second Greater Mekong Subregion Regional Communicable Diseases Control Project

Sovereign Project | 41507-012 Status: Active


ADB is helping enhance communicable disease control systems in the Greater Mekong Subregion. The project, which includes Cambodia and the Lao People’s Democratic Republic, will expand surveillance and response systems, target the control of dengue and neglected tropical diseases, and include communicable disease control training for agencies and communities in border districts.

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Procurement Documents

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Project Name Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Project Number 41507-012
Country Lao People's Democratic Republic
Project Status Active
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 0232-LAO: Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Concessional ordinary capital resources / Asian Development Fund US$ 12.00 million
Grant 0449-LAO: Second Greater Mekong Subregion Regional Communicable Diseases Control Project (Additional Cofinancing to Grant 232-LAO)
Regional Malaria and Other Communicable Disease Threats Trust Fund under the Health Financing Partnership Facility US$ 3.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Sector / Subsector

Health - Disease control of communicable disease - Health system development

Gender Equity and Mainstreaming Effective gender mainstreaming
Description The project follows Strategy 2020, which realigns ADB's role in the health sector with emphasis on regional, intersector, and interagency cooperation, as also detailed in the operational plan for health. It is in line with ADB s Regional Cooperation and Integration Strategy, the GMS regional cooperation strategy and the country partnership strategies and country operations business plans of Cambodia, Lao PDR, and Viet Nam. The project supports regional public goods and capacity towards regional health and economic security and the Millennium Development Goals (MDGs) for reducing child mortality and malnutrition, halting the spread of communicable diseases, and others. In partnership with WHO, the Mekong Basin Disease Surveillance Cooperation, the Kenan Institute Asia and other partners, it addresses critical funding gaps for the roll-out of the International Health Regulations (2005) and APSED, as well as regional strategies for the control of dengue and NTDs. Under the leadership of WHO, regional and national aid coordination mechanisms are in place including regular meetings, surveys and publications for aid coordination, technical forums, community of practice groups, and websites.
Project Rationale and Linkage to Country/Regional Strategy Emerging infectious diseases such as severe acute respiratory syndrome (SARS), avian influenza, and swine flu have had major economic impacts on productivity, trade, and tourism in the GMS, and continue to pose a major public health concern. New diseases, mostly of animal origin, also pose a constant threat. Dengue, chikungunya, cholera, typhoid, and HIV/AIDS fueled by better connectivity, urban development, and social and environment changes continue to spread in the GMS. Controlling these diseases requires strong surveillance systems, community prevention and preparedness, and quick system response capacities.
Impact Improved health of the population in the Greater Mekong Subregion (GMS).

Project Outcome

Description of Outcome Timely and adequate control of communicable diseases of regional relevance
Progress Toward Outcome

- Since project commencement, 384 disease outbreaks reported. 84% within 24 hours and 68% investigated within 24-48 hours (source: NCLE Monthly Surveillance Report). Outbreak Manual available in NCLE and SOPs for rapid response in place.

- September 2014 ADB mission identified need to clarify this indicator and compile data. New cross-border exchange protocols agreed among CLV countries, however no data collected yet.

- HH survey data and analysis show 45.1% conduct core CDC prevention and care activities. This is expected to improve after the HHS in April 2016

Implementation Progress
Description of Project Outputs

1. Enhanced regional CDC systems

2. Improved CDC along borders and economic corridors

3. Integrated project management

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

Progress in Output-1:

- Focal center established in CDC Department of MOH and its role and responsibilities outlined in the draft strategy\policy documents.

- Five regional steering committee meetings conducted to date. Two regional meetings and one forum are expected to be conducted until June 2017. (List of regional and cross-border meetings in Appendix 5). A cluster cross-border meeting was conducted in Luang Prabang in July 2016. The next cluster cross-border meeting hosted by the EA will be on 16-17 August in Champasak. Lao PDR will host a regional forum on IHR, tentatively set for October 2016.

- Bilateral regional meetings and cross-border provincial information-sharing can be sustained even after the project because of existing MOUs. The cross-border meetings have already been integrated into provincial budgets. However, these budgets are not sufficient. The effectiveness of the regional and provincial cross-border meetings will be validated during the post-project assessment.

- NCLE continues to refine the EWARN system and is reviewing the reporting format of outbreaks to clarify timeliness of communication from health facilities to NCLE. There were 13 outbreaks with 554 people affected and 6 deaths (5 due to food poisoning [mushroom] and 1 due to acute water diarrhea) in the current quarter. 61.5% of outbreaks were reported within 24 hours and 61.6% were also investigated within 24 48 hours. Females accounted for around 46% of all cases. From 2011 to the present, 397 outbreaks have been identified in Lao PDR with around 16,200 persons affected, with 83% reported within 24 hours and 69% investigated within 24 48 hours.

- Training on surveillance and response systems was conducted in the current quarter, including training on malaria and disease surveillance and risk assessment for district surveillance officers/RRT members. Integrated on job training on lab quality services including malaria and other communicable diseases diagnosis for district lab staff and selected health canters including lab quality by provincial lab staff was conducted.

- There were 13 training sessions conducted for nurses at the central and provincial on dengue case management on 2012. PMU provided support for mosquito/larvae surveillance in 10 provinces covering 140 target villages. The PMU provided assistance in survey and communication on the prevention and control of liver fluke in 4 provinces (Attapeu, Champasak, Bolikhamxay and Salavanh) covering 1944 villages; schistosomiasis in 202 villages in Champasak; lymphatic filiasis in 204 villages in Attapeu.

Progress in Output-2:

- In total, around 350 model healthy villages were targeted during the course of the Project and priority considerations including MHVs were: optimal targeting to ensure relevant villages are included in the program; coordination with the existing MHV program to ensure consistency and complementarity and use of agreed and accepted material and approaches. As of 31 December 2015, 304 MHVs have been established under the Project (86.5% of original overall target).

- Monitoring and assessment of the provincial and district training system continues. Overall, following numerous field visits, it has been concluded that steady progress was being made and that the training management teams (TMTs) were being institutionalized within provincial and district organizational and management structures. An estimated 20,000 trainees at various levels have undergone training under the project (some people have had multiple training).

- The project has developed and implemented a teaching methodology, training management manual and guidelines for implementation. A training advisory group provides inputs to training conduct and content.

Progress in Output-3:

- All local experts were recontracted for the AF extension phase.

Geographical Location

Safeguard Categories

Environment C
Involuntary Resettlement C
Indigenous Peoples B

Summary of Environmental and Social Aspects

Environmental Aspects The project is assessed category C for environment.
Involuntary Resettlement The project is assessed category C for involuntary resettlement.
Indigenous Peoples Ethnic groups constitute 31% of the population in the targeted border districts, most of them in the Lao PDR. They suffer disproportionately from common communicable diseases, and have less access to health care because of physical, financial, language, and cultural barriers. The project is assessed category B for indigenous people and is expected to have positive impacts on ethnic groups. The accrual of benefits to ethnic groups is discussed in the ethnic groups plan, and included in the project design. Under the sub-output for community based CDC, the aim is that 50% of 1,160 targeted villages belong to ethnic groups. This includes training of village health workers and support for healthy village development. The project will also provide scholarships for ethnic group members to become health workers.
Stakeholder Communication, Participation, and Consultation
During Project Design Included: (i) group discussions with potential beneficiaries, village health workers, and community-based organizations; (ii) consultation of health staff, provincial and district health managers, provincial governments, central ministries and partners; and (iii) workshop with ministries, partners, and NGOs.
During Project Implementation Level of consultation and participation envisaged are information sharing, Consultation,Collaborative decision making and empowerment. Existing organizational structures down to the village level will be used, no need for a separate system. However, participation will be monitored.

Business Opportunities

Consulting Services All consultants will be recruited according to ADB's Guidelines on the Use of Consultants. Nine positions of individual consultants and one consulting firm are provided for the duration of the project.
Procurement All procurement of goods and works will be undertaken in accordance with ADB's Procurement Guidelines.(2010, as amended from time to time). International Competitive Bidding procedures will be applied for any packages valuing more than $0.5 million. Any bid packages of goods and civil works valuing less than $ 0.5 million will be procured through national competitive bidding. Smaller goods and civil works packages costing less than $0.1 million may be procured through shopping procedures.

Responsible Staff

Responsible ADB Officer Sato, Azusa
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Human and Social Development Division, SERD
Executing Agencies
Ministry of Health
[email protected]
Simuang Road


Concept Clearance 30 Mar 2010
Fact Finding 06 Apr 2010 to 23 Apr 2010
MRM 06 Sep 2010
Approval 22 Nov 2010
Last Review Mission -
PDS Creation Date 15 Apr 2010
Last PDS Update 29 Sep 2016

Grant 0232-LAO

Approval Signing Date Effectivity Date Closing
Original Revised Actual
22 Nov 2010 08 Dec 2010 22 Mar 2011 30 Jun 2016 31 Dec 2017 -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 13.00 Cumulative Contract Awards
ADB 12.00 22 Nov 2010 11.69 0.00 97%
Counterpart 1.00 Cumulative Disbursements
Cofinancing 0.00 22 Nov 2010 12.57 0.00 105%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - - - Satisfactory

Grant 0449-LAO

Approval Signing Date Effectivity Date Closing
Original Revised Actual
26 Oct 2015 17 Nov 2015 04 Jan 2016 31 Dec 2017 - -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 3.15 Cumulative Contract Awards
ADB 0.00 26 Oct 2015 0.00 1.14 38%
Counterpart 0.15 Cumulative Disbursements
Cofinancing 3.00 26 Oct 2015 0.00 3.80 127%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - - - Satisfactory

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

Title Document Type Document Date
Second Greater Mekong Subregion Regional Communicable Diseases Control Project: Ethnic Groups Plan Indigenous Peoples Plans/Indigenous Peoples Development Plans Jul 2015

Evaluation Documents See also: Independent Evaluation

None currently available.

Related Publications

None currently available.

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