The midterm review of ADB''s Strategy 2020 strategic priorities includes support for regional public goods, poverty reduction and inclusive growth, which includes an expansion of health sector operations. The TA is aligned with (i) the environment and biodiversity priority of the Strategic Framework of the GMS Economic Cooperation Program (2012- 2022); (ii) the Strategic Framework and Action Plan for Human Resource Development in the GMS (2013 -2017); (iii) the program framework document (PFD) for CEP-BCI (2012- 2016); and (iv) the SERD climate change implementation plan. The TA is consistent with the GMS Regional Cooperation Operations Business Plan (2013 -2014) (RCOBP), with an increased focus on climate change as a broader development issues as well as an environmental issue.
|Project Name||Strengthening Resilience to Climate Change in the Health Sector in the Greater Mekong Subregion|
Lao People's Democratic Republic
|Project Type / Modality of Assistance||Technical Assistance
|Source of Funding / Amount||
|Strategic Agendas||Environmentally sustainable growth
Inclusive economic growth
|Drivers of Change||Gender Equity and Mainstreaming
Governance and capacity development
|Sector / Subsector||
Health / Health sector development and reform
|Gender Equity and Mainstreaming||Some gender elements|
|Description||The midterm review of ADB''s Strategy 2020 strategic priorities includes support for regional public goods, poverty reduction and inclusive growth, which includes an expansion of health sector operations. The TA is aligned with (i) the environment and biodiversity priority of the Strategic Framework of the GMS Economic Cooperation Program (2012- 2022); (ii) the Strategic Framework and Action Plan for Human Resource Development in the GMS (2013 -2017); (iii) the program framework document (PFD) for CEP-BCI (2012- 2016); and (iv) the SERD climate change implementation plan. The TA is consistent with the GMS Regional Cooperation Operations Business Plan (2013 -2014) (RCOBP), with an increased focus on climate change as a broader development issues as well as an environmental issue. The TA will build on ADB-financed projects and TAs including the Second Communicable Disease Control (CDC 2) Project, the Water Resources Management Sector Development Program in Cambodia, Mainstreaming Climate Resilience into Development Planning in Cambodia, Climate Impact and Adaptation Sectoral Strategy for Rural Infrastructure in Lao PDR, Climate Change Impact and Adaptation Study in the Mekong Delta in Viet Nam, the regional TA for Managing Climate Impacts on Health in Water and Agriculture Sectors and Disaster Risk Reduction, the Core Environment Program and Biodiversity Conservation Corridors Initiative in the GMS, and Greater Mekong Subregion Flood and Drought Risk Management and Mitigation Project. The completion report of a previous TA recommended that (i) countries are encouraged to adapt their tools and instruments so that health impacts of climate change can be taken into account in the design, implementation, and monitoring process for all projects; and (ii) ADB should consider supporting DMCs in developing climate resilient sector road maps that include health impacts and evidence-based good practices on climate change and health for key sectors. Disaster risk management interventions will not be included in the TA. TA results will be instrumental for the design of the proposed GMS project on health security, the former communicable disease control project.|
|Project Rationale and Linkage to Country/Regional Strategy||Climate change is recognized as a major threat to economic development in southeast Asia, which is one of the most climate at risk regions in the world, in particular, coastal and low-lying regions like the Greater Mekong Sub-region (GMS). Rapid infrastructure development including hydropower, roads and new urban areas, as well as the increased mobility of populations, is likely to have an impact on vector ecology and disease incidence. The major diseases most sensitive to climate change (e.g. vector-borne diseases, diarrhea, and infections associated with under nutrition) are most significant among children living in poverty. In the GMS, the World Health Organization (WHO) estimates that climate change will contribute to about 150,000 deaths annually. Populations are vulnerable to climate-induced health risks because of (i) changes in temperature and rainfall patterns that affect the incidence of vector-borne diseases (e.g. malaria and dengue) and also change in the geographical habitat of the disease vectors; (ii) extreme weather events that cause injuries, deaths, water contamination, and infectious and water-borne diseases; (iii) droughts and heavy rainfall that cause significant reduction in crop yield, that lead to low food security and malnutrition; and (iv) increased risk of heat waves in urban areas, along with forest fires that adversely affect air quality over broad areas and exacerbate the occurrence and intensity of respiratory diseases and heat strokes. The direct costs to health (excluding costs in health-determining sectors such as agriculture and water and sanitation) are estimated to be $2- $4 billion per year by 2030 worldwide. Cambodia and the Lao PDR have a high burden of vector-borne diseases and in recent years more than 150,000 dengue cases were reported annually. In Cambodia, vector-borne and water-borne diseases (malaria, dengue and cholera) cause significant impact on health outcomes such as an increase in dengue cases. Viet Nam is more vulnerable to climate change due to regular flooding of low coastal areas and frequent typhoons and therefore an increased burden of vector-water and food borne diseases. Diseases related to frequent heat waves such as respiratory infections are increasing in the region. The Government of Viet Nam has recognized that climate change is a major threat to development and approved the National Target Program (NTP) in 2008, which policy and implementation was supported by ADB financed through the Nordic Development Fund. Recent regional analyses show that a warmer, more variable climate will have adverse health effects, which significantly will impact on the poor, particularly women and children. Climate change will strain health resources of countries that already face public health challenges, poor infrastructure, poverty, and inequality. The urban and rural poor in the GMS have limited adaptive capacity given the existing burden of climate sensitive diseases, poverty, low educational attainment, and inadequate quality of health services. In this context, it will be necessary to identify investment priorities such as for climate resilient infrastructure and capacity building to cope and prevent the effects of climate sensitive diseases including those related to natural disasters and thereby strengthen governments' capacity for planning and implementing national climate change programs. Women and children are disproportionately more vulnerable than men to impacts of climate change. However, efforts to integrate gender perspectives in health adaptation programs, plans, and policies have also been limited. Gender-sensitive collection, analysis and reporting of sex-disaggregated data, is needed to better understand the health implications of climate change and climate policies. This will provide information to supporting gender mainstreaming in climate change policies, alongside empowerment of individuals to build their own resilience.|
|Impact||Reduced vulnerability to climate-induced health risks, especially for vulnerable populations, including the poor, migrants, and ethnic minority groups in the GMS|
|Description of Outcome||Enhanced capacity of participating countries and health agencies in climate change adaptation|
|Progress Toward Outcome||Regional training of trainers (TOTs) and national workshops have been conducted for all three countries. Vulnerability and adaptation (V&A) assessments are currently being conducted. National health adaptation plans (HNAP) are also being prepared and updated.|
|Description of Project Outputs||
Knowledge and understanding of the relationship between climate change and human health improved
Human resource skills in coping with climate change adaptation in the health sector strengthened
Knowledge products shared and advocacy promoted
|Status of Implementation Progress (Outputs, Activities, and Issues)||
A consulting firm was engaged to implement the various activities of the TA. Advance payment facilities (APFs) were also established with MOH-DHHP (Lao PDR) and MOH-PMD (Cambodia) to provide funding for national workshops and procurement of small-scale equipment.
The consulting firm and the implementing agencies have (i) developed and received approval for work plans in each country; (ii) engaged international and national consultants to develop science-based knowledge products including modeling and forecasting climate-related disease burden and a set of interactive vulnerability maps; (iii) developed training modules and organized three regional training of trainers (ToTs) on climate change and human health (CC&HH); and (iv) organized a series of capacity building workshops and regular consultations with key stakeholders, such as workshops on Integrated Surveillance System/Early Warning System (ISS/EWS), Geographic Information System, Public Private Partnership to sensitize relevant stakeholders on potential investment options and to build capacity within related government agencies.
Some remaining tasks are: (i) Under Output 1, national and provincial vulnerability and adaptation (V&A) assessments have commenced, and subsequent tasks to be done are cost-effectiveness analyses, prioritization of adaptation options, development of prefeasibility studies, and dissemination and advocacy efforts. (ii) Under Output 2, Lao PDR and Viet Nam need to adapt the regional training modules to local language and materials. National and provincial training in all three countries are expected to roll out in the second half of 2018. (iii) Under Output 3, three knowledge products on climate change and health and dissemination activities need to be delivered. A Nordic Seminar is proposed to be organized in December 2018. A high-level final regional workshop is planned in March 2019.
|Geographical Location||Cambodia - Nation-wide; Lao People's Democratic Republic - Nation-wide; Viet Nam - Nation-wide|
|Summary of Environmental and Social Aspects|
|Stakeholder Communication, Participation, and Consultation|
|During Project Design||Positive feedback about the proposed TA was received during initial discussions with the ministries of health. During fact-finding, a number of agencies/institutions and donor organizations working on climate change and health will be consulted to discuss scope and implementation arrangements.|
|During Project Implementation||The TA will be monitored through the IAs and supported by the consulting team. The results of the TA (midterm and final) will be evaluated and disseminated through regional workshops and or consultation meetings which will include key regional institutions on climate change and academia. Good practices and lessons learned will be disseminated through regional workshops, the CDC and related government websites, and a proposed joint publication on the pilot results.|
The TA requires 58 person-months of international consultants and 123 person-months of national consultants with expertise in public health, climate change adaptation in the health sector, climate change modeling, health economy, training, public private partnerships, data management, epidemiology, gender and community development and communications. It was discussed previously that the TA office could be based in the Viet Nam Health Environment Management Agency, Ministry of Health, Hanoi, Viet Nam. The international consultant team will have to undertake frequent visits to Cambodia and Lao PDR to assist during TA inception and implementation.
A team of international and national consultants, to be provided by a consulting firm, will assist the team leader in coordinating the consulting inputs and facilitating efficient and effective use of resources. The consulting firm, recruited using quality- and cost-based selection method (90:10) will be engaged. TA funds for administration, training, regional meetings, workshops, and study tours will be managed under the consulting firm's contract.
|Procurement||All equipment (computers and software to support data analysis) will be procured in accordance with the ADB Procurement Guidelines (2015, amended from time to time).|
|Responsible ADB Officer||Xu, Ye|
|Responsible ADB Department||Southeast Asia Department|
|Responsible ADB Division||Human and Social Development Division, SERD|
Asian Development Bank
6 ADB Avenue,
Mandaluyong City 1550, Philippines
|Concept Clearance||24 Jul 2014|
|Fact Finding||01 Apr 2014 to 12 May 2014|
|Approval||26 May 2015|
|Last Review Mission||-|
|Last PDS Update||21 Sep 2018|
|Approval||Signing Date||Effectivity Date||Closing|
|26 May 2015||-||26 May 2015||31 Dec 2018||31 Dec 2019||-|
|Financing Plan/TA Utilization||Cumulative Disbursements|
|0.00||4,360,000.00||50,000.00||0.00||0.00||0.00||4,410,000.00||26 May 2015||2,591,474.46|
Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.
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|Title||Document Type||Document Date|
|Strengthening Resilience to Climate Change in the Health Sector in the Greater Mekong Subregion: Technical Assistance Report||Technical Assistance Reports||Apr 2015|
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.
None currently available.
Evaluation Documents See also: Independent Evaluation
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ADB, Nordic Development Fund Help GMS Counter Climate Change Health ThreatADB has approved a pioneering regional technical assistance initiative, with finance from the Nordic Development Fund, to help Cambodia, the Lao People’s Democratic Republic, and Viet Nam respond to climate-induced health threats.
No tenders for this project were found.
|Contract Title||Approval Number||Contract Date||Contractor||Contractor Address||Executing Agency||Contract Description||Total Contract Amount (US$)||Contract Amount Financed by ADB (US$)|
|Capacity Development||Technical Assistance 8898||12 Jan 2016||Conseil Sante S.A. (France) in Association with Societe Francaise De Realisation D'Etudes et de Co (France)||92-98 BOULEVARD VICTOR HUGO 92110 CLINCHY FRANCE||Asian Development Bank||2,746,952.00||—|
None currently available.