Mongolia : Strengthening Rapid Epidemic Response Capacity of Health Systems Project

Project Name

Strengthening Rapid Epidemic Response Capacity of Health Systems Project

Project Number

55023-001

Country / Economy

• Mongolia

Project Status

Active

Project Type / Modality of Assistance

• Grant

Source of Funding / Amount

Grant 9218-MON: Strengthening Rapid Epidemic Response Capacity of Health Systems in Mongolia

Source	Amount
Japan Fund for Prosperous and Resilient Asia and the Pacific	US$ 5.00 million

Operational Priorities

• OP1: Addressing remaining poverty and reducing inequalities
• OP2: Accelerating progress in gender equality
• OP6: Strengthening governance and institutional capacity
• OP7: Fostering regional cooperation and integration

Sector / Subsector

• Health /

Gender

Some gender elements

Description

The coronavirus disease (COVID-19) pandemic is causing significant health, social, and economic impacts on Mongolia. The project will help the country respond to the ongoing outbreak of COVID-19 by providing resources and training support that will help strengthen its capacity for (i) conducting reverse transcription polymerase chain reaction (RT-PCR) tests, (ii) administering COVID-19 vaccines to target populations in compliance with infection prevention and control (IPC) protocols, (iii) ensuring the complete uptake of immunization services by target groups, and (iv) undertaking post-immunization surveillance. The project is closely linked to the Support for COVID-19 Vaccine Delivery in Mongolia under the Asia Pacific Vaccine Access Facility which will provide safe and effective COVID-19 vaccines in Mongolia. The project has strong pro-poor and socially inclusive features.

Project Rationale and Linkage to Country/Regional Strategy

On 30 January 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a public health emergency of international concern. On 11 March 2020, WHO declared the COVID-19 a pandemic. By 3 June 2021, nearly 171.6 million people had been diagnosed with COVID-19, with more than 3.7 million deaths, globally. The first case of community transmission in Mongolia was reported on 10 November 2020, and since then several clusters of local transmission have emerged in Ulaanbaatar and in six provinces. The Government of Mongolia initiated stringent measures to prevent the spread of COVID-19, including international and national travel restrictions; the closure of schools and kindergartens and all non-essential business, public awareness campaigns, restrictions on public gatherings, meetings, and celebrations; and preparation of hospitals to manage emergencies in the event of a surge of cases. The government has implemented three rounds of strict lockdowns from November 2020 to end of May 2021. As of 3 June 2021, there have been 60,372 cases of COVID-19 with 286 deaths recorded in the country (footnote 3). The risk of continued community spread of COVID-19 remains substantial. Of these, some 522,428 people are at high risk (i.e., frontline medical workers, emergency management staff, police and border military personnel, state inspectors, and the elderly).

The COVID-19 crisis is more severe and prolonged than the initial expectations in early 2020. In 2020, the economy of Mongolia shrank significantly by 5.3% in 12 months because of the COVID-19 crisis, a drop of 10.5 percentage points compared with 2019. The official job losses reached 63,900 or 5.4% of total employment, and unemployment rate increased by 1.0 percentage point to 7.6% in the second half of 2020. Except agriculture, all sectorsincluding construction, services, trade, transportation, and other industries shrank, affected by negative spillovers of the pandemic. Overall budget deficit increased significantly to 9.6% of the gross domestic product (GDP) in 2020 because of revenue shortfalls, fiscal response measures against the COVID-19, and contraction in GDP. This led to a temporary increase in public debt-to-GDP ratio, including the central bank's external liabilities, by 14.1 percentage points to 92.4% by end of 2020. Public health concerns have been elevated since the first community transmission of COVID-19 in November 2020.

To effectively pursue COVID-19 containment measures, Mongolia needs to expand its network of molecular biology laboratories to increase capacity for RT-PCR testing. The increased testing capacity will help the government expand screening and surveillance of the population and thereby reduce COVID-19 cases. At the same time, the country needs to rapidly prepare for COVID-19 vaccination to bring the epidemic under control and allow the country to safely reopen borders, enterprises, and schools. The efficient and safe distribution and administration of the vaccine requires capacity development and resource support for social mobilization and community engagement, compliance with IPC protocols at all immunization units, registration, recording and reporting, and post-vaccine surveillance.

Impact

Morbidity and mortality of COVID-19 reduced

Project Outcome

Description of Outcome

COVID-19 detection and containment strengthened

Progress Toward Outcome

With the support of the project, the NCCD organized trainings on "Coronavirus infection (COVID-19) vaccination, "Injectable infectious disease surveillance" and "Vaccine management" in Sukhbaatar, Dornogobi, Dundgobi, Umnogobi and Tuv provinces. The supportive supervision, monitoring and training were organized from June 6, 2022 to June 24, 2022.

Implementation Progress

Description of Project Outputs

Goods and services for COVID-19 testing and immunization procured

Capacity for efficient and safe vaccination of COVID-19 improved

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

1. As a result of the inception mission's review, the Procurement Plan of the project revised. The reason justified as of the goods reflected in purchase of personal protective equipment and the printing of vaccination books for adults, which were originally planned by the Ministry of Health, are no longer necessary.- The Ministry of Health has shifted to a strategy for detection/diagnosis and treatment of patients post Covid-19 with chronic non-communicable diseases.

2. Medical doctors and vaccinator/nurses of the Soum Health Centers, Family Health centers, General hospitals participated in the trainings and their understanding of "Coronavirus infection (COVID-19) vaccination", "Injectable infectious disease surveillance" and "Vaccine management" improved.

4.2 Procurement

Geographical Location

Nation-wide, Ulaanbaatar

Safeguard Categories

Environment

C

Involuntary Resettlement

C

Indigenous Peoples

C

Summary of Environmental and Social Aspects

Environmental Aspects

Involuntary Resettlement

Indigenous Peoples

Stakeholder Communication, Participation, and Consultation

During Project Design

During Project Implementation

Business Opportunities

Consulting Services

Individual consultant selection - 5 contracts

Procurement

Request for quotations - Multiple contracts

Contact

Responsible ADB Officer

Habib, Najibullah

Responsible ADB Department

Sectors Group

Responsible ADB Division

Human and Social Development Sector Office (SG-HSD)

Executing Agencies

Ministry of Health (formerly Ministry of Health and Sports)

Timetable

Concept Clearance

08 Dec 2020

Fact Finding

02 Mar 2021 to 04 Mar 2021

MRM

-

Approval

29 Jun 2021

Last Review Mission

-

Last PDS Update

30 Sep 2022

Funding

Grant 9218-MON