Mongolia: Strengthening Rapid Epidemic Response Capacity of Health Systems Project

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.

Morbidity and mortality of COVID-19 reduced

COVID-19 detection and containment strengthened

Goods and services for COVID-19 testing and immunization procured

Capacity for efficient and safe vaccination of COVID-19 improved

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