Hyderabad(Telangana): In order to tackle an emergency like COVID-19, Central government along with several ministries has prepared a graded action plan with a three-week nationwide lockdown. Emergency financial package of Rs 15,000 crore for healthcare, strengthening of personal protection equipment for medical professionals, increasing isolation wards and ICU beds, and for the training of medical and paramedical manpower are also being done to contain the spread of the virus.
But apart from this, few other plans are also being worked upon to fight against coronavirus which includes COVID-19 Emergency Response and Health Systems Preparedness project, Environmental and Social Commitment Plan and more.
As part of the Fast Track COVID-19 Response Program 1, the proposed India COVID-19 Emergency Response and Health Systems Preparedness Project is a four-year project with US$500 million from the World Bank’s COVID-19 fast-track facility.
The priority areas identified under the project is to build on the GOI’s response to date and are informed by international best practice and WHO’s Guidance Note on COVID-19 emergency response. The proposed India COVID-19 Emergency Response and Health Systems Preparedness Project aims to respond to and mitigate the COVID-19s threat and strengthen national systems for public health preparedness in India. The key project indicators include:
(1) Proportion of laboratory-confirmed cases of COVID-19 responded to within 48 hours;
(2) Proportion of specimens submitted for SARS-COV-2 laboratory testing confirmed within WHO-stipulated standard time
(3) Proportion of the population able to identify three key symptoms of COVID-19 and/or seasonal influenza and three personal prevention measures (as assessed by a representative population survey).
Various components of the project are:
1.Emergency COVID-19 Response
2.Strengthening National and State Health Systems to Support Prevention and Preparedness
3.Strengthening Pandemic Research and Multi-sector, National Institutions and Platforms for One Health
4.Community Engagement and Risk Communication
5.Implementation Management and Monitoring and Evaluation
6.Contingent Emergency Response Component (CERC)
COVID-19 Emergency Response and Health Systems Preparedness project:
1. The Republic of India (hereinafter the Recipient) will implement the COVID-19 Emergency Response and Health Systems Preparedness project (the Project), with the involvement of the following Ministries/Agencies/Units: Ministry of Health and Family Welfare (MoHFW), Indian Council of Medical Research (ICMR) and the National Center for Disease Control (NCDC). The International Bank for Reconstruction and Development (hereinafter the Bank) has agreed to provide financing for the Project.
2. The Recipient will implement material measures and actions so that the Project is implemented in accordance with the Environmental and Social Standards (ESSs). This Environmental and Social Commitment Plan (ESCP) sets out material measures and actions, any specific documents or plans, as well as the timing for each of these.
3. The Recipient is responsible for compliance with all requirements of the ESCP even when the implementation of specific measures and actions is conducted by the Ministry of Health and Family Welfare (MoHFW), Indian Council of Medical Research (ICMR) and the National Center for Disease Control (NCDC) referenced in paragraph 1 above, jointly or independently.
4. Implementation of the material measures and actions set out in this ESCP will be monitored and reported to the Bank by the Recipient as required by the ESCP and the conditions of the legal agreement, and the Bank will monitor and assess progress and completion of the material measures and actions throughout the implementation of the Project.
5. As agreed by the Bank and the Recipient, this ESCP may be revised from time to time during Project implementation, to reflect adaptive management of Project changes and unforeseen circumstances or in response to the assessment of Project performance conducted under the ESCP itself. In such circumstances, the Recipient will agree to the changes with the Bank and will update the ESCP to reflect such changes. Agreement on changes to the ESCP will be documented through the exchange of letters signed between the Bank and the Recipient. The Recipient will promptly re-disclose the updated ESCP.
6. Where Project changes, unforeseen circumstances, or Project performance result in changes to the risks and impacts during Project implementation, the Recipient shall provide additional funds and resources, if needed, to implement actions and measures to address such risks and impacts.
For the purposes of effective and tailored engagement, stakeholders of the proposed project(s) can be divided into the following core categories:
• Affected Parties – persons, groups and other entities within the Project Area of Influence (PAI) that are directly influenced (actually or potentially) by the project and/or have been identified as most susceptible to change associated with the project, and who need to be closely engaged in identifying impacts and their significance, as well as in decision-making on mitigation and management measures;
• Other Interested Parties – individuals/groups/entities that may not experience direct impacts from the Project but who consider or perceive their interests as being affected by the project and/or who could affect the project and the process of its implementation in some way; and
• Vulnerable Groups – persons who may be disproportionately impacted or further disadvantaged by the project(s) as compared with any other groups due to their vulnerable status2, and that may require special engagement efforts to ensure their equal representation in the consultation and decision-making process associated with the project.
For the awareness-raising activities project activities will support awareness around:
(i) social distancing measures such as school, restaurant, religious institution, and café closures as well as reducing large gatherings (e.g. weddings)
(ii) preventive actions such as personal hygiene promotion, including promoting handwashing and proper cooking, and distribution and use of masks, along with increased awareness and promotion of community participation in slowing the spread of the pandemic
(iii) design of comprehensive Social and Behavior Change Communication (SBCC) strategy to support key prevention behaviours (washing hands, etc.), community mobilization that will take place through credible and effective institutions and methods that reach the local population and use of tv, radio, social media and printed materials as well as the community health workers
(iv) awareness and provision of mental health and psychosocial services for vulnerable communities.
Regular monitoring and reporting of measures and actions:
Bank regular monitoring reports on the environmental, social, health and safety (ESHS) performance of the Project, including but not limited to, stakeholder engagement activities and grievances should be prepared and submitted quarterly to institutes like MOHFW, ICMR, NCDC.
Assessment and mangement of Environmental and social risks and impacts:
TheMOHFW shall establish and maintain a PMUwith qualified staff, at the minimum including a health and safety expert and a social specialist, and resources to support the management of ESMF, risks and impacts of the Project ESHS. If any additional PIUs are established in the other implementing agencies social and environmental safeguards capacity will be included.
The PMU coordinator, a health and safety expert and social specialist will be assigned to the project within three months after the effective date. PIU/PMU should be maintained throughout project implementation and responsibility lies with MOHFW, ICMR, NCDC.
Environmental and social assessment/management plans and instruments
Environmental and social risks and impacts of proposed Project activities, in accordance with ESSs and the Environmental and Social Management Framework (ESMF) should be prepared and assessed which will ensure that individuals or groups who, because of their particular circumstances, may be disadvantaged or vulnerable, have access to the development benefits resulting from the project. The ESMF will also include a template
for Environmental and Social Management Plan (ESMP) as necessary for low-medium scale construction works. The ESMF will describe the procedures for screening of activities to be supported under the CERC component and actions to mitigate potential adverse impacts. The ESMF will be prepared within 60 days from the effective date and the authority lies with MOHFW, ICMR, NCDC.
EXCLUSIONS:
The following type of activities shall not be eligible for finance under the Project:
1. Activities that may cause long term, permanent and/or irreversible adverse impacts (e.g. loss of major natural habitat)
2. Activities that have a high probability of causing serious adverse effects to human health and/or the environment (e.g.constructing new hospitals without Effluent Treatment Plants, related to general wastewater treatment, not COVID-19)
3. Activities that may affect lands or rights of indigenous people or other vulnerable minorities
4. Activities that may involve permanent resettlement or land acquisition or adverse impacts on cultural heritage
5. All the other excluded activities set out in the ESMF of the Project
Labour and Working conditions:
1. The Project shall be carried out in accordance with the applicable requirements of ESS2, in a manner acceptable to the bank, including through, inter alia, implementing adequate occupational health and safety measures (including emergency preparedness and response measures, the ESHGs and other relevant GIIP including the updated national and/or WHO guidelines on COVID19 in all facilities, including laboratories, quarantine and isolation centres, and screening posts), setting out grievance arrangements for Project workers, and incorporating labour requirements into the ESHS specifications of the procurement documents and contracts with contractors and supervising firms. The time frame will be taken throughout project implementation and MOHFW, ICMR, NCDC will take the responsibility.
2. The Recipient shall ensure that all health workers adhere to the WHO Code of Ethics and Professional Conduct prepared for the Project. The Recipient shall prohibit child labour (any person under the age of 18) due to the hazardous work situation.
Resource Efficiency and Pollution Prevention and Management:
Relevant aspects of this standard shall be considered, as needed, including, inter alia, measures to manage health care wastes and other types of hazardous and non-hazardous wastes. While upgrading existing and/or constructing new healthcare facilities (hospitals, laboratories, quarantine centres), the Recipient shall ensure adoption of energy and water efficiency measures consistent with ESS3 as guided in the ESMF, and as per the national law, guidelines and policies and ensure proper disposal of construction wastes. The time frame will be taken throughout project implementation and MOHFW, ICMR, NCDC will take the responsibility.
Community Health and Safety:
1. Relevant aspects of this standard shall be considered, as needed, under action including, inter alia, measures to minimize the potential for community exposure to communicable diseases will ensure that individuals or groups who, because of their particular circumstances, may be disadvantaged or vulnerable have access to the development benefits resulting from the Project; manage the risks of the use of security personnel; manage the risks of labour influx; and prevent and respond to sexual exploitation and abuse, and sexual harassment.
2. The Recipient will ensure the avoidance of any form of SEA by relying on the WHO Code of Ethics and Professional Conduct for all workers in the quarantine facilities as well as the provision of gender-sensitive infrastructures such as segregated toilets and adequate lighting in quarantine and isolation centres.
3. The Recipient will implement emergency preparedness measures in case of laboratory accidents/ emergencies, e.g. a fire response or natural phenomena event.
4. The Recipient will operate quarantine and isolation centres in line with the applicable requirements of ESS3, the ESHGs and other relevant GIIP including the WHO guidelines on “Key considerations for repatriation and quarantine of travellers in relation to the outbreak of novel coronavirus 2019-nCoV”.
5. The Recipient will ensure that any security personnel operating for quarantine and isolation centres and screening posts follow strict rules of engagement and avoid any escalation.
Stakeholder Engagement and Information Disclosure:
A Stakeholder Engagement Plan (SEP) consistent with ESS10 in a manner acceptable to the Association should be prepared, disclosed, adopted and implemented. A preliminary SEP is prepared and will be updated in 30 days following the effective date. The SEP will be continuously updated throughout the project implementation. The SEP will be implemented throughout project implementation and responsibilities lie with MOHFW, ICMR and NCDC.
Resources and Responsibilities for implementing stakeholder engagement activities:
The MOHFW, along with other Ministries and NDMA/SDMAs, will be in charge of stakeholder engagement activities for their respective components. Overall coordination will be with MOHFW for this purpose. The budget for the SEP is included under Component 4 – Mitigation of Social Impact of the project.
Grievance Mechanism:
Accessible grievance arrangements to receive and facilitate the resolution of concerns and grievances in relation to the Project, consistent with ESS10, in a manner acceptable to the Association shall be made publicly available. The grievance mechanism will be implemented throughout project implementation and responsibilities lie with MOHFW, ICMR and NCDC.
Capacity Support:
Training topics for personnel involved in the implementation of Project activities will include, among others:
1. COVID-19 Infection Prevention and Control – the safety of healthcare workers
2.Laboratory biosafety guidance related to the COVID-19
3. Specimen collection and shipment
4. BMWM arising out of COVID19 testing, treatment, quarantine
5. Standard precautions for COVID-19 patients
6. Risk communication and community engagement
7. Quarantine best practices
8. Preventing GBV, SEA and SH trainings to healthcare workers
9. Orientation training on implementing the various provisions of ESMF
10. Training on stakeholder engagement and consultations
11. Training on OHS/Community Health and Safety, use of PPE etc.
12. Training on preparedness and response to emergency situations
