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Lao PDR: New Financing to Improve Access to Health and Nutrition Services

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The World Bank’s Board of Executive Directors today approved US$23 million for Lao PDR under the Health and Nutrition Services Access Project (HANSA). The project aims to strengthen the country’s health system and improve the quality and coverage of service by providing funds to health centers and departments, with support benchmarked against performance. The project enhances the sustainability of public health programs, including maternal and child health, immunization, tuberculosis (TB) and HIV prevention, with a special focus on reducing malnutrition in the north of the country.

Among the performance indicators of HANSA are the availability of essential drugs and supplies and placement of clinical staff at health centers, as well as the number of mothers and children receiving quality care services in public health facilities.

Lao PDR’s maternal and child mortality rates and chronic malnutrition levels remain among the highest in the East Asia and Pacific region. Through this project, the World Bank and its partners will work together to improve primary care for women and children, which will in turn help raise living standards and break the cycle of poverty,” said Nicola Pontara, World Bank Country Manager for Lao PDR.

About 33 percent of children under five years in Lao PDR are stunted. This persistence of high levels of childhood undernutrition presents a loss of human and economic potential for the country. The project supports the multisectoral nutrition ‘convergence’ approach, launched in November 2019 by the Government of Lao PDR to reduce the prevalence of childhood undernutrition in four northern provinces – Oudomxay, Phongsaly, Huaphan and Xiengkhuang. The new project will also improve detection and treatment for TB as well as increase coverage of HIV testing of key populations and vulnerable groups through a more integrated service delivery.

“This financing will not only contribute to Lao PDR’s investments in human capital but will help to save lives, by making treatment and basic healthcare available to some of the most vulnerable communities in the country,” said Somil Nagpal, Senior Health Specialist and Team Leader for this project.

The US$23 million in financing comes from the World Bank’s International Development Association (IDA). This is expected to be complemented, subject to approvals,  with co-financing and grants of US$10 million and US$3 million, respectively, from the Global Fund and the Integrating Donor‐Financed Health Programs (IDFHP) Multi-Donor Trust Fund to Advance Universal Health Coverage.  The Government of Australia is the largest donor to the IDFHP with other partners being the Bill and Melinda Gates Foundation, and Gavi, the Vaccine Alliance. The World Bank’s IDA, established in 1960, helps the world’s poorest countries by providing grants and low to zero-interest loans for projects and programs that boost economic growth, reduce poverty, and improve poor people’s lives.

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EU Politics

EU clears way for the EU Digital COVID Certificate

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Today, the Presidents of the three EU institutions, the European Parliament, the Council of the EU and the European Commission attended the official signing ceremony for the Regulation on the EU Digital COVID Certificate, marking the end of the legislative process. On this occasion Presidents David Sassoli and Ursula von der Leyen and Prime Minister António Costa said:

“The EU Digital COVID Certificate is a symbol of what Europe stands for. Of a Europe that does not falter when put to the test. A Europe that unites and grows when faced with challenges. Our Union showed again that we work best when we work together. The EU Digital COVID Certificate Regulation was agreed between our institutions in the record time of 62 days. While we worked through the legislative process, we also built the technical backbone of the system, the EU gateway, which is live since 1 June.

We can be proud of this great achievement. The Europe that we all know and that we all want back is a Europe without barriers. The EU Certificate will again enable citizens to enjoy this most tangible and cherished of EU rights – the right to free movement. Signed into law today, it will enable us to travel more safely this summer. Today we reaffirm together that an open Europe prevails.”

EU Digital COVID Certificate

The aim of the EU Digital COVID Certificate is to facilitate safe and free movement inside the EU during the COVID-19 pandemic. All Europeans have the right to free movement, also without the certificate, but the certificate will facilitate travel, exempting holders from restrictions like quarantine.

The EU Digital COVID Certificate will be accessible for everyone and it will:

  • cover COVID-19 vaccination, test and recovery;
  • be free of charge and available in all EU languages;
  • be available in a digital and paper-based format;
  • be secure and include a digitally signed QR code;

Member States shall refrain from imposing additional travel restrictions on the holders of an EU Digital COVID Certificate, unless they are necessary and proportionate to safeguard public health.

In addition, the Commission committed to mobilising €100 million under the Emergency Support Instrument to support Member States in providing affordable tests.

The Regulation will apply for 12 months as of 1 July 2021.

Background

On 17 March 2021, the European Commission presented a proposal to create an EU COVID Certificate to facilitate the safe free movement of citizens within the EU during the pandemic. On 20 May, co-legislators reached a provisional agreement. On 1 June, the technical backbone of the systems, the EU gateway, went live. The gateway allows the verification of the security features contained in the QR codes.

Following the official signature today, the Regulation will enter into application on 1 July, with a phasing-in period of six weeks for the issuance of certificates for those Member States that need additional time.

13 Member States have already started to issue EU Digital COVID Certificates.

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Health & Wellness

Landmark G7 agreement pledges 870 million COVID-19 vaccine doses

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G7 leaders plenary: Building back better from COVID19, Cornwall, UK. ©Karwai Tang/G7 Cornwall 2021

A senior UN official welcomed on Sunday, the Group of Seven (G7) leading industrialized nations’ commitment to immediately share at least 870 million doses of COVID-19 vaccines, supporting global access and helping to end the acute phase of the pandemic. 

“Equitable access to COVID-19 vaccines represents the clearest pathway out of this pandemic for all of us — children included, and commitments announced by G7 members…are an important step in this direction”, the Executive Director of the UN Children’s Fund (UNICEF), Henrietta Fore, said in a statement

Building on the momentum of the G20 Global Health Summit and the Gavi COVAX AMC Summit, in a landmark agreement at the G7 Summit – underway in Cornwall, United Kingdom – the global leaders made the pledge, with the aim of delivering at least half by the end of 2021  

Secretary-General António Guterres had previously said that despite “unequal and very unfair” access to inoculations, “it is in the interest of everybody that everybody gets vaccinated sooner rather than later”.  

The G-7 leaders also reaffirmed their support for the UN-led equitable vaccine distribution initiative COVAX, calling it “the primary route for providing vaccines to the poorest countries”. 

Prompt action, please 

The COVAX alliance, meanwhile, welcomed the G7’s commitment, including their continued support for exporting in significant proportions and for promoting voluntary licensing and not-for-profit global production. 

The partners look forward to “seeing doses flowing to countries” as soon as possible.  

COVAX will work with the G7 and other countries that have stepped up to share doses as rapidly and equitably as possible to help address short-term supply constraints currently impacting the global response to COVID-19 and minimize the prospect of future deadly variants. 

“We have reached a grim milestone in this pandemic: There are already more dead from COVID-19 in 2021 than in all of last year”, lamented Ms. Fore. “Without urgent action, this devastation will continue”. 

Aligning interests 

Noting the need for a “ramp up”, in both the amount and pace of supply, the top UNICEF official attested that when it comes to ending the COVID-19 pandemic, “our best interests and our best natures align. This crisis will not be over until it is over for everyone.” 

The Director General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, underscored that many countries are facing a surge in cases, without vaccines.  

“We are in the race of our lives, but it’s not a fair race, and most countries have barely left the starting line”, he said.  

While grateful for the generous announcements of vaccine donations, he stressed, that “we need more, and we need them faster”. 

Time of the essence 

As many high-income countries begin to contemplate post-vaccination life, the future in low-income countries appears quite bleak.  

“We are particularly worried about the surges in South America, Asia and Africa”, said the UNICEF chief. 

Moreover, as the pandemic rages, the virus mutates and produces new variants that could potentially threaten the vaccinated and unvaccinated alike.  

“Donating doses now is smart policy that speaks to our collective best interests”, she continued, adding that in addition to vaccine pledges, “distribution and readiness need clear timelines” as to when they will be available, particularly in countries with poor health infrastructure. 

“The COVID-19 pandemic has upended the lives of children, affecting every aspect of their lives: their health, education, protection and future prosperity. Now, more than ever, what we do today will have significant and lasting impact on our collective tomorrows. There is no time to waste”, she concluded. 

Explanations 

The G7 is made up of Canada, France, Germany, Japan, Italy, UK and United States. 

COVAX was set up by WHO, GAVI the vaccine alliance and the Coalition for Epidemic Preparedness Innovations (CEPI). It is part of the Access to COVID-19 Tools (ACT) Accelerator to equitably provide COVID-19 diagnostics, treatments and vaccines to all people globally, regardless of their wealth. 

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Africa Today

Kenya Receives $750 million Boost for COVID-19 Recovery Efforts

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To reinforce Kenya’s resilient, inclusive and green economic recovery from the COVID-19 crisis, the World Bank approved $750 million in development policy financing to support policy reforms that will strengthen transparency and accountability in public procurement and promote efficient public investment spending.

This development policy operation supports measures to improve medium-term fiscal and debt sustainability through greater transparency and efficiency in government spending, building on ongoing World Bank support to enhance public finance management systems. The operation provides for the establishment of an electronic procurement platform for the public sector that seeks to make government purchases of goods and services transparent. This will help increase accountability in public spending and reduce opportunities for corruption. The support also strengthens public investment management by seeking cost-savings and applying rigorous selection and monitoring and evaluation criteria to all projects. Both measures are expected to yield fiscal savings of up to $2.6 billion.

“The operation prioritizes reforms in hard hit sectors, such as healthcare, education, and energy, which have been made urgent by the impacts of the COVID-19 crisis,” said Keith Hansen, World Bank Country Director for Kenya. “In recognition of the severity of the crisis and need for a comprehensive response, we are supporting the government’s post-COVID-19 Economic Recovery Strategy, which is designed to mitigate the adverse socioeconomic effects of the pandemic and accelerate economic recovery and attain higher and sustained economic growth.”

The policy operation also prioritizes energy sector reforms to improve electricity access and ensure that Kenyans benefit from least-cost, clean energy sources. Further, the new policy framework will help strengthen Kenya Power and Lighting Company’s (KPLC’s) finances with a new competitive pricing regime.

Kenyans will also benefit from better healthcare and disease prevention, especially for the poorest and most vulnerable households, through National Hospital Insurance Fund (NHIF) governance reforms and the establishment of the Kenya Center for Disease Control (KCDC) to strengthen disease prevention, detection, and response. Reforms will further seek to provide Kenyans with more equitable access to higher education, through a performance-based funding method to reduce the imbalances and inefficiencies created by the existing funding model for universities.

“Stabilizing the debt trajectory and reducing high debt costs is a top priority,” said Alex Sienaert, Senior Economist and Task Team Leader, World Bank Kenya. “This policy operation supports measures to reduce the budget deficit over time, such as by making public spending more efficient, whilst minimizing debt costs by helping to meet the government’s current financing requirements on concessional terms.”

DPOs are used by the World Bank to support a country’s policy and institutional reform agenda to help to accelerate inclusive growth and poverty reduction. The negative impacts of the COVID-19 crisis have made reforms that improve governance and service delivery, including those covered by this operation for Kenya, even more critical because they create better conditions for Kenya to inclusively and sustainably recover from it. Financing provided by the World Bank is offered on concessional terms, making it significantly lower than commercial loans. The total annual interest and service cost of the Kenya DPO is 3.1%.

* The World Bank’s International Development Association (IDA), established in 1960, helps the world’s poorest countries by providing grants and low to zero-interest loans for projects and programs that boost economic growth, reduce poverty, and improve poor people’s lives. IDA is one of the largest sources of assistance for the world’s 76 poorest countries, 39 of which are in Africa. Resources from IDA bring positive change to the 1.6 billion people who live in IDA countries. Since 1960, IDA has supported development work in 113 countries. Annual commitments have averaged about $21 billion over the last three years, with about 61 percent going to Africa.

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