PROJECT INFORMATION DOCUMENT (PID) APPRAISAL STAGE REPORT NO AB5980

FEDERAL EMERGENCY MANAGEMENT AGENCY PROJECT WORKSHEET OMB NO
DATE INDIANA DEPARTMENT OF TRANSPORTATION ATTN INDOT PROJECT MANAGER
LYNLEY SHIMAT LYS MIAP INTRO FINAL PROJECT HADASSAH FILM

PROJECT NAME NJDOT SCOPE STATEMENT TSM LIMITED SCOPE FINAL
[PROJECT NAME] PARTNERSHIP STORY AGENCY PROJECT CONTACT NAME LOCATION
UNDP PROJECT DOCUMENT GOVERNMENTS OF

PROJECT INFORMATION DOCUMENT (PID)

PROJECT INFORMATION DOCUMENT (PID)

APPRAISAL STAGE

Report No.: AB5980

Project Name

KE-Total War Against HIV & AIDS (TOWA) - Additional Financing

Region

AFRICA

Sector

Health (100%)

Project ID

P122491

Borrower(s)

GOVERNMENT OF KENYA


Government of Kenya

Office of the Deputy Prime Minister and

Ministry of Finance, The Treasury

Nairobi, Kenya

Kenya

Tel: +254 20 2252299 Fax: +254 20 2240045

Implementing Agency



National AIDS Control Council

Landmark Plaza

Argwings Kodhek Road

P.O Box 61307 – 00200

Nairobi, Kenya


Tel:+254 20 2896000 Fax:+254 20 2711072

Environment Category

[ ] A [X] B [ ] C [ ] FI [ ] TBD

Date PID Prepared

October 12, 2010

Date of Appraisal Authorization

October 21, 2010

Date of Board Approval

December 14, 2010


  1. Country and Sector Background


  1. Recent economic and governance performance. Kenya is a low-income country with GNI per capita estimated at US$680 (in 2007) and a population of about 38 million. Kenya’s economy grew strongly between 2003 and 2007, peaking at 6.9 percent in 2007. In 2008, however, growth contracted to 1.7 percent and remained feeble in the first half of 2009, due particularly to: (i) post-election violence in 2008, (ii) the international financial crisis; and (iii) drought. Growth is now estimated to be increasing to about 5 percent for 2010. Kenya used to be the most prosperous country in East Africa, but its economic performance and institutions worsened significantly in the 1990’s due to corruption, inefficient use of public resources, loss of economic competitiveness, a deteriorating security condition, reductions in donor funding and the HIV/AIDS epidemic. In recent years, some positive steps have been taken to address corruption, but there is much unfinished business in the fight to strengthen governance and improve services for the people.


  1. The HIV/AIDS epidemic continues to be a disaster in Kenya. It is threatening the socio-economic development of individuals, communities and the country at large; it is a destabilizing force in all sectors of the economy; and it is affecting a wide cross-section of the community (children, youth, men and women). The Kenya AIDS Indicators Survey (KAIS, 2007) estimates the average HIV prevalence among the general population aged 15-49 at 7.4 percent and the number of people living with HIV between 1.3 million to 1.6 million. Kenya also has 2.4 million orphans, which makes up 12 percent of all children. Of the total orphans it is estimated that HIV has killed either one or both parents of 700,000 children. There are currently 380,000 people on ARV treatment in Kenya. There has been a rapid expansion from 20,000 in 2005 to 380,000 today.


  1. In addition, malaria continues to be a huge problem in Kenya. It is a major contributor to outpatient cases, childhood illnesses, poor outcomes in pregnancies and low vitality in the workface. In the past, bednet distribution was concentrated on children under 5 and pregnant women. In the new Malaria Strategy 2009-2017, emphasis is on Universal Coverage (defined as 1 net for every 2 persons). The Government has a good track record of success in its bednet program and is giving it greater priority, although further funding is needed to help it reach the ambitious targets.


  1. The Total War Against AIDS (TOWA) Project was approved in June 2007 to prevent and mitigate HIV and AIDS in Kenya. The original Project’s Development Objective was to support the Republic of Kenya to: (a) expand the coverage of targeted HIV and AIDS prevention and mitigation measures through sustaining the improved institutional performance of the National AIDS Control Council (NACC); and (b) support the implementation of the Kenya National AIDS Strategic Plan (KNASP). The Project was designed and appraised for a total value of US$115 million, with 70 percent from IDA (US$80 million), 28 percent co-financing from DFID (US$33 million) and 2 percent (US$2 million) from the Government of Kenya (GOK).

  1. The Project has two components: (i) Strengthening Governance and Coordination Capacity to support the continued development of the coordinating function of the NACC, the monitoring and evaluation framework of the KNASP, and capacity building of beneficiaries in the use of grant funds; and (ii) Support for Program Implementation to make financial resources available to civil society, public sector, private sector, and research institutions, focusing on initiatives in line with the KNASP and responding to priorities identified by the Joint HIV and AIDS Program Review, and also with provision of some essential commodities.


  1. The Project became effective in March 2008, and is now performing satisfactorily. Some delays were experienced at the beginning of the Project, particularly due to (i) the time needed to recruit the necessary fiduciary strengthening consultants, and (ii) the post election violence in early 2008. The IDA credit is expected to be fully utilized by June 2011 (the original completion date for the Project) or soon afterwards.


  1. Objectives


  1. The revised Project Development Objectives are to: (i) expand the coverage of targeted HIV and AIDS prevention and mitigation measures; and (ii) expand access to bednets among targeted People Living with HIV and AIDS and other households in malaria risk areas.


  1. Rationale for Bank Involvement

  1. The TOWA) Project has improved its performance significantly since its launch, especially since the Mid-Term Review (MTR) of mid-2009. The TOWA was declared effective on December 3, 2007, after an approval of US$80 million on June 26, 2007. However, effectiveness was delayed slightly, and the start of the Project was caught up in the Kenya post-election violence of 2007/2008. The implementation of the TOWA therefore did not effectively start until July 2008. By the time of the MTR review in September 2009, the absorption and utilization of funds had improved, and the Project has continued to make positive progress in its implementation. Over 50 percent of IDA Project funds have already been disbursed, and most of the remaining funds are already committed, particularly in the Call For Proposals for grants.

  2. There is growing evidence of the achievement of results in the HIV and AIDS program in Kenya, with significant progress being made in the key outcome indicators for prevention and mitigation in the TOWA results framework. While not all of the progress of recent can be attributed to the TOWA, it is clear that a large number of Kenyans have benefitted from the Project, with over 4.5 million Kenyans having benefited from the community grants. The Project’s strong governance and fiduciary measures also appear to be mitigating risks quite effectively. The Project continues to be in full compliance with legal covenants. This proposed Additional Financing request for US$55 million is to: (i) cover a financing gap due to less availability of co-financing than originally expected; (ii) increase the financial allocation for the procurement of bednets for the national malaria program; (iii) restore some funding that had been reallocated and provide for the extended implementation of the Project, including particularly for continued fiduciary and M&E strengthening.


  1. Description


  1. The TOWA is an ongoing successful Project for which additional financing is being requested. The bulk of the additional funds would be to continue to expand the CFPs to channel money and provide capacity building support to CBOs and NGOs working at the constituency and district levels. Extra money is also needed to purchase more bednets. Added to this are costs relating to a project extension of 18 months, which includes continued fiduciary strengthening and risk mitigation measures, as well as M&E activities.


  1. The additional US$55m is broken down as follows:


Activity

Extra Financing (US$ million)

Additional Call for Proposals - Grants

23.0

Bednets

10.0

Commodities (Condoms and TB drugs)

6.7

Strategic Leadership

6.5

Fiduciary Accountability

4.8

Other Programmatic Expenditure and M&E

4.0

TOTAL

55.0


  1. Financing


Source:

(US$ million.)


Government of Kenya

0

International Development Association (IDA)

55.0

Total

55.0


  1. Implementation


  1. The design of the Project remains fundamentally similar to the original design, with no major changes in the institutional, financial management, procurement or disbursement arrangements. The closing date and implementation schedule have changed, with the proposed 18 month Project extension. However, in addition to the slight revision of the Project Development Objective, some key indicators and selected targets have also been revised for the Additional Financing. The revisions include: (i) an increased focus on the provision of bednets for the malaria program; (ii) greater clarity on the definitions of some key indicators; and (iii) adjustments in some of the targets.


  1. Sustainability


  1. The Government, with support of IDA and other development partners, has mobilized different sectors, mass organizations and communities to increase their capacity to respond to the demands of the HIV and AIDS epidemic. However, the TOWA Project is a significant step forward in helping institutional sustainability. The position of the NACC is now considerably more established and accepted, with the institution having survived the challenges of the earlier period of financial irregularities and institutional confusion. Technical sustainability is believed to be likely, as the TOWA Project aims to support well-established, simple technical interventions and policies, the operational implications of most of which have been well-documented in Kenya. The financial sustainability of the HIV and AIDS program ultimately rests with Kenya’s ability to: (i) increase domestic resource allocations for HIV and AIDS and health, in addition to improved prioritization and governance; and (ii) further reduce new HIV infections. By helping the Government, the NACC and implementers to become more strategic and selective, the Project will also contribute to financial sustainability of Kenya’s response to the HIV and AIDS epidemic.


  1. Lessons Learned from Past Operations in the Country/Sector


  1. The TOWA Project seeks to strengthen “learning-by-doing,” and maintain the participatory and community-focused approach of the World Bank’s response to the HIV and AIDS challenge in Africa. The TOWA Project supports a more prioritized and evidence-based approach to Kenya’s national response to the epidemic. Lessons from the implementation of KHADREP, as well as other IDA-supported HIV and AIDS projects, have been integrated into the TOWA design, and minor adjustments are being made for the Additional Financing. The main lessons learned include: (i) Program coordination: the KHADREP support to the NACC was essential for the progress achieved; (ii) Public sector programs: the emphasis on the work of the AIDS Control Units (ACUs) was initially on the “internal domain” and needed to be reorientated; (iii) Civil society programs: there is need for the FMA and arrangements to mitigate concerns about inappropriate selection of projects and “briefcase NGOs”; (iv) Monitoring and evaluation: the Kenya HIV and AIDS epidemic is one of the most comprehensively monitored in Africa, but needs to be extended for operational programs; (v) Management and governance: the experience of the KHADREP shows that the NACC had earlier suffered from a lack of creative, results-based and effective leadership; and (vi) fiduciary strengthening efforts and measures appear to be successful, but need to be sustained over time.


  1. Safeguard Policies (including public consultation)


  1. The ongoing Project was classified as “Category B” for environmental screening purposes, and this rating will be maintained. As a repeater project, the TOWA project has made use of the existing arrangements for safeguard issues, which had been successfully implemented under the KHADREP Project. In addition, a national medical waste management action plan has been developed and disclosed by the Borrower, and later further updated. Both the updated health Waste Management Plan and the ISDS for the additional funds have been disclosed at the Bank’s Info Shop. The medical waste management action plan is now being implemented (including with support from the Health Project which has recently been declared effective).


  1. However, in view of the increased focus on issues affecting indigenous peoples (IPs) and the development of thinking on the issue in Kenya, it has been decided that the IP safeguard should now be triggered. In the original TOWA project, OP 4.10 safeguard was not triggered; but for the additional financing, it has been triggered. An IP framework has been prepared by the Borrower; and it will be disclosed in the Borrower’s website and in the Bank’s Info Shop as soon as it has been cleared by the Bank. The IP Plan will be implemented as specified in the framework by the NACC.


Safeguard Policies Triggered by the Project

Yes

No

Environmental Assessment (OP/BP/GP 4.01)

[x]

[ ]

Natural Habitats (OP/BP 4.04)

[ ]

[x]

Pest Management (OP 4.09)

[ ]

[x]

Cultural Property (OPN 11.03, being revised as OP 4.11)

[ ]

[x]

Involuntary Resettlement (OP/BP 4.12)

[ ]

[x]

Indigenous Peoples (OD 4.20, being revised as OP 4.10)

[x]

[]

Forests (OP/BP 4.36)

[ ]

[x]

Safety of Dams (OP/BP 4.37)

[ ]

[x]

Projects in Disputed Areas (OP/BP/GP 7.60)

[ ]

[x]

Projects on International Waterways (OP/BP/GP 7.50)

[ ]

[x]


  1. List of Factual Technical Documents



  1. Contact point


Contact: Wacuka Ikua

Title: Senior Operations Officer

Tel: 5368+6417 / 254-20-322-6417

Fax:

Email: [email protected]

Location: Nairobi, Kenya (IBRD)


  1. For more information contact:


The InfoShop

The World Bank

1818 H Street, NW

Washington, D.C. 20433

Telephone: (202) 458-4500

Fax: (202) 522-1500

Email: [email protected]

Web: http://www.worldbank.org/infoshop

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