Report and Recommendation of the President to the Board of Directors

Project Number: 54173-001 April 2020

Proposed Loan People’s Republic of Bangladesh: COVID-19 Response Emergency Assistance Project

Distribution of this document is restricted until it has been approved by the Board of Directors. Following such approval, ADB will disclose the document to the public in accordance with ADB's Access to Information Policy.

CURRENCY EQUIVALENTS

(as of 19 April 2020)

Currency unit – Taka (Tk) SDR1 = $1.38 $1.00 = Tk84.97

ABBREVIATIONS

ADB – Asian Development Bank COVID-19 – coronavirus disease 2019 CPRP – Country Preparedness and Response Plan DGHS – Directorate General of Health Services IEDCR – Institute of Epidemiology, Disease Control and Research IHR – International Health Regulations IPC – infection prevention and control MOHFW – Ministry of Health and Family Welfare NPRP – National Preparedness and Response Plan OCB – open competitive bidding PIU – project implementation unit PPE – personal protective equipment RETA – regional technical assistance RIPPF – resettlement and indigenous peoples planning framework TA – technical assistance WHO – World Health Organization

NOTE

(i) The fiscal year (FY) of the Government of Bangladesh and its agencies ends on 30

June. “FY” before a calendar year denotes the year in which the fiscal year ends, e.g., FY2019 ends on 30 June 2019.

(ii) In this report, “$” refers to United States dollars.

Vice-President Officer-in-Charge Director Team leaders Team members Peer reviewers

Shixin Chen, Operations 1 Diwesh Sharan, South Asia Department (SARD) Sungsup Ra, Human and Social Development Division (SAHS), SARD Uzma Hoque, Senior Social Sector Specialist, SAHS, SARD Tika Limbu, Senior Portfolio Management Specialist, Bangladesh Resident Mission (BRM), SARD Md. Monjurul Ahmed, Senior Financial Management Officer, BRM, SARD Alamgir Akanda, Finance and Administration Officer, BRM, SARD Kazi Akhmila, Associate Safeguards Officer (Resettlement), BRM, SARD Mikael Andersson, Financial Management Specialist, Portfolio, Results and Quality Control Unit (SAOD-PR), SARD Brian Chin, Social Sector Specialist, SAHS, SARD Farhat Jahan Chowdhury, Senior Project Officer (Environment), BRM, SARD Angelique Deny, Project Specialist, Office of the Director General (SAOD), SARD Taniya Fardus, Project Analyst, BRM, SARD Alfredo P. Garcia, Senior Operations Assistant, SAHS, SARD Md. Humayun Kabir, Procurement Officer, BRM Stella Leonora S. Labayen, Project Analyst, SAHS, SARD Yang Lu, Transport Specialist, Transport and Communications Division (SATC), SARD Kirsty Rowan Marcus, Transport Specialist, SATC, SARD Hiroyuki Maruyama, Principal Procurement Specialist, Procurement Division 1 (PFP1), Procurement, Portfolio and Financial Management Department (PPFD) Agnes Navera, Senior Operations Officer, SAOD-PR, SARD Lyailya Nazarbekova, Principal Counsel, Office of the General Counsel S.M. Ebadur Rahman, Senior Social Sector Officer (Education and Health), BRM, SARD C. Janyna Rhor, Principal Procurement Specialist, PFP1, PPFD M. Shahadat H. Russell, Unit Head, Project Administration, SAHS, SARD Ruby Sarcar, Project Analyst, BRM, SARD Nasheeba Selim, Senior Social Development Officer (Gender), BRM, SARD Unika Shrestha, Young Professional, SAHS, SARD Francesco Tornieri, Principal Social Development Specialist (Gender and Development), SAOD-PR, SARD Jyotsana Varma, Principal Country Specialist, BRM, SARD Dongdong Zhang, Principal Financial Sector Specialist, Public Management, Financial Sector, and Trade Division, SARD Rosemary Victoria M. Atabug, Social Development Officer (Gender and Development), Thematic Advisory Service Cluster (Gender), Sustainable Development and Climate Change Department (SDCC) Michiel Van der Auwera, Senior Financial Sector Specialist (Social Security), Public Management, Financial Sector, and Trade Division, Central and West Asia Department Eduardo Banzon, Principal Health Specialist, Sector Advisory Service Cluster (Health), SDCC Tulsi Bisht, Senior Social Development Specialist (Safeguards), Safeguards Division (SDSS), SDCC Nely Defo, Financial Control Specialist, Loan and Grant Disbursement Section, Controller’s Department (CTL) Veronica L. Dela Cruz, Portfolio Management Officer, SAOD-PR, SARD Steven Goldfinch, Disaster Risk Management Specialist, Climate Change and Disaster Risk Management Division, SDCC Arndt Christoffer Husar, Senior Public Management Specialist (Digital Transformation), Digital Technology for Development Unit, SDCC

Srinivasan Janardanam, Principal Financial Management Specialist, PFFM, PPFD Rouselle Lavado, Senior Health Specialist, Economic Analysis and Operational Support Division, Economic Research and Regional Cooperation Department Kristopher D. Marasigan, Associate Integrity Officer, Prevention and Compliance Division, Office of Anticorruption and Integrity (OAI) Ashish Narain, Principal Economist (Regional Cooperation), Regional Cooperation and Integration Thematic Group, SDCC Mocktar Adamou Ndiaye, Financial Management Specialist, Public Financial Management Division (PFFM), PPFD Aniruddha V. Patil, Principal Investment Specialist, Office of the Director General, Private Sector Operations Department Srinivas Sampath, Chief of Public-Private Partnership Thematic Group, Office of the Head, Office of Public-Private Partnership Frances Lynette V. Sayson, Senior Integrity Officer, Office of the Head OAI, OAI Rishikesh Singh, Project Management Specialist, SAOD, SARD Sonomi Tanaka, Chief of Gender Equity Thematic Group, Thematic Advisory Service Cluster (Gender), SDCC Marie Antoinette G. Virtucio, Senior Environment Officer, SDSS, SDCC Won Mo Yang, Senior Financial Control Specialist, Loan and Treasury Accounting Section, CTL Hyun Joo Youn, Senior Results Management Specialist, Results Management and Aid Effectiveness Division, Strategy, Policy and Partnerships Department Liping Zheng, Advisor, SAOD, SARD Mohammed Zulyaminayn, Senior Procurement Officer, BRM, SARD

In preparing any country program or strategy, financing any project, or by making any designation of or reference to a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

CONTENTS

Page

PROJECT AT A GLANCE

I. THE PROPOSAL 1

II. THE PROJECT 1

A. Rationale 1 B. Project Description 5 C. Value Added by ADB 6 D. Summary Cost Estimates and Financing Plan 6 E. Implementation Arrangements 7

III. DUE DILIGENCE 9

A. Technical 9 B. Economic and Financial Viability 9 C. Governance 10 D. Poverty, Social, and Gender 10 E. Safeguards 11 F. Summary of Risk Assessment and Risk Management Plan 12

IV. ASSURANCES 12

V. RECOMMENDATION 12

APPENDIXES

1. Design and Monitoring Framework 13

2. List of Linked Documents 15

Project Classification Information Status: Complete

PROJECT AT A GLANCE

Source: Asian Development BankThis document must only be generated in eOps. 19042020133022754459 Generated Date: 21-Apr-2020 0:48:55 AM

1. Basic Data Project Number: 54173-001Project Name COVID-19 Response Emergency Assistance

Project Department/Division SARD/SAHS

Country Bangladesh Executing Agency Ministry of Health and Family WelfareBorrower Banlgadesh

Country Economic Indicators

https://www.adb.org/Documents/LinkedDocs/?id=54173-001-CEI

Portfolio at a Glance https://www.adb.org/Documents/LinkedDocs/?id=54173-001-PortAtaGlance

2. Sector Subsector(s) ADB Financing ($ million)Health Health system development 100.00

Total 100.00

3. Operational Priorities Climate Change InformationAddressing remaining poverty and reducing inequalities

Accelerating progress in gender equality

Strengthening governance and institutional capacity

Fostering regional cooperation and integration

Climate Change impact on the Project

Low

Sustainable Development Goals Gender Equity and MainstreamingSDG 1.5SDG 3.3, 3.d

Effective gender mainstreaming (EGM)

Poverty TargetingGeneral Intervention on Poverty

4. Risk Categorization: Low.

5. Safeguard Categorization Environment: B Involuntary Resettlement: C Indigenous Peoples: B

.

6. Financing

Modality and Sources Amount ($ million)

ADB 100.00

Sovereign Special assistance (Concessional Loan): Ordinary capital resources 100.00

Cofinancing 0.00

None 0.00

Counterpart 13.38

Government 13.38

Total 113.38

Currency of ADB Financing: US Dollar

I. THE PROPOSAL 1. I submit for your approval the following report and recommendation on a proposed loan to the People’s Republic of Bangladesh for the COVID-19 Response Emergency Assistance Project. 2. The project will support the Government of Bangladesh (the government) in addressing immediate and urgent needs for financial, logistical, and systemic support to respond to the COVID-19 outbreak. The project will support the procurement of equipment and supplies, the upgrading of health and testing facilities, and build system and community capacities for surveillance, prevention, and response to COVID-19.

II. THE PROJECT A. Rationale 3. The description of the COVID-19 health emergency. The COVID-19 outbreak, declared a pandemic by the World Health Organization (WHO) on 11 March 2020, has spread rapidly across the globe, with severe impact on lives and economies. As of 17 April 2020, over 2 million confirmed cases and over 139,000 deaths have been recorded.1 In Bangladesh, the first case was reported on 8 March 2020. Cases started rising steeply in April, and by 17 April, Bangladesh had confirmed 1,838 cases and 75 deaths due to COVID-19, with a cumulative total of over 108,000 people quarantined.2 The country is now moving to the fourth stage of infection (community transmission) with 52 of the 64 districts affected. Millions had already left the cities for their village homes before the lockdown on 26 March, possibly spreading the infection. It is, therefore, crucial to support Bangladesh’s efforts to mitigate the impact and flatten the curve. 4. Request for emergency assistance. On 23 March 2020, the government asked the Asian Development Bank (ADB) to provide emergency assistance for the health sector response to COVID-19, as an integral part of the Country Preparedness and Response Plan (CPRP),3 and the National Preparedness and Response Plan (NPRP) for COVID-19 (para. 7).4 Since then, the caseload has grown more than 55 times. The proposed project meets the requirements for emergency assistance loan (EAL) financing.5 A health EAL is justified since (i) it will support the urgent need of the health system to immediately respond to the escalating COVID-19 situation; (ii) the government has immediate procurement requirements; (iii) dedicated funding for the critical health sector response will be assured; and (iv) the health sector requires significant capacity and implementation support in the short to medium term. Complementary health sector support is also being extended by the World Bank and World Health Organization (WHO) (para. 12). The project is part of ADB emergency support for other sectors in Bangladesh (para. 14).

1 Worldometer. https://www.worldometers.info/coronavirus/ (accessed 17 April 2020); World Health Organization (WHO).

Coronavirus Disease 2019 (COVID-19) Situation Reports. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports (accessed 17 April 2020).

2 Coronavirus COVID-19 Dashboard, 2020. Government of Bangladesh, Ministry of Health and Family Welfare (MOHFW). http://103.247.238.81/webportal/pages/covid19.php (accessed 17 April 2020).

3 Government of Bangladesh and Development Partners, 2020. Country Preparedness and Response Plan. Draft V1, 26 March 2020. Dhaka. This plan supports the National Preparedness and Response Plan (footnote 4).

4 Government of Bangladesh, MOHFW. 2020. National Preparedness and Response Plan for COVID-19 Bangladesh. Version 5. 18 March 2020. Dhaka.

5 The project meets the eligibility criteria for an emergency assistance loan: (i) government official request, (ii) potential impact and priorities identified in a damage and needs assessment, (iii) intended to address immediate needs and/or expedite the preparation of a regular project, (iv) security risks to ADB staff at acceptable levels, and (v) appropriate level of burden and risk sharing among partners. ADB. 2004. Disaster and Emergency Assistance Policy. Manila.

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5. Significant challenges in combatting the pandemic. High population density,6 rapid urbanization, a large population of migrant workers, and more than 20% of its urban population living in slums without adequate sanitation, make Bangladesh vulnerable to infectious disease outbreaks. For example, cholera affects an estimated 100,000 people and causes some 4,500 deaths yearly.7 According to WHO’s scale of International Health Regulations (IHR) core capacities, Bangladesh has limited capacity to prevent, detect, and respond to public health emergencies.8 Overall, the health system is underdeveloped and underfunded, with only 9.9 doctors, nurses and midwives9 and 8.8 hospital beds per 10,000 people.10 Current health expenditure is only 2.3% of gross domestic product, while out-of-pocket expenditure accounts for over two-thirds of health spending, making healthcare unaffordable to many.11 Following the first case on 8 March 2020, the government allocated Tk500 million (about $6 million) to the Ministry of Health and Family Welfare (MOHFW) to contain the outbreak, followed by Tk2 billion (about $24 million) on 24 March 2020.

6. Damage and needs assessment.12 The impacts of the damage to the health system and the need for support were assessed by ADB, WHO, and other development partners. The damage and needs assessment found weaknesses and risks in four main areas—surveillance and diagnostic capacity, testing and contact tracing, clinical treatment capacity, and infection prevention and control (IPC). First, the surveillance and diagnostic capacity is rapidly becoming overstretched. The testing capacity was extended from one to 17 laboratories, as of 17 April 2020.13 However, even with this capacity, the health system will scarcely cope with the planned screening of suspected COVID-19 cases at all 42 points-of-entry (air, sea, and land), as well as surveillance and diagnosis within the country. Second, insufficient testing and inadequate contact tracing and quarantine measures mean that the full extent of cases is unknown. A total of 19,193 tests have been conducted as of 17 April 202014 (or 117 tests per million population). Third, the clinical treatment capacity is inadequate, with shortages of ventilators to support critical patients, insufficient specialized wards and hospitals, low hospital bed capacity (para. 5), and only 878 intensive care unit (ICU) beds and 296 intermediate care unit beds nationally available across public and private sectors.15 Reportedly, suspected COVID-19 patients were turned away from health facilities due to such inadequacies. In addition, there is a need for contracting-in, recruitment, and training of human resources (such as medical officers, nurses, medical technologists, etc.). Fourth, the inadequacy of IPC measures poses a risk. Reports from the field indicate shortages in personal protective equipment (PPE) and other supplies, and insufficient sanitized ambulances to transport patients.16

6 Bangladesh has 1,253 people per square kilometer of land area, among the highest density in the world. Source: United

Nations Department of Economic and Social Affairs. 2019. World Population Prospects. New York. 7 Taufiqul Islam et al. 2018. ‘Cholera Control and Prevention in Bangladesh: An Evaluation of the Situation and Solutions’.

The Journal of Infectious Diseases, 15 November 2018. https://academic.oup.com/jid/article/218/suppl_3/S171/5085578 (accessed 15 April 2020).

8 WHO. 2016. Joint External Evaluation of IHR Core Capacities of the People’s Republic of Bangladesh. https://www.who.int/ihr/publications/WHO-HSE-GCR-2016.23/en/ (accessed 15 April 2020).

9 WHO. 2018. Global Health Workforce Statistics 2018. https://apps.who.int/gho/data/node.main.HWFGRP?lang=en (accessed 17 April 2020).

10 Directorate General of Health Services, Ministry of Health and Family Welfare. 2019. Health Bulletin 2018. Dhaka. 11 WHO. 2020. Global Health Observatory. https://www.who.int/gho/database/en (accessed 22 April 2020). 12 Summary assessment of damage and needs (accessible from the list of linked documents in Appendix 2) 13 Data supplied by the Ministry of Health and Family Welfare on 17 April 2020. 14 Government of Bangladesh, Institute of Epidemiology, Disease Control and Research, MOHFW. COVID-19 Status

Bangladesh. http://www.iedcr.gov.bd/ (accessed 14 April 2020). 15 J. Phua et al. 2020. Critical Care Bed Capacity in Asian Countries and Regions, Critical Care Medicine. 48(5):654-662.

https://pubmed.ncbi.nlm.nih.gov/31923030/ 16 WHO Bangladesh. 2020. COVID-19 Situation Report #7, 13 April 2020.

https://www.who.int/bangladesh/emergencies/coronavirus-disease-(covid-19)-update/coronavirus-disease-(covid-2019)-bangladesh-situation-reports (accessed 17 April 2020).

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7. The damage and needs assessment identified urgent needs that are reflected in the government’s NPRP and CPRP. The CPRP, prepared by the government and development partners to support the NPRP, is estimated at $378 million. It has five pillars: (i) surveillance and laboratory support; (ii) contact tracing and points of entry; (iii) case management and infection prevention and control; (iv) risk communication and awareness and community engagement; and (v) logistics and procurement. The NPRP has seven components: (i) planning and coordination; (ii) surveillance, laboratory, and points of entry; (iii) contact tracing and quarantine; (iv) clinical case management; (v) IPC; (vi) risk communication and public awareness; and (vii) operational research. The damage and needs assessment, the NPRP, and the CPRP together informed the government’s request for assistance to each development partner (para. 11). 8. Disaster risk.17 Bangladesh is highly susceptible to various types of natural hazards, including cyclones, flooding, landslides, windstorms, heat waves, and cold spells. Climate change is expected to aggravate the intensity, frequency, and unpredictability of extreme weather events. The 2019 World Risk Index ranks Bangladesh as the 10th most vulnerable country among 180 countries.18 Disease outbreaks often follow natural disasters. 9. Economic impacts. ADB estimates19 indicate that a significant domestic outbreak would lead to an economic loss of up to $13.3 billion, 4.9% of gross domestic product, and the loss of 1.4 million to 3.7 million jobs. The pandemic will affect the economy through three main channels: slowdown in domestic economies, sharp decline in exports, and reduction in remittances.20 10. Poverty impacts. With 20.5% of the population under the poverty line, and 10.5% living in extreme poverty (FY2019),21 Bangladesh is especially vulnerable to economic shocks. Any economic shock would push a significant proportion of the near-poor under the poverty line and deepen the poverty of those already poor, reversing previous gains made in poverty reduction. Of the total workforce, 85% (of whom 92% are women) operate in the informal economy, leading a hand-to-mouth existence.22 Social distancing and quarantine measures will affect the livelihoods of small traders, day laborers, and other informal workers. The official unemployment rate is 4.3%. However, many employed in the ready-made garment sector and micro, small, and medium enterprises may already have lost their jobs, and economic downturn will further dampen the employment market. The poor are especially vulnerable to infectious diseases such as COVID-19, due to overcrowding, unsanitary conditions, and poor access to health services. 11. Development partners coordination. Development partners are supporting the response and are part of the National Coordination Committee for Prevention and Control of COVID-19, chaired by the Directorate General of Health Services (DGHS). The government has set up the COVID-19 Emergency Operation Center at the Institute of Epidemiology, Disease Control and Research (IEDCR) to coordinate preparedness and response measures at five

17 Disaster risk is a function of hazards, exposure, and vulnerability. 18 World Risk Index developed by Bündnis Entwicklung Hilft in cooperation with the United Nations University. World Risk

Report 2019. https://reliefweb.int/sites/reliefweb.int/files/resources/WorldRiskReport-2019_Online_english.pdf (accessed 15 April 2020).

19 ADB’s latest assessment (28 March 2020). 20 Further details on the economic impact are provided in ADB. Forthcoming. Report and Recommendation of the President

to the Board of Directors: Proposed Loans and Technical Assistance Grant—People’s Republic of Bangladesh: COVID-19 Active Response and Expenditure Support (CARES) Program.

21 Government of Bangladesh, Bureau of Statistics. 2019. Poverty and Extreme Poverty Rate of Bangladesh 2018-19. Dhaka. 22 Government of Bangladesh, Bureau of Statistics. 2018. Labour Force Survey (LFS) 2016-17. Dhaka. No later data is

available.

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levels.23 The IEDCR conducts contact tracing and most of the surveillance.24 The NPRP provides six response levels depending on COVID-19 infection status, as well as mechanisms for surge capacity to manage patients, sustain essential services, and reduce social impacts. The government, with development partners, will continually review and adjust the response as necessary. 12. The government is closely planning and coordinating the emergency assistance by working with each development partner to allocate specific elements of the CPRP, in line with the country’s needs and the volume of assistance provided. Thus, the World Bank Group’s loan project for COVID-19 response will support information-technology-based approaches to disease surveillance, and training and equipment for the facilities and geographic areas identified by the government.25 WHO will support the more technical aspects of IPC, such as laboratory testing and clinical case management. To support the Rohingya people, the government has a separate program to prevent the breakout of COVID-19 in the camps and mitigate any impact through establishing isolation units and providing health facilities for them. The World Bank has two ongoing grant projects ($185 million) for the health sector to manage and mitigate COVID-19 impact in camp areas within the Coxsbazar district. ADB is exploring additional grant funds to complement the World Bank support. 13. Lessons in disaster response. First, the joint IHR evaluation with WHO in 2016 (footnote 8) revealed limited capacity to prevent, detect, and respond to public health emergencies. Another evaluation highlighted inadequate on-site monitoring and subdistrict-based healthcare.26 Therefore, efforts are needed to strengthen the medium- to long-term capacity to handle health emergencies and meet IHR standards, raise community risk awareness, and improve health risk management planning. Second, any response to COVID-19 must incorporate key lessons learned by other countries in combating the disease. Third, duplication and gaps are recurring features in the management of large disasters everywhere, so the coordination of emergency assistance requires extra attention. 14. Proposed ADB support.27 The project complements other ADB support for COVID-19 response by providing urgently needed health equipment, supplies, and infrastructure, and limited activities to strengthen the health workforce. As initial support, ADB had provided $350,000 technical assistance grant from ADB regional technical assistance (RETA) Regional Support to Address the Outbreak of Coronavirus Disease 2019 and Potential Outbreaks of Other Communicable Diseases. Complementing these health sector interventions are: (i) a $500 million loan, comprising $250 million from ordinary capital resources lending and $250 million concessional loan for countercyclical support to address downstream effects of increased spending on social protection, salary support to workers, and low interest loans to affected sectors; and (ii) an attached TA grant of $1 million to support strengthening the social safety net

23 The five levels of coordination for COVID-19 efforts are (i) the Inter-ministerial National Committee, and Multi-sectoral

Coordination Committees at (ii) Divisional, (iii) District, (iv) City Corporation, and (v) Upazila (subdistrict) levels. 24 The Institute of Epidemiology, Disease Control and Research is the WHO-recognized National Influenza Centre. 25 The project ($100 million) has three components: (i) surveillance, diagnostics and community engagement; (ii) healthcare

strengthening; and (iii) institutional capacity to improve management, monitoring, and preparedness. World Bank. 2020. Covid-19 Emergency Pandemic Preparedness and Response Project, Bangladesh. Washington.

26 Only 2.38% of subdistrict health facilities (which make up 82% of all health facilities) had “good” performance. MOHFW and WHO. 2019. An in-depth analysis of the performance of public sector health facilities in Bangladesh 2017.Dhaka.

27 Complementing World Bank support, ADB was requested to support the most urgent needs for the first response phase—largely equipment and medical supplies—and short- to medium-term needs, such as infrastructure and related equipment for health facilities identified by the government, and capacity strengthening activities not supported by others. ADB support corresponds to all pillars of the CPRP. ADB will ensure there is no duplication through its Bangladesh Resident Mission, which is coordinating closely with other development partners.

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and institutional capacity.28 The proposed project aligns with four operational priority areas within Strategy 2030: (i) addressing poverty and reducing inequalities, through improved health and disease control; (ii) accelerating gender equality, through recruitment and training targets for women, and gender-sensitive health services; (iii) strengthening governance and institutional capacity, in health, environmental and social safeguards, procurement, and financial management; and (iv) fostering regional cooperation and integration through mitigating cross-border risks of infectious diseases.29 The project aligns with ADB’s country partnership strategy for Bangladesh 2016–2020 in the priority areas of easing infrastructure constraints, providing disaster resilient services, improving human capital and healthcare, and promoting gender equality.30 B. Project Description 15. The project is aligned with the following impact: accelerated social and economic recovery of the COVID-19 affected population in Bangladesh (footnote 4). The project will have the following outcome: health and wellbeing of COVID-19 affected persons improved. The outcome will be achieved through three outputs.31 16. Output 1: Immediate and medium-term equipment needs for testing and managing COVID-19 met. The project will help meet the government’s immediate and medium-term needs to prevent the spread of COVID-19, by supporting emergency procurement and the provision of the most crucial medical equipment and supplies. The supplies will enable (i) affected people and healthcare workers to be treated and protected from infection; and (ii) selected health facilities to be equipped with essential IPC supplies. The supplies will include PPE, biohazard bags, disinfecting materials, ventilators, oxygen meters, and other equipment.

17. Output 2: Infrastructure and related equipment for supporting and sustaining prevention and management of COVID-19 delivered. The project will support the modification and rehabilitation of infrastructure to provide (i) at least 80% of points of entry with screening facilities for passengers coming into the country via air, land, and water; (ii) at least 17 medical college hospitals with critical care units and isolation units to reduce secondary infections among contacts and healthcare workers; and (iii) at least 19 microbiological diagnostic facilities with capability to apply real-time and advanced diagnostics, as well as other emergency response infrastructure as needed. 18. Output 3. Health system and community capacities in combatting COVID-19 strengthened. The project will support measures to strengthen the health system’s response capacities and provide short- and medium-term capacity development, including (i) recruitment of additional staff and training of 3,500 health and other staff to optimize the use of the new or upgraded facilities; (ii) provision of adequate incentives to staff to go to remote areas; (iii) support for operational research on COVID-19 and case treatment to inform policy briefs and decisions; and (iv) development and implementation of a COVID-19 risk communication strategy.

28 ADB. Forthcoming. Proposed Countercyclical Support Facility Loan and Technical Assistance Grant to the People’s

Republic of Bangladesh: COVID-19 Active Response and Expenditure Support Program. Manila. 29 ADB. 2018. Strategy 2030: Achieving a Prosperous, Inclusive, Resilient, and Sustainable Asia and the Pacific. Manila. 30 ADB. 2016. Country Partnership Strategy: Bangladesh, 2016–2020. Manila. 31 The design and monitoring framework is in Appendix 1.

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C. Value Added by ADB 19. Overall, the project will contribute to the government’s NPRP with vital infrastructure and system-building support. ADB’s unique contribution will be the experience gained from its ongoing Urban Primary Health Care Services Delivery Project, which has two main components relevant to combating COVID-19: (i) providing primary healthcare services to the urban population, especially the poor and vulnerable; and (ii) fostering of active community leadership in urban health coordination committees. ADB will also bring additional new technology for screening, testing, and microbiological diagnostic laboratories. D. Summary Cost Estimates and Financing Plan 20. The project is estimated to cost $113.38 million (Table 1), inclusive of taxes and duties, physical and price contingencies, and interest and other charges during implementation. Detailed cost estimates by expenditure category are included in the project administration manual.32

Table 1: Summary Cost Estimates ($ million)

Item Amounta

A. Base Costb

1. Immediate and medium-term equipment needs for testing and managing COVID-19 met 66.47 2. Infrastructure and related equipment for supporting and sustaining prevention and Management of COVID-19 delivered

32.10

3. Health system and community capacities in combatting COVID-19 strengthened 5.85 Subtotal (A) 104.41

B. Contingenciesc 6.80 C. Financial Charges during Implementationd 2.16

Total (A+B+C) 113.38

COVID-19 = coronavirus disease 2019. Notes: Numbers may not sum precisely because of rounding. a Includes taxes and duties of $12.56 million. Such amount does not represent an excessive share of the project cost. b In March 2020 prices. c Physical contingencies computed at about 5%. Price contingencies computed at average of 2.8% on foreign

exchange costs and 7.6% on local currency costs. d Includes only interest. Interest during construction for concessional ADB loans from ordinary capital resources has

been computed at 1% per annum. Source: Asian Development Bank.

21. The government has requested a concessional loan of $100 million from ADB’s ordinary capital resources to help finance the project. The loan will have an interest charge at the rate of 1.0% per annum; a term of 40 years, including a grace period of 10 years; repayment of principal at 2% per annum for the first 10 years after the grace period and 4% per annum thereafter, and such other terms and conditions set forth in the draft loan agreement. 22. The summary financing plan is in Table 2. ADB will finance the expenditures in relation to goods, civil works, consulting services, and non-consulting services. The government will finance the taxes and duties. The government will finance the shortfall of finances, if required.

32 Project administration manual (accessible from the list of linked documents in Appendix 2).

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Table 2: Summary Financing Plan

Source Amount

($ million) Share of Total

(%) Asian Development Bank

Ordinary capital resources (concessional loan) 100.00 88.20 Government of Bangladesh 13.38 11.80 Total 113.38 100.00

Note: The program will be funded by a portion of the performance-based country allocation in concessional ordinary capital resources lending (COL) and Asian Development Fund (ADF) grant, some ADF grant and COL resources from the regional set-aside following some reprogramming, and some concessional resources freed up from savings and cancellation of ongoing projects. Source: Asian Development Bank estimates.

E. Implementation Arrangements 23. The project will be implemented over 3 years. A project implementation unit (PIU) will be established in DGHS, the implementing agency. The PIU will comprise a project director and a deputy project director for ADB. The PIU will provide the technical, administrative, and logistical support required for implementation, supported by consultants, as necessary. Project management support will be provided. A project steering committee will provide guidance to the PIU and oversee the overall project implementation, meeting at least twice a year or more frequently, if required. A project implementation committee, chaired by the director general, DGHS, will provide technical oversight and hands-on supervision, meeting at least quarterly, or more frequently as needed. The PIU and the project implementation committee will work directly with the government entity involved in each component: the COVID-19 Emergency Operation Center in preparedness and response, the subnational coordination committees in communication, and IEDCR in surveillance strengthening activities. The PIU will conduct monitoring, evaluation, and quarterly reviews. Individual consultants, such as a project management coordinator, and environment, social, procurement, and financial management experts, will be recruited under the project to support the PIU. 24. The implementation arrangements are summarized in Table 3 and described in detail in the project administration manual (footnote 32).

Table 3: Implementation Arrangements Aspects Arrangements

Implementation period May 2020–April 2023a

Estimated completion date 30 April 2023

Estimated loan closing date 31 October 2023

Management

(i) Oversight body Project Steering Committee; Secretary, MOHFW (chair); Director General, DGHS (member); officials from different divisions of MOHFW (members)

(ii) Executing agency HSD, MOHFW

(iii) Key implementing agency DGHS

Procurement OCB (international advertisement) 8 contracts (goods and works); 3 contracts

(non-consulting)

$102.76 million OCB (national advertisement)

Direct Contract

LCB

Request for quotations

Consulting services QCBS and CQS, OCB, international and/or national advertisement, or LCB

125 person-months (individual);

1 firm

$1.43 million

Single source selection

Individual consultant international advertisement/national advertisement

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Aspects Arrangements

Retroactive financing and/or advance contracting

Advance contracting and retroactive financing will apply for the procurement of civil works, goods, and consulting services, and for project administration. The amount to be retroactively financed will be allowed for up to 30% of the loan amount provided that such eligible expenditures incurred before the effectiveness of the loan agreement, but not earlier than 8 March 2020. b

Disbursement The loan proceeds will be disbursed following ADB's Loan Disbursement

Handbook (2017, as amended from time to time) and detailed arrangements agreed between the government and ADB.

ADB = Asian Development Bank, CQS = consultants qualifications selection, DGHS = Directorate General of Health Services, HSD = Health Services Division, LCB = local competitive bidding, MOHFW = Ministry of Health and Family Welfare, OCB = open competitive bidding, PIU = project implementation unit, QCBS = quality- and cost-based selection. a The project will be implemented over 3 years. The extended implementation period beyond the emergency assistance loan’s norm of 2 years is justified given the (i) possibility of supply chain disruptions during the extended lockdown, which could hamper the procurement of medical equipment and supplies; (ii) ADB interventions supporting capacity development and systems building in the short to medium term to manage other health emergencies in addition to those related to COVID-19; (iii) capacity constraints of the executing agency and implementing agency; and (iv) alignment with the government’s 3-year response plan and a related World Bank project. b 8 March 2020 is the date when the government first allocated resources for the response. Sources: Asian Development Bank and Ministry of Health and Family Welfare.

25. Procurement. The executing and implementing agencies will carry out all activities related to the procurement of goods, works, and consulting services using simplified approaches that are in line with the ADB Disaster and Emergency Assistance Policy (2004), the ADB Procurement Policy (2017, as amended from time to time), and Procurement Regulations for ADB Borrowers (2017, as amended from time to time). In formulating the procurement arrangements, consideration was given to value for money to increase efficiency; flexibility measures suited to the context of the emergency health pandemic considering market analysis; the capability of local manufacturers and contractors; and the operating environment, wherein the use of electronic procurement is already in place. To help achieve value for money and to ensure competitive tension in the procurement processes, several packages will be tendered using various procurement methods, with due attention to flexibility, agility, but also fiduciary compliance to fit the purpose of this emergency loan. Most of the goods contracts for medical equipment and supplies will be awarded through open competitive bidding (OCB) and the national advertisement method. Civil works procurement, if any, will follow the same approaches. To ensure efficiency, special procedures for emergency lending will be used, including reducing the bidding period to 14 days when appropriate; using single-stage one-envelope bidding procedures; and developing a time-bound action plan to award contracts, including a contract management plan. Some civil works and goods contracts may be procured using direct contracting, where appropriate, following procedures acceptable to ADB. Goods needed immediately may be procured using international and/or national requests for quotations subject to prior review by ADB. Subject to bidding documents being modified to comply with ADB requirements, the national electronic government procurement system will be used for OCB to award most of the goods and civils works contracts, although manual or off-line bidding may be used where appropriate.

26. Consulting firm(s) will be recruited through OCB procedures, local advertisements, and/or limited competitive bidding using a quality- and cost-based selection procedure, a simplified technical proposal, or a biodata technical proposal. Other methods, such as the consultants’ qualification selection, may also be used where appropriate. For implementation support, individual consultants will be recruited using the individual selection method with international and/or local advertisements, based on the project’s requirements. Consultants who are already engaged in ADB-financed projects and provide similar services as those required for the project may be recruited directly, subject to their satisfactory performance. This arrangement will provide

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an efficient way to recruit consultants under the circumstances. Local nongovernment organizations may provide some social and gender studies and/or support. The option to have a direct contract or a memorandum of understanding with nongovernment organizations and/or United Nations agencies already engaged in the project area may also be explored where appropriate. 27. All goods, works, and consulting services will be procured based on the detailed arrangements in the project’s procurement plan, including procurement and selection methods, type of bidding documents, and ADB’s review requirements. ADB will review the first contract per bidding method per implementing agency prior to bidding, and the rest of the contracts will be post-reviewed (sampling). The executing and implementing agencies will be required to (i) use the Procurement Activity Monitoring Tool, a web-based database, to record and monitor the time taken for each step of the procurement process and to track any delays; and (ii) take appropriate actions for all prior and post-review packages of goods and works under the project.

III. DUE DILIGENCE A. Technical 28. All project activities will incorporate measures to strengthen resilience to future epidemics and disease outbreaks, thus addressing the systemic weaknesses found in Bangladesh’s IHR core capacities (para. 5). All new and upgraded infrastructure will be disaster-resilient and climate-smart based on hazard, climate, and risk analyses; modified design criteria and careful selection of materials; and monitoring of field practices. The project has a low climate risk category because most facilities will be constructed within existing structures such as health centers, medical colleges, and ports. Project management actions need to include strong contingency planning for potential physical impacts resulting from an increase in temperature (heat stress) and extreme rainfall events (floods). B. Economic and Financial Viability 29. The project is likely to generate significant social benefits through disease prevention, improved health risk management, and greater health awareness. Bangladesh could suffer significant economic impacts as a result of COVID-19 (para. 9 and 10). If unchecked, the pandemic could overwhelm the health system, which, in its present state, is unable to cope with the increased need for intensive care, protective equipment, and human resources. COVID-19 affects economic activity through various channels, such as declines in domestic consumption, production, investment, and trade. In the short to medium run, it leads to higher unemployment and disruption of schooling, and to an increase in deaths and morbidities, all of which could have a debilitating effect on the country’s human capital. The project outputs are expected to prevent the loss of human capital and address short-term gaps in the health system. Due to the short processing time available for the emergency response, economic due diligence following ADB guidelines on economic analysis33 will be conducted during project implementation. The ADB RETA34 will include resources to undertake the necessary project economic analysis, in compliance with ADB requirements.

33 ADB. 2017. Guidelines for the Economic Analysis of Projects. Manila. 34 ADB. Forthcoming. Support to Address Outbreak of Coronavirus Disease 2019 and Strengthen Health Systems

Preparedness for Communicable Disease in South Asia. Manila (under preparation).

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30. The project’s outcome and outputs—such as disease prevention and control—are public goods with positive externalities, with no opportunity for cost recovery; hence no financial viability assessment is required. Regarding the financial sustainability, about 64% of project cost will be utilized to procure emergency equipment, which will be discarded after use. About 30% will be invested in infrastructure and facilities, which will either be dismantled after the emergency (such as screening facilities at airport and ports) or repurposed for use in hospitals (such as isolation wards). To ensure the project’s sustainability, the government will provide assurances as part of the loan agreement that (i) adequate budget support for incremental operations and maintenance is provided to the respective entities, and (ii) all entities receiving project equipment will maintain sound asset management practices, including an asset register, and conduct periodic inventories. C. Governance 31. A financial management assessment, conducted in accordance with ADB guidelines, found that DGHS and MOHFW have adequate financial management arrangements in place to implement the project. The financial management risk is rated substantial, because of weaknesses in country financial management systems, capacity constraints of the implementing agency, and the project’s urgent nature. These risks will be mitigated by (i) assigning dedicated and qualified financial management staff to the PIU; (ii) providing training in ADB’s procedures and systems; (iii) requiring comprehensive financial information in quarterly progress reports; and (iv) assigning an internal auditor to the project. Furthermore, a financial management expert will be funded by the ADB RETA (footnote 34) to support the project during the first 6 months. The project will maintain separate books of account in accordance with accounting standards acceptable to ADB, and the project financial statement will be audited annually by an independent auditor acceptable to ADB and in accordance with the International Standards on Auditing. 32. A procurement assessment of the executing and implementing agencies, conducted for the project, revealed that the procurement and contract management risk is high but manageable by implementing the agreed mitigation measures, such as (i) deploying PIU staff with prior ADB project experience; (ii) introducing an efficient contract award and contract implementation management plan; (iii) applying the e-Government Procurement (e-GP) process; (iv) conducting frequent and close monitoring, audits, and reviews; and (v) ensuring close supervision of and adequate mechanisms for the distribution of goods and equipment through credible agencies. Procurement experts funded by the ADB RETA (footnote 34) will provide capacity building support to ensure compliance with the agreed procurement procedures. 33. ADB’s Anticorruption Policy (1998, as amended to date) was explained to and discussed with the government and MOHFW. The specific policy requirements and supplementary measures are described in the project administration manual (footnote 32). D. Poverty, Social, and Gender 34. The project will benefit all, especially the poor and vulnerable, by preventing or mitigating the impact of infectious disease (para. 10) and providing inclusive healthcare services, health education and awareness raising. Disease prevention benefits especially the poor, through reduced out-of-pocket expenditures, reduced absenteeism at work, and improved well-being. Women and their health will need special attention, in the cultural context of Bangladesh, since the burden of enforcing family hygiene and caring for the sick falls largely on them. Female health workers and patients have specific needs related to menstrual hygiene, personal safety, and transportation. The project is classified as effective gender mainstreaming and a gender action plan was prepared. The key activities involve: (i) a gender sensitive communication strategy, and

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community education and mobilization (Output 3); (ii) targets for women for recruitment and capacity building (Output 3) and gender-segregated isolation units (Output 2). E. Safeguards 35. The safeguards requirements for emergency assistance set out in ADB’s Safeguard Policy Statement (2009) have been followed. The screening and assessment of sites will be undertaken during project implementation in accordance with the environmental assessment and review framework and the resettlement and indigenous peoples planning framework (RIPPF). The safeguards frameworks have been designed to respond to the exceptional nature of the emergency and the challenges imposed by COVID-19 on meeting safeguards requirements, such as audits and consultations. The frameworks are broad enough to address (i) impacts and risks identified at a later stage; and (ii) any change of scope required by the rapidly evolving situation, while ensuring continued compliance with the Safeguard Policy Statement. In view of the limited capacity, safeguards consultants engaged under this loan will provide support. 36. Environment (category B). Most civil and structural works will consist of rehabilitation or minor extensions to buildings on existing premises, so potential direct, indirect, cumulative, and induced impacts of the project are anticipated to be site-specific and minor, and few (if any) to be irreversible in nature. The main impacts and risks relate to (i) medical waste management, requiring environmentally sound and safe handling, storage, transport, and disposal; (ii) occupational and community health and safety risks35 associated with the construction and operation of project-supported facilities and the high contagiousness of COVID-19; and (iii) construction-related pollution, disruption, and disturbance. The environmental assessment and review framework provides guidance on mitigation of these impacts, through the development of guidelines on waste management, health and safety risk assessment, and management plans, Environmental Code of Practices, provision of PPE, and trainings. The implementation of Environmental Management Plans shall be closely supervised and monitored. Specific project funding has been dedicated to medical waste management, the provision of PPE, health and safety trainings, and the mitigation of other environmental problems. 37. Involuntary resettlement (category C). Involuntary resettlement is not expected to occur under this project since the works will be carried out within existing facilities on government land. However, to cater to emerging issues during implementation,36 the RIPPF includes site selection criteria and guidelines. For existing facilities, a rapid audit to assess any legacy issues or risks related to involuntary resettlement will be undertaken. If such issues are identified, a corrective action plan will be developed and implemented. The RIPPF and the project administration manual include involuntary resettlement screening and audit guidelines. 38. Indigenous peoples (category B). No adverse impact on indigenous peoples37 or small ethnic communities is expected; however, while most facility sites are unknown at this stage, indigenous people will be among the project beneficiaries. The project is thus rated category B and the RIPPF includes site selection criteria to this effect. Communication activities will be

35 For health workers, laboratory technicians, medical waste handlers, contractor and construction workers, patients and

visitors to existing facilities, and the wider local communities in the event of inadequate waste management processes. 36 The RIPPF anticipates issues that may arise during implementation, such as, if squatters are found, or if, for example, the

health situation requires more isolation room, which could require more ground than initially expected. 37 For operational purposes, the term Indigenous Peoples is used in a generic sense to refer to a distinct, vulnerable, social

and cultural group as defined in SPS 2009. In considering these characteristics, national legislation, customary law, and any international conventions to which the country is a party will be taken into account. The Constitution of Bangladesh refer to ethnic communities as Small Ethnic Communities. Both the terms have been used in related documentation.

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presented in culturally appropriate ways for indigenous peoples. Any risk of exclusion from access to information and services for indigenous communities and other vulnerable and disadvantaged groups will be addressed through the indigenous peoples plan. F. Summary of Risk Assessment and Risk Management Plan 39. Significant risks and mitigating measures are summarized in Table 4 and described in detail in the risk assessment and risk management plan. 38

Table 4: Summary of Risks and Mitigating Measures Risks Mitigation Measures

Disease transmission patterns or severity could suddenly accelerate, which could overwhelm system capacity and invalidate all reasonable planning assumptions.

The government and development partners are conducting risk scenario planning, including surge capacity development. The residual risk that remains is deemed acceptable for the project.

Risks linked to weak financial management, complex activities, and lack of experience in implementing Asian Development Bank financed projects.

Technical support (footnote 34) will be provided on financial management and an internal auditor will be assigned to the project.

Risks linked to inadequate procurement capacity. Procurement and selection methods will be streamlined and technical support will be provided on procurement (Footnote 34).

Source: Asian Development Bank.

IV. ASSURANCES

40. The government and MOHFW have assured ADB that implementation of the project shall conform to all applicable ADB requirements, including those concerning anticorruption measures, safeguards, gender, procurement, consulting services, financial management, and disbursement as described in detail in the project administration manual and loan documents. 41. The government and MOHFW have agreed with ADB on certain covenants for the project, which are set forth in the draft loan agreement.

V. RECOMMENDATION 42. I am satisfied that the proposed loan would comply with the Articles of Agreement of the Asian Development Bank (ADB) and recommend that the Board approve the loan in the amount of $100,000,000 to the People’s Republic of Bangladesh for the COVID-19 Response Emergency Assistance Project, from ADB’s ordinary capital resources, in concessional terms, with an interest charge at the rate of 1.0% per annum; for a term of 40 years, including a grace period of 10 years; with repayment of principal at 2.0% per annum for the first 10 years after the grace period and 4.0% per annum thereafter; and such other terms and conditions as are substantially in accordance with those set forth in the draft loan agreement presented to the Board.

Masatsugu Asakawa President

22 April 2020

38 Risk Assessment and Risk Management Plan (accessible from the list of linked documents in Appendix 2).

Appendix 1 13

DESIGN AND MONITORING FRAMEWORK

Impact the Emergency Assistance Loan is Aligned with: Accelerated social and economic recovery of the COVID-19 affected population in Bangladesh. (National Preparedness and Response Plan for COVID-19, Bangladesh, Version 5, March 2020)a

Results Chain Performance Indicators with Targets and Baselines

Data Sources and Reporting Mechanisms

Risks

Outcome: Health and wellbeing of COVID-19 affected persons improved.

a. By 2023, 65% of suspected domestic COVID-19 cases reported and investigatedb as per MOHFW guidelines, with sex- and age disaggregated data

(March 2020 baseline: 0)

a. MOHFW/ DGHS/IEDCR and PIU

Disease transmission patterns or severity could suddenly accelerate, which could overwhelm system capacity and invalidate all reasonable planning assumptions.

Output 1. Immediate and medium-term equipment needs for testing and managing COVID-19 met.

1a. By May 2023, emergency equipment and personal protective equipment for managing COVID-19 outbreak procured and distributed to national and district health facilitiesc (March 2020 baseline: 0).

1a. MOHFW/ DGHS and PIU

The pandemic’s prolonged impact on supply chains could delay procurement and installation of infrastructure and equipment.

Output 2. Infrastructure and related equipment for supporting and sustaining prevention and management of COVID-19 delivered.

For screening

2a. By May 2022, at least 80% of selected points-of-entryd upgraded and fully functional for screening and identifying cases of COVID-19 as per MOHFW guidelines/standards. (March 2020 baseline: 0 points-of-entry)

2a–2c. MOHFW/ DGHS and PIU

2d. MOHFW/ IEDCR and PIU

For prevention

2b. By December 2021, at least 17 of 37 medical college hospitals equipped with isolation units. (xx isolation units for women; and xx isolation units for men)e (March 2020 baseline: 0 facilities)

For treatment

2c. By May 2021, at least 17 of 37 medical college hospitals equipped with critical care units. (March 2020 baseline: 0 facilities) For testing

2d. By May 2022, at least 19 laboratories upgraded with COVID-19 microbiological diagnostic facilities with testing capacity of xx per dayf per facility, as per MOHFW guidelines (17 April 2020 baseline: 17 laboratories for testing but not upgraded,g)

Output 3. Health system and community capacities in combatting COVID-

3a. By April 2021, at least xx health professionals and technical staff recruited (including at least 30% eligible women)h

(March 2020 baseline: 0)

3a. MOHFW/ DGHS and PIU

Potential unrest may cause disruption of activities.

14 Appendix 1

Results Chain Performance Indicators with Targets and Baselines

Data Sources and Reporting Mechanisms

Risks

19 strengthened. 3b. By May 2022, at least 3,500 health professionals (including at least 50% eligible women) trained and practicing acquired skills and knowledge (March 2020 baseline: 0 staff trained)

3b. MOHFW/ DGHS and PIU, Post training skills test for trainees 3c. MOHFW/ IEDCR and PIU 3d. MOHFW/ DGHS and PIU

3c. By April 2021, at least 2 operational researches completed on COVID-19 testing and case treatment. (March 2020 baseline: research not in place) 3d. By May 2023, inclusive and gender responsive COVID-19 risk communication strategy and plan developed and implemented in at least x% districts.i (March 2020 baseline: not developed or implemented)

Key Project Activities: 1. Immediate and medium-term equipment needs for testing and managing COVID-19 met 1.1. Procure and deliver immediate and medium-term equipment for first response, as identified by MOHFW (March 2021). 2. Infrastructure and related equipment for supporting and sustaining prevention and management of COVID-19 delivered 2.1. Prepare bid documents and commence bidding for infrastructure and logistics (July 2020). 2.2. Put supervision and monitoring measures in place (August 2020). 2.3. Ensure that technical norms and guidelines set by MOHFW are met (July 2020—October 2022). 3. Health system and community capacities in combatting COVID-19 strengthened 3.1 Prepare bid documents and commence bidding (July 2020). 3.2. Put supervision and monitoring measures in place (August 2020). Project management activities: Establish PIU at DGHS (April 2020). Recruit necessary consultants for construction supervision and project management (June 2020). Establish monitoring and evaluation system (June 2020). Establish a mechanism of regular reviews (June 2020). Financing Plan ADB: $100 million (OCR concessional loan) Government: $13.38 million Assumptions for Partner Financing Not applicable.

ADB = Asian Development Bank; COVID-19 = coronavirus disease; DGHS = Directorate General of Health Services; IEDCR = Institute of Epidemiology, Disease Control and Research; MOHFW = Ministry of Health and Family Welfare; OCR = ordinary capital resources; PIU = project implementation unit. a Government of Bangladesh. 2020. Ministry of Health and Family Welfare. National Preparedness and Response Plan for COVID-19, Bangladesh, Version 5, March 2020. Dhaka. b Investigation of COVID-19 cases means contact tracing, management of cases and contacts, and collection and testing of specimen as defined by World Health Organization. c The list of national and district health facilities to be determined during the inception mission. d Points-of-entry to be selected during inception mission. e To be determined during inception mission.

f Testing capacity per day to be defined during the inception mission. g Source for number of laboratories: Government of Bangladesh, 17 April 2020. h The number of health professionals and other staff to be recruited, and gender targets to be confirmed during the inception

mission. i Target districts to be determined during the inception mission. Contribution to the ADB Results Framework: To be determined Source: Asian Development Bank.

Appendix 2 15

LIST OF LINKED DOCUMENTS

http://www.adb.org/Documents/RRPs/?id=54173-001-3

1. Loan Agreement

2. Summary Assessment of Damage and Needs: Health System Assessment

3. Project Administration Manual

4. Emergency Assistance Coordination

5. Financial Analysis

6. Summary Poverty Reduction and Social Strategy

7. Risk Assessment and Risk Management Plan

8. Gender Action Plan

9. Environmental Assessment and Review Framework

10. Resettlement and Indigenous Peoples Planning Framework

Supplementary Documents 11. Project Financial Management Assessment 12. Strategic Procurement Planning 13. Project Procurement Risk Assessment Report