Indonesia: Emergency Response to COVID-19 Program

OBJECTIVE

To prevent, detect and respond to the threat posed by COVID-19 and to strengthen national systems for public health preparedness in Indonesia.

DESCRIPTION

The proposed program to be supported under the COVID-19 Crisis Recovery Facility (the Facility) is being co-financed with the World Bank (WB) and has been designed in accordance with the WB’s Policy on Program for Results (PforR). The adoption of PforR design will facilitate a rapid response to the current health emergency.

The program aims to focus on three results areas:

• Results Area 1 - Help expand health system preparedness by addressing the immediate needs of designated COVID-19 referral facilities. The Program will support the expanded network of health facilities owned by the Ministry of Health (MOH) that have been designated as COVID-19 referral hospitals. It will ensure they are fully equipped to manage and treat the increase in severe respiratory illness and critical care patients. It will also support the MOH’s development and implementation of infection control and safety measures in healthcare settings as well as treatment protocols to manage cases at all stages. For medium-term outcomes aimed at strengthening the health system, the program will support the updating of the national pandemic preparedness plan, including emergency funds flows and emergency procurement systems, development of a communication strategy, improvement of reporting and a strengthened surveillance system, incorporating lessons from COVID-19 experience.
• Results Area 2 - Strengthen the laboratory network and surveillance system to help increase testing and contact tracing. The Program will support the development of national guidelines for laboratories adhering to Bio Safety Level 2 (as defined by National Institute for Health Research) or higher standards, covering sample collection, transportation, and laboratory testing procedures for suspected Severe Acute Respiratory Illnesses (SARI) or Coronaviruses. This results area also aims to provide consumables for testing to every province and district of the country (subject to the availability of affordable COVID-19 cartridges for GeneXpert machines). The Program will also promote the development and implementation of laboratory quality assurance mechanisms for those in the network. Lastly, the Program will strengthen the GOI’s capacity to do contact tracing and surveillance by supporting the surveillance hotline for community-based reporting of outbreaks and new illnesses.
• Results Area 3 - Ensure MOH support for communications and coordination across sectors and levels of government. The Program will facilitate communication and coordination for pandemic response and preparedness as it recognizes the need for the MOH to coordinate with other sectors. It will support the development and establishment of mechanisms for communication of COVID-19 test results (in coordination with the sub-national level), and support the National Disaster Risk Management Agency (BNPB) and other agencies in developing messages on personal hygiene promotion and other preventive communications.

ENVIRONMENTAL AND SOCIAL INFORMATION

This Program will be co-financed with the WB as lead co-financier, and its environmental and social (ES) risks and impacts have been assessed in accordance with the WB’s Policy on Program-for-Results Financing (PforR Policy). AIIB’s Environmental and Social Policy (ESP) was designed to apply to investment projects and has no provisions for its application to PforR operations. Therefore, as permitted by a decision of the AIIB’s Board of Directors, the WB’s PforR Policy will apply to this operation in lieu of AIIB’s ESP. This will ensure a harmonized approach to addressing the ES risks and impacts of the Program.

The WB has categorized the ES risks of this Program as “Substantial” (which is similar to Category B if AIIB’s ESP were applicable). As required under the WB’s PforR Policy, the program excludes activities that are likely to have significant adverse ES impacts that are sensitive, irreversible, or unprecedented (similar to Category A if AIIB’s ESP were applicable).

An Environmental and Social Systems Assessment (ESSA), which involves assessing the country’s systems for managing ES risks and impacts of the proposed Program, has been conducted by the WB in accordance with its PforR Policy. The ESSA is complemented by Environmental and Social Program Plans, which form a part of the Program Action Plan (PAP), at the operational level. The country systems applicable to the Program were reviewed to ascertain their adequacy to manage ES risks and impacts as identified during the ESSA. The country’s legislation related to ES safeguards for the Program was found to be adequate. Consequently, the country’s ES management system, based on the ESSA, will be applied to the Program given that the ES risks and impacts are limited in their scope and can be successfully managed by known and tested measures.

Risk areas of concern include medical waste and wastewater; Occupational Health and Safety (OHS) for medical workers; community health and safety related to the handling of medical waste; transportation, treatment and isolation of people with confirmed COVID-19 and/or people who may have COVID-19; poor consent processes; communication and outreach; and privacy concerns due to mass surveillance. However, the Program is expected overall to have mostly positive ES impacts, insofar as it should improve COVID-19 surveillance, monitoring, case management and containment, thereby preventing a wider spread of the disease. In the longer run, the Program also seeks to promote further reform in Indonesia’s health system and enhance its resilience and preparedness for future pandemics.

The ESSA has been disclosed on the WB’s website (http://documents.worldbank.org/curated/en/290721589508650794/pdf/Final-Environmental-and-Social-Systems-Assessment-ESSA-Indonesia-Emergency-Response-to-COVID19-P173843.pdf).