(ESRS Appraisal Stage) - Appraisal Environmental and Social Review Summary Appraisal Stage - World Bank Group
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Public Disclosure Authorized
The World Bank
Mongolia PEF support for COVID-19 (P174571)
Public Disclosure Authorized
Appraisal Environmental and Social Review Summary
Appraisal Stage
Public Disclosure Authorized
(ESRS Appraisal Stage)
Public Disclosure
Date Prepared/Updated: 08/18/2020 | Report No: ESRSA01015
Public Disclosure Authorized
Aug 20, 2020 Page 1 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
BASIC INFORMATION
A. Basic Project Data
Country Region Project ID Parent Project ID (if any)
Mongolia EAST ASIA AND PACIFIC P174571
Project Name Mongolia PEF support for COVID-19
Practice Area (Lead) Financing Instrument Estimated Appraisal Date Estimated Board Date
Health, Nutrition & Investment Project 8/28/2020
Population Financing
Borrower(s) Implementing Agency(ies)
Mongolia Mongolia Ministry of Health
Proposed Development Objective
The proposed project development objective is to strengthen Mongolia’s capacity to prevent and to respond to the
COVID-19 outbreak.
Public Disclosure
Financing (in USD Million) Amount
Total Project Cost 1.00
B. Is the project being prepared in a Situation of Urgent Need of Assistance or Capacity Constraints, as per Bank IPF
Policy, para. 12?
Yes
C. Summary Description of Proposed Project [including overview of Country, Sectoral & Institutional Contexts and
Relationship to CPF]
The aim of this project is to strengthen Government of Mongolia’s to prevent and to respond to the COVID-19
outbreak. Assistance will be provided to the health care system for preparedness planning to provide optimal medical
care, maintain essential lifesaving services, ensuring hospital infection control interventions and minimize risks for
patients, health personnel and other front line workers. In doing this it will support the health system with supplies
including Personal Protective Equipment like N95 respirators, medical masks, goggles, gloves, gowns; laboratory
equipment and supplies for improved diagnostic capabilities etc. Through these measures the project will enhance
preparedness and strengthen essential health care service delivery to be able to provide the best care possible in the
event of a surge in demand.
Aug 20, 2020 Page 2 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
D. Environmental and Social Overview
D.1. Detailed project location(s) and salient physical characteristics relevant to the E&S assessment [geographic,
environmental, social]
This emergency operation is proposed as a new stand-alone project which will be implemented alongside the
Mongolia COVID-19 Emergency Response and Health System Preparedness project (P173799) and will be
implemented throughout Mongolia. In supporting the health system with supplies of personal protection equipment
(PPE), laboratory equipment and medical supplies for case management and infection prevention, as well as
procurement of drugs such as antivirals, antibiotics and essential medicines for patients with co-morbidity and
complications such as CVDs and diabetes, the project activities will mirror a subset of those being undertaken under
the $26.9 million for the Mongolia COVID-19 Emergency Response and Health System Preparedness Project approved
in April 2020. The new project will support the availability of equipment and drugs through the Ministry of Health and
selected tertiary hospitals. The primary beneficiaries include patients visiting hospitals, health care providers in
Aimags, Districts and selected hospitals and Taxation and / Customs General Administration personnel who will
receive protective equipment to ensure safe interactions with local communities.
The decision to use the stand-alone Recipient Executed Trust Fund RETF was made by the Government of Mongolia.
The Pandemic Emergency Financing Facility (PEF) had offered the GPM 3 modalities including directly through a WB
operation (co-financing from a Trust Fund); through a new stand-alone Trust-Fund operation; by nominating a PEF
accredited Responding Agency to receive the funds. Considering the relative smaller volume of funding, the clear
definition of its use and the limitations set with a short implementation time frame, GOM decided to sue the RETF
option. Further, an Additional Financing would have also required special waiver from the RVP given that there is less
than 12 months of implementation of the parent project and eventually RVP level clearance. The final decision was
Public Disclosure
made by the China/Mongolia Country Management Unit.
The first ISR for the Emergency Response Project has just been completed. The ESMF is under preparation and is
expected to be completed by end of September 2020. Similarly, recruitment of E&S specialists in the PIU is in progress
and these people are expected to be onboard by end of September 2020. Although the goods to be procured under
the PEF can be purchased, the client will commit (via the ESCP) to not dispensing/using the goods until the ESMF and
requisite staff are in place.
D. 2. Borrower’s Institutional Capacity
The Project Implementation Unit (PIU) for the Mongolia COVID-19 Emergency Response and Health System
Preparedness Project (Emergency Response Project) approved in April 2020 will provide all support required for
implementation of this project. This Project Implementation Unit consists of the PIU for the ongoing E-health project,
strengthened with a bio-medical engineer, environment and occupational health specialist, risk communication and
community engagement officer, and procurement officer with good English language skills who are expected to be
engaged/appointed by end of September 2020. This strengthened and amalgamated PIU will liaise with the World
Bank on day to day activities.
Since these operations have been prepared under emergency procedures during a period of extreme constraint on in
country support the successful resourcing and implementation of the proposed ES instruments is still to be
demonstrated. However, the institutional capacity is considered to be more than adequate to manage the level of
E&S risks associated with the RETF activities.
Aug 20, 2020 Page 3 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
II. SUMMARY OF ENVIRONMENTAL AND SOCIAL (ES) RISKS AND IMPACTS
A. Environmental and Social Risk Classification (ESRC) Substantial
Environmental Risk Rating Substantial
This emergency operation has been prepared as a new stand-alone project which will be implemented alongside the
Mongolia COVID-19 Emergency Response and Health System Preparedness project (P173799), which has an ESRC of
Substantial.
The environmental risks relate primarily to waste management and occupational health and safety. Specifically, the
risks would include (i) purchasing sub-standard PPE; (ii) inadequate training on the use of the PPE leading to it not
providing the intended level of protection; (iii) effective management of used PPE in a manner which ensures
pathogens and diseases are not transferred between people and/or places and that it is disposed of in a manner
meeting GIIP for medical waste. The Mongolia COVID-19 Emergency Response and Health System Preparedness
project (P173799) (Emergency Response Project) presents these (and other) risks. The E&S instruments being
prepared for the Emergency Response Project will manage and mitigate risks relevant to this RETF also.
Accordingly, standalone E&S instruments for this RETF are not proposed; instead, the risks will be managed in an
integrated manner with the Emergency Response Project. Although procurement of the supplies can proceed upon
project effectiveness, the client commits via the ESCP to not dispensing/using the goods until these instruments and
requisite staff are in place.
Public Disclosure
While the grant funds will be used for the purchase and distribution of medicines and medical supplies, the entire
implementation arrangement as well as the risk assessment and management are directly linked to P172799 which
has an ESRC of Substantial. At a practical level supplies will be provided to medical/health care facilities and the E&S
risk management cannot be ring-fenced from the other COVID project.
Accordingly, it is proposed that this project also have an Environmental risk categorization of Substantial.
The RETF will be legally linked to the Emergency Response Project via the Environmental and Social Commitment Plan
(ESCP) which forms part of the loan agreement.
Social Risk Rating Substantial
The social risks relate primarily to occupational and community health and safety in addition to ensuring inclusion of
vulnerable people (including ethnic minorities) and those personnel who work with them as project beneficiaries.
COVID-19 impacts tend to reinforce existing inequity in access to quality medical care and supplies. Vulnerable
communities risk experiencing disproportionate impacts from the virus and typically have poorer access to services.
By increasing the supply of protective equipment and medicines for hospitals and administrative officials in
preparation for the event of an outbreak, the operation will benefit vulnerable groups such as the elderly, the urban
poor, ethnic minorities and others at increased risk of infection and hospitalization who may otherwise experience
barriers to prevention and treatment.
Aug 20, 2020 Page 4 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
As outlined under "Environment Risk Rating" above:
1. The RETF will be legally linked to the Mongolia COVID-19 Emergency Response and Health System Preparedness
project (P173799) (Emergency Response Project) via the Environmental and Social Commitment Plan (ESCP) which
forms part of the loan agreement, and E&S instruments being prepared for the Emergency Response Project will
manage and mitigate risks relevant to this RETF;
2. the implementation arrangement as well as the risk assessment and management are directly linked to P172799
which has an ESRC of Substantial.
Accordingly, it is proposed that this project also have a social risk categorization of Substantial.
B. Environment and Social Standards (ESSs) that Apply to the Activities Being Considered
B.1. General Assessment
ESS1 Assessment and Management of Environmental and Social Risks and Impacts
Overview of the relevance of the Standard for the Project:
ESS 1 is relevant. The project will have positive environmental and social impacts as it should improve supply of
quality protective equipment as well as medication to address the COVID-19 emergency. Multiple disadvantaged or
other vulnerable groups stand to benefit, starting with the elderly and those with compromised immune systems due
Public Disclosure
to pre-existing conditions. The community engagement activities proposed under component 1.1 of the MONGOLIA
COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799) (Emergency Response
Project), which will be implemented in parallel with this project, will seek to ensure inclusion of these groups. This is
addressed under ESS 10 below and the ESCP.
Environmentally and socially sound health facilities management will require adequate provisions for minimization of
occupational health and safety risks, proper management of hazardous waste and sharps, use of appropriate
disinfectants, proper quarantine procedure for COVID-19, appropriate chemical and infectious substance handling
and transportation procedures, etc.
A Project ESMF for the Emergency Response Project (P173799) has been drafted and is expected to be completed by
the end of September 2020 (based largely on adopting WHO guidance, World Bank EHS Guidelines and other GIIP).
This will provide for the application of international best practices in COVID-19 diagnostic testing and handling of
medical supplies, disposing of the generated waste, and treating confirmed cases.
The ESMF under preparation includes both environmental and social assessments to ensure all project E&S risks and
opportunities are adequately managed/optimized. The RETF project is being prepared under the emergency
provisions of Paragraph 12 of the World Bank’s IPF policy, and deferral of E&S instrument preparation is proposed so
that these can be prepared during project implementation. The E&S risks associated with this RETF project will all be
addressed through the ESMF for the Emergency Response Project and this will be documented in the Environmental
and Social Commitment Plan (ESCP) and therefore in the loan agreement.
Aug 20, 2020 Page 5 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
Whereas procurement of the supplies can proceed upon project effectiveness, the client commits via the ESCP to not
dispensing/using the goods until these instruments and requisite staff are in place.
ESS10 Stakeholder Engagement and Information Disclosure
Component 1.1 of the Emergency Response Project is the Risk Communication and Community Engagement activity,
which will be undertaken in accordance with WHO Guidance. The WHO guidance is a tool designed to support risk
communication, community engagement staff and responders working with national health authorities, and other
partners to develop, implement and monitor an effective action plan for communicating effectively with the public,
engaging with communities, local partners and other stakeholders to help prepare and protect individuals, families
and the public’s health during early response to COVID-19. This RETF funded project will be integrated into this
outreach and communication campaign and likely affected and interested stakeholders are the same for this new
operation. Engagement will be required with vulnerable groups and those personel who work with them who are at
greater risk of infection and hospitalization and who are typically less able to access medical services and supplies
(these may be poor communities in urban areas of Aimags, ethnic minorities and remote indigenous herders).
The Stakeholder Engagement Plan (SEP) prepared for the Emergency Response Project covers activities under the
RETF. The SEP was prepared by the client and cleared by the Bank in March 2020. The SEP has subsequently been
updated by the client to include measures to address the activities under the RETF and is currently under review by
Public Disclosure
the Bank Task Team.
It is not considered that a separate SEP is needed for this RETF funded project because all of the activities proposed
are also being carried out as part of the Emergency Response Project. A Grievance Redress Mechanism for receipt of
environmental and social concerns about the RETF as well as for the Emergency Response project will be included in
the updated SEP and will be managed by the PIU.
B.2. Specific Risks and Impacts
A brief description of the potential environmental and social risks and impacts relevant to the Project.
ESS2 Labor and Working Conditions
The procurement of international standard personal protective equipment under this project aims to reduce
occupational health and safety risks in medical facilities. Primary caregivers and other hospital staff, Taxation and /
Customs General Administration personnel who will receive protective equipment to ensure safe interactions with
local communities, are considered beneficiaries of the project activities (in receipt of protective equipment and
medical supplies). Risks associated with transport, storage and distribution of personal protective equipment and
medical supplies are minor, site specific and relatively easily managed. Risk of improper/ineffective use of PPE is to be
addressed through training.
An ESMF and a Labor Management Procedure is being prepared under the Emergency Response Project. It is
proposed that the Labor and Working Conditions risks associated with this RETF project (including training for
Aug 20, 2020 Page 6 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
personal protective equipment) be addressed via the ESMF and LMP for Emergency Response Project and this will be
documented in the Environmental and Social Commitment Plan (ESCP) and therefore in the loan agreement.
ESS3 Resource Efficiency and Pollution Prevention and Management
Medical and chemical wastes (including water, reagents, infected materials, etc.) from the labs, quarantine, and
screening posts to be supported through provision of drugs, supplies and PPE can have significant impact on
environment and human health. Wastes that may be generated from medical facilities/ labs could include liquid
contaminated waste, chemicals and other hazardous materials, and other waste from labs and quarantine and
isolation centers including sharps, used in diagnosis and treatment.
A health care waste management plan (HCWMP) will be developed as part of the Emergency Response Project to
ensure the waste management practices at the various hospitals receiving assistance from the project comply with
WHO guidance and international best practice for infectious and hazardous waste management.
The Resource Efficiency and Pollution Prevention and Management risks associated with the current RETF project will
all be addressed via the HCWMP and ESMF for the Emergency Response Project and this will be documented in the
Environmental and Social Commitment Plan (ESCP) and therefore in the loan agreement.
ESS4 Community Health and Safety
Public Disclosure
Protecting the safety of communities from infection with COVID-19 is a central part of the Emergency Response
Project and the current RETF project.. Community exposure to health issues therefore is relevant and the project
activities are designed to mitigate these risks, primarily by increasing supply of protective equipment and medicines
for distribution to key medical centres to assist in swift prevention and treatment in event of an outbreak. Measures
will be required to target distribution on a needs basis in the event of an outbreak to ensure that vulnerable
communities and staff who work with them who are more at risk of infection are able to access relevant supplies.
Exposure of health care workers and broader community members to the virus and other pathogens will be reduced
with the proper use of high quality PPE and its safe disposal in a manner which meets GIIP for healthcare waste
disposal.
The Community Health and Safety risks associated with the project will all be addressed in the ESMF for the
Emergency Response Project and this will be documented in the Environmental and Social Commitment Plan (ESCP)
and therefore in the loan agreement.
ESS5 Land Acquisition, Restrictions on Land Use and Involuntary Resettlement
No land acquisition will be required.
ESS6 Biodiversity Conservation and Sustainable Management of Living Natural Resources
Aug 20, 2020 Page 7 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
No construction or other physical activities are proposed by this project.
ESS7 Indigenous Peoples/Sub-Saharan African Historically Underserved Traditional Local Communities
ESS7 is considered relevant as the personal protective equipment and other supplies proposed to be purchased with
RETF funds will be distributed/used in accordance with the procedures governing the Emergency Response Project
and, accordingly, will consider the specifc needs of ethnic minority people. The project is nationwide and therefore
supply of equipment and medicine may apply to areas where ethnic Kazakh reside in the western part of Mongolia
and speak and read in Kazakh language. Similarly, it may apply to indigenous herder communities in some remote
rural areas. Measures to ensure awareness, enhance participation, and minimize risk for these groups are included in
the SEP and the ESMF for the emergency Response Project. The Indigenous Peoples related risks associated with the
RETF will all be addressed in the social assessment to be included in the ESMF for the Emergency Response Project
and this will be documented in the Environmental and Social Commitment Plan (ESCP) and therefore in the loan
agreement
ESS8 Cultural Heritage
This standard is currently considered Not Relevant as the project is not expected to support any construction or
rehabilitation activities that would involve the movement of earth or other activities that could have an impact on
Public Disclosure
intangible cultural heritage.
ESS9 Financial Intermediaries
No FI proposed.
C. Legal Operational Policies that Apply
OP 7.50 Projects on International Waterways No
The Project will not affect international waterways
OP 7.60 Projects in Disputed Areas No
The project will not be in or near disputed areas.
III. BORROWER’S ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP)
DELIVERABLES against MEASURES AND ACTIONs IDENTIFIED TIMELINE
ESS 1 Assessment and Management of Environmental and Social Risks and Impacts
Aug 20, 2020 Page 8 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
The MoH will commit to managing E&S risks in accordance with the ESMF, SEP and other instruments
being prepared to manage E&S risks associated with MONGOLIA COVID-19 EMERGENCY RESPONSE 10/2020
AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799).
The existing E-Health Project Implementation Unit, which will also manage the MONGOLIA COVID-19
EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT and the new RETF project, will
10/2020
be staffed with relevant experts including bio-medical engineer, environment and occupational health
specialist, risk communication and community engagement officer.
Prepare and submit to the Association regular monitoring reports on the environmental, social, health
and safety (ESHS) performance of the Project, including but not limited to, stakeholder engagement 10/2020
activities and grievances log.
Assess the environmental and social risks and impacts of proposed Project activities, in accordance an
Environmental & Social Management Framework (ESMF) to be prepared and cleared by the
Association prior to goods and supplies procured under the project being dispensed or used. This
10/2020
ESMF will include measures to ensure that individuals or groups who, because of their particular
circumstances, may be disadvantaged or vulnerable, have access to the development benefits
resulting from the Project.
Prepare, disclose, adopt, and implement any environmental and social management plans or other
instruments required for the respective Project activities based on the assessment process, in
Public Disclosure
accordance with the ESSs, the Environmental, Health, and Safety Guidelines (EHSGs), and other
10/2020
relevant Good International Industry Practice (GIIP) including the WHO guidelines on Risk
Communication and Community Engagement, Migrant camps and camp-like settings; Guidance for
schools, workplaces & institutions
Incorporate the relevant aspects of this ESCP, including, inter alia, any environmental and social
management plans or other instruments, ESS2 requirements, and any other required ESHS measures,
10/2020
into the ESHS specifications of the procurement documents and contracts with suppliers. Thereafter
ensure that the suppliers comply with the ESHS specifications of their respective contracts.
The following type of activities shall not be eligible for finance under the Project: causing long term,
permanent and/or irreversible (e.g. loss of major natural habitat) adverse impacts; serious adverse
effects to human health and/or the environment other than during treatment of COVID-19 cases; 10/2020
significant adverse social impacts and may give rise to significant social conflict; affecting lands or
rights of indigenous people/vulnerable minorities; may involve permanent resettlement;
Capacity Support Training: Training topics for personnel involved in the implementation of Project
activities will among others include:
• COVID-19 Infection Prevention and Control Recommendations Laboratory biosafety guidance related 10/2020
to the COVID-19
• Specimen collection and shipment
• Standard precautions for COVID-19 patients
Aug 20, 2020 Page 9 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
• Risk communication and community engagement
• Medical and hazardous waste management
ESS 10 Stakeholder Engagement and Information Disclosure
Update, disclose, adopt, and implement a Stakeholder Engagement Plan (SEP) consistent with ESS10,
10/2020
in a manner acceptable to the Bank/Association.
Accessible grievance arrangements shall be made publicly available to receive and facilitate resolution
of concerns and grievances in relation to the Project, consistent with ESS10, in a manner acceptable to 10/2020
the Bank/Association
ESS 2 Labor and Working Conditions
The Project shall be carried out in accordance with the applicable requirements of ESS2, in a manner
10/2020
acceptable to the Association.
The Recipient shall prepare, adopt and implement a Labor Management Plan (LMP) in a manner and
10/2020
substance acceptable to the Bank/Association.
The Borrower/Recipient shall implement adequate occupational health and safety measures (including
emergency preparedness and response measures) in line with the ESMF, the applicable requirements 10/2020
of ESS2, the ESHGs and other relevant GIIP.
Public Disclosure
The Borrower/Recipient shall ensure that all health workers adhere to the WHO Code of Ethics and
10/2020
Professional conduct.
The Borrower/Recipient shall establish a grievance hotline and assignment of focal points to address
10/2020
these grievances within MoH.
The Borrower/Recipient will prohibit child labor (any person under the age of 18) due to the hazardous
10/2020
work situation.
ESS 3 Resource Efficiency and Pollution Prevention and Management
Relevant aspects of this standard shall be considered, as needed, under action ESS 1 above, including,
inter alia, measures to manage health care wastes and other types of hazardous and non-hazardous 10/2020
wastes.
ESS 4 Community Health and Safety
Relevant aspects of this standard shall be considered, as needed, under ESS 1 above 10/2020
ESS 5 Land Acquisition, Restrictions on Land Use and Involuntary Resettlement
Not relevant
Aug 20, 2020 Page 10 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
ESS 6 Biodiversity Conservation and Sustainable Management of Living Natural Resources
Not relevant
ESS 7 Indigenous Peoples/Sub-Saharan African Historically Underserved Traditional Local Communities
Relevant aspects of this standard shall be considered, as needed, under ESS 1 above 10/2020
ESS 8 Cultural Heritage
Not relevant
ESS 9 Financial Intermediaries
Not relevant
B.3. Reliance on Borrower’s policy, legal and institutional framework, relevant to the Project risks and impacts
Is this project being prepared for use of Borrower Framework? No
Areas where “Use of Borrower Framework” is being considered:
The borrower framework is not considered to manage this emergency operation
Public Disclosure
IV. CONTACT POINTS
World Bank
Contact: Dinesh M. Nair Title: Senior Health Specialist
Telephone No: 5788+7786 / 86-10-58617786 Email: dnair@worldbank.org
Contact: Anna L Wielogorska Title: Lead Procurement Specialist
Telephone No: 5777+7320 / 84-243-9367320 Email: awielogorska@worldbank.org
Contact: Pagma Genden Title: Operations Officer
Telephone No: 5725+8243 / 976-70-078243 Email: pgenden@worldbank.org
Borrower/Client/Recipient
Borrower: Mongolia
Implementing Agency(ies)
Implementing Agency: Mongolia Ministry of Health
Aug 20, 2020 Page 11 of 12The World Bank
Mongolia PEF support for COVID-19 (P174571)
V. FOR MORE INFORMATION CONTACT
The World Bank
1818 H Street, NW
Washington, D.C. 20433
Telephone: (202) 473-1000
Web: http://www.worldbank.org/projects
VI. APPROVAL
Task Team Leader(s): Anna L Wielogorska, Dinesh M. Nair, Pagma Genden
Practice Manager (ENR/Social) Susan S. Shen Cleared on 18-Aug-2020 at 22:07:55 EDT
Public Disclosure
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