One WASH Fund November 2019 - International Federation of Red Cross and ...
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I. Background The Humanitarian and Development Sector provide a shared founda- tion for social and economic justice that can contribute to shared pros- perity through the principles of inclusive participation and risk sharing, and achievement of the Sustainable Development Goals (SDGs). The Islamic Development Bank (IsDB) and the International Federation of Red Cross and Red Crescent National Societies (IFRC) together developed an innovative approach involving development finance, humanitarian aid and private capital investment to support One WASH programs and contribute towards achieving the SDGs. As a priority the IsDB and the IFRC have set themselves the ambitious objective of contributing to the reduction of Cholera related deaths by 90% in the most affected Organization of Islamic Cooperation (OIC) States, over the next 10 years. This objective contributes not only to SDG 6 (Clean Water and Sanitation) but also SDG 3 (Good Health and Wellbeing), SDG 5 (Gender Equality), SDG 13 (Climate Action) and SDG 17 (Partnership for the Goals) and aligns with the Global Task Force for Cholera Control (GTFCC) ‘Cholera Roadmap’. The funds required for delivering on SDGs and the Cholera Roadmap will require innovative and transformative forms of financing beyond traditional humanitarian aid or development finance responses. To achieve this vision, IsDB and IFRC are creating a multi-million-dollar fund (the One WASH Fund) to combat cholera and other diarrheal diseases as part of the Global One WASH Initiative targeting 40 cholera hotspots globally. Specifically, the One WASH Fund will finance One WASH Programs in 29 OIC member states where it aims to impact the lives of 5 million people by strengthening and integrate the delivery of water, sanitation, and hygiene (WASH) with health services building upon well proven methodologies being practiced by the IFRC at the grass roots level. The One WASH Fund uses an innovative financing mechanism de- signed to attract new philanthropic and private investor capital in addition to traditional humanitarian donor financing. Primarily, the model seeks to blend outcome-based financing with grant financing in a structure that will position participating funders and stakeholders ahead of the innovative financing curve and suggests a new approach to humanitarian development organizations resource mobilization. 3
II. THE PROBLEM The 2017 mapping of the “Progress on drinking water, sanitation and SNAPSHOT hygiene” from the Joint Monitoring Program (WHO/UNICEF) states that 844 million people still lack access to an improved water supply, 2.3 billion lack basic sanitation and 159 million people still collect drinking 2.3 billion water from unprotected sources. People still lack In addition, 47 per cent of people in less developed countries have no even a basic hand-washing facilities1. The resulting and continuing negative health sanitation service impact of unsafe water, poor sanitation and hygiene practices place a heavy burden on individuals, families, communities and governments due to the added cost of health care and loss of productivity. Lack of 844 million sanitation, contaminated water and poor hygiene contribute to almost People still lack 90 per cent of child deaths from diarrheal diseases (289,000 children every year)2 and these factors are major causes of the spread of other a basic drinking acute diseases, particularly cholera. Further, lack of adequate sanitation water service and water supply costs $260 billion every year in economic losses (World Bank estimate) and poses greater risks of epidemics and political crises exacerbated by climate change. 159 million People still c†ollect Why Cholera? drinking water Cholera continues to disproportionately affect the poorest and most from unprotected vulnerable communities in high-risk countries. Cholera spread, inci- sources dence and severity are exacerbated by rapid and often unplanned urbanization and population growth, by climate change, food insecu- rity, extreme weather events or trends and complex settings, especially where conflict and unrest are present, and health and WASH services One WASH are weak. objective • There are an estimated 2.9 million cholera cases and 95,000 #ENDCHOLERA deaths per year globally3. related deaths • 89 million people live in cholera “high-risk” areas in Africa by 90% in the alone. most affected OIC member • Providing access to basic WASH services requires between countries, by 2030 USD 40 and USD 80 per person4. 1 https://www.globalwaters.org/resources/assets/handwashing-soap-where-are-we 2 https://www.wateraid.org/uk/media/world-health-assembly-cholera-resolution-a-vi- tal-next-step-towards-prevention-but-promises 3 Global Task Force on Cholera Control – GTFCC 4 https://sustainabledevelopment.un.org/content/documents/hlpwater/13-UniversalAccess. pdf 4
III. THE SOLUTION – ONE WASH PROGRAMME WASH and It is estimated that every 10 seconds someone is infected with Cholera. And every case and death from cholera is preventable with the tools Cholera we have today: effective cholera prevention and control interventions are well established. However, current efforts focus more on emer- Every 10 seconds, gency response that have less of an impact on long-term control or someone is infected elimination of cholera. A proven solution exists in linking public health, with cholera vaccination and long-term WASH. All these components are needed to eventually eliminate cholera. There are 95,000 preventable The roadmap to end cholera is based on a multi-sectoral approach that has been defined by the Global Task Force for Cholera Control (GTFCC) deaths from who with other partners and stakeholders, including the International cholera every year Federation of Red Cross and Red Crescent Societies (IFRC), has adopted. Bringing WASH Over the past 12 years, the IFRC and its membership have significantly and public health scaled up delivery of longer-term water and sanitation programs together to through the Global Water and Sanitation Initiative (GWSI). The GWSI promotes a common but adaptable approach amongst National Red fight cholera Cross Red Crescent Societies to establish large-scale, long-term sustain- able water and sanitation Programs. The Initiative provides equitable, affordable and sustainable solutions to help improve the health and quality of life of vulnerable communities. Additionally, it is estimated that every $1 spent gives a return of $4.305 in developmental impact. IFRC Global Water and The IFRC have reached more than 20 million people between 2005 and 2017 through the GWSI and a further 16 million through emergency Sanitation WASH services by delivering over 750 projects and operations in over 80 countries and is committed to use this capacity to contribute to Footprint cholera elimination. 36 million The One WASH Objective: People reached Align the expected outcomes and impact of the ‘One WASH’ Initiative with the GTFCC ‘Cholera Roadmap’ and by doing so contribute to ‘reduc- with WASH ing cholera related deaths by 90% by 2030’. Concurrently, ‘One WASH’ infrastructure and programming will reduce vulnerability to and incidence of cholera and services since 2005 Acute Watery Diarrhoea (AWD) outbreaks, their severity and resultant morbidity in recognised ‘hot spots’ while further contributing, by deliv- ering integrated WASH and public health interventions, to SDG’s 3, 5, 6 and 17 while indirectly contributing to other cross cutting goals related Sustainable to climate action, WASH related diseases and malnutrition and overall Development poverty reduction. This global initiative intends to reach a minimum of 7 million ‘high risk’ people within the first five years expanding to over Goals 12 million people by 2030. contribution The One WASH Fund, to be managed by IsDB and IFRC for target coun- tries in the OIC that are affected or at risk from cholera and AWD, a minimum of over 25 countries are targeted within which over 5 million people are targeted in the first five years to be expanded to over 10 million by 2030. 5 https://www.who.int/water_sanitation_health/publications/glaas_report_2014/en/ and https://news.un.org/en/story/2014/11/484032-every-dollar-invested-water-sanitation-brings- four-fold-return-costs-un 5
(In addition to OIC member countries, the Global One WASH initiative targets as well non OIC cholera endemic countries which will reach an additional minimum of 2 million ‘high risk’ people.) IV. WHY INNOVATIVE FINANCE Globally, there has been remarkable economic and social progress in the past two decades. This prosperity, however, is unevenly distributed and the next tranche of gains are threatened by persistent develop- ment challenges exacerbated by prolonged crisis, climate change and rising inequality. The relative importance of drivers of economic growth and prosperity has evolved over time, and, for a growing number of countries, innovation in its many dimensions is emerging as a leading factor. SDGs Require Unlocking New Funding Sources SDGS FINANCING GAP ($ TRILLION) 4.5 DEMAND X3 $3T 1.4 = ~1.5% OF PRIVATE CAPITAL CAN FILL 0.1 ANNUAL CAPITAL CURRENT ANNUAL ODA THE SDG GAP NEEDS FOR SDGS INVESTMENT ~1.5% HARNESSING PRIVATE CAPITAL SOURCES ($ TRILLION THIS CAPITAL REQUIRES A × 121 NEW RESOURCE MOBILISATION SUPPLY MODEL $210T 34 26 25 6.3 BANK PENSION INSURANCE TNCS SWFS ASSETS FUNDS Governments’ ability to strategically mobilize various sources of financ- ing for social purposes remains constrained and many traditional donors around the world are dealing with fiscal pressure that exacerbates the reality of limited Official Development Assistance (ODA). UN estimates suggest that developing countries will need more than $2.5 trillion a year to fill the SDG financing gap while the total ODA does not exceed $150 billion. Compare this to private capital sources alone amounting to more than $200 Trillion and it is clear that an increasing contribution of funds to achieve the SDGs must come from non-government sources. Much has been written about the urgent need for new sources and forms of finance for development as a complement to ongoing public financing efforts. True enough, of recent times, we are finding the 6
emergence of several new financing models, growing both in terms of their market size, their operations and the way they serve those in need, as a new alternative. Development Impact Bonds (DIBs) are perceived as an innovative model that seeks to unlock private capital and help further leverage public funding while at the same time realigning interests of various partners around an objective: focus on defined and measurable out- comes. We believe the model is promising especially to achieve impact by focusing on outcome delivery for a multi country programme like One WASH. However, DIBs in its current form carries several limitations and falls woefully short of meeting expectations of donors: 1. Yet to prove their scalability – of the 166 impact bonds in 30 countries, only an average of 13,231 beneficiaries have been served while half of impact bonds have so far served fewer than 480 people. 2. Do not serve countries most in need i.e. low and middle-in- come countries (LIC and MIC), of the total issued more than 70% are in the US – UK and the total issuance amount of the few instruments for developing countries so far does not exceed $50 million, and fails to meet the critical financ- ing gap of development and humanitarian needs globally. 3. Costs are high and therefore does not truly unlock private capital as claimed since returns are paid to the investors who take on the implementation risk. Based on our analysis, we identified that the critical obstacle in the modality of outcome focused instruments is the shift of risk from the commissioner to the investors in DIBs that prevents their flourishing, with the following assumptions: 1. The financial markets are not familiar with the outcome achievement risk of a humanitarian or development assis- tance project in low and middle-income countries, 2. Because they are not familiar with this risk, they tend to price it very high or refuse to engage with it, 3. The lack of investors willing to engage limits the potential of scaling the use of DIBs that are exclusively subscribed by a small group of social investors, in many cases they are initially donors themselves, ready to subsidize the structure for the development impact to be achieved, 4. The mix of investment for return and subsidy (grant) in a single instrument creates confusion about the role of the social investors and how much grant they are contributing. 5. It also challenges the popular affirmation that the DIBs in their current form mobilize private sector contribution for humanitarian and development as the subsidy portion remains undefined. It was therefore clear that the current construct of DIBs considered innovative required further innovation to truly achieve impact at scale. 7
The challenge: a small market focused on developed countries 33 30 67 3 4 9 5 25 4 50 75 11 A TOTAL OF 161 BONDS FOR 400M US$ Source: The New Humanitarian - Brookings Institution Global Impact Bond Database, August 1, 2019 V. The One WASH Fund The One WASH Fund is the product of a strong partnership between IsDB, a multilateral development bank with 44 years of experience in providing support to its 57 member countries to achieve social and eco- nomic development in the framework of the SDGs, with a strong exper- tise in financial engineering; and IFRC, an international organization that federates the efforts of the Red Cross and Red Crescent Societies with over a 100 years of activity with a strong track record in WASH and cholera control project implementation all around the world including high risk areas. The joint vision for the One WASH Fund is triggered by the basic ques- tion of: how can DIBs work at scale for LICs MICs and bring additionality in terms of grant financing? The One WASH Fund proposes an innovative grant capital blending approach that ambitions to address some of the main criticisms of the DIBs model by defining an adapted role for each partner involved in the structure. The structure is based on the understanding that tra- ditional donors are more familiar with the outcome non-delivery risk of a humanitarian or development project in a low- or middle-income country and therefore are more relevant to take this risk versus inves- tors. The grant capital – not conditional to outcome delivery and paid upfront – and the guarantees – covering the outcome non-delivery risk – are blended with the outcome funding to absorb the outcome non-delivery risk externalized by outcome funders that is usually, in traditional impact bond structures, shifted to investors. 8
The One WASH Fund internalizes the outcome non-delivery risk and shifts only credit risk of outcome funders and guarantors to investors that are by nature more familiar with credit risk and willing to take it when it matches their available allocations. This mechanism allows to expect for a broader investor base versus the limited social investor base usually targeted by traditional impact bonds. With these innovations on existing DIB models, the financial model of this outcome fund proposes to allocate to each stakeholder in the structure a role that better fits its natural role and experience, as follows: • Donors Leverage: The grant donors and guarantors are absorb- ing the outcome non-delivery risk shifted by outcome funders to enable the structure and are leveraging on their grant contri- bution for a minimum of 1 to 5 ratio. • Outcomes Driven Structure: The outcome funders commit only for defined KPIs and drive the Fund strategy towards an out- come-based implementation that generates better monitored and quantifiable impact while being involved in a structure that ultimately allocates more of their contribution to project activities versus payment to investors. • Investors Credit Risk Allocation: The investors are only exposed to the credit risk of outcome funders and guarantors, a risk they are familiar with and can easily price and engage in. In summary, compared to existing DIB occurrences of 3 LIC / 6 MIC for a volume of $37million, the One WASH Fund and Sukuk instead pro- poses 29 countries (22 LIC / 7 MIC), with a total programming volume of $160million. The One WASH Fund Financial Markets Sukuk Donors Grants Guarantors Guarantees ONE WASH FUND Trustee A L Grants Projects Outcome Guarantees Sukuk Commitments Implementation Funders Commitments *This is not an accounting approach but just an illustration where assets are understood as assets backing the Sukuk (or inputs to the fund) and liabilities as outputs of the fund. 9
VI. The One WASH Sukuk The Fund will seek to mobilize resources, principally on commercial basis from the international capital markets. One WASH SUKUK term sheet Obligor ONE WASH FUND Obligor Type Trust Fund under IsDB Article of Agreement Art. 11, 13, 14 and 23 Credit Risk Philanthropic Capital (Donors, Outcome Funders and Guarantors) Credit Risk Type Bilateral Development Agencies, Institutional Donors, International Foundations, Multinational Corporate Donors Underlying Contract Mudaraba Shariah Pronouncement IsDB Shariah Board Expected Issue date First quarter 2020 Expected Sukuk Issue US$ 80.000.000,00 Final Maturity Date 8 years after issue date Sukuk Type Bullet Payment Mark-up Payment Fixed at X per cent. per annum, payable semi-annually Notional Payment Callable at 5 years / 7 years / 8 years VII. Value Proposition Exposing Investors to Credit Risk By blending traditional donor financing and guarantees with outcomes funding, the fund absorbs the implementation risk amongst donor partners familiar with WASH implementation therefore exposing investors only to credit risk. This allows for the model to be accessible to capital investors and provides them a more familiar risk return match. Ensuring additionality of capital As investors are only exposed to credit risk, it not only optimizes the cost of the bond but also ensures that any upside paid for overperformance stays within the fund unlocking additional capital for continued WASH programming. Scalability of impact With the convergence of the above, the model is uniquely placed to ensure channeling of resources to communities most in need and enable scalability of impact For endemic diseases like Cholera, an inte- grated multi country programmatic approach that targets well defined disease ‘hotspots’ to scale provides a realistic opportunity to improve not only the expected overall impact of One WASH but also the efforts of other local national and international stakeholders. Incentivize over-performance In case the implementing agency over-perform, the upside for over-per- formance is paid to the Fund instead of being paid to the investors (in a traditional impact bond set-up) and all amounts paid to the Fund are ultimately used to finance additional WASH projects. This way, the 10
implementing agency has additional funds for projects as a way to incentivize it to overperform. Enhanced Data and Monitoring Providing more time and resources during pre-inception and planning phases of projects goes beyond standard developmental good practice and ensures investments at a systems level are put to their best use in the whole planning cycle. This investment in better planning helps to better define the processes required for better project delivery, setting of targets and creating a more positive internal and external enabling environment tailored to any specific context. It also ensures that the systems required for more robust verification of outcomes and a more easily measurable evidence base is clear from the beginning and roles and responsibilities of all stakeholders are adequately defined. Reduced aversion to high risk areas A criticism often documented is that outcomes or results-based mod- els are known to create to some extent a ‘risk averse’ response. This is not favorable to mandates of reaching the most vulnerable or ‘high risk’ communities in fragile and complex settings. In response, by introduc- ing a ‘weighting’ when setting both expected outcomes and outputs ensures instead that impact is maximized without setting unachieva- ble targets especially in such scenarios. The intended value therefore is to reduce the likely consequences of recognized implementation risks rather than avoid risks or enable low setting of targets that do not encourage over performance. Economies of Scale In addition to strengthening impact at scale, a portfolio of projects approach especially on WASH infrastructure is crucial if economies of scale are to be realized and impact and sustainability achieved. Hardware procurement and contracting alone done at scale reduce costs significantly without creating increased transaction, administra- tion or overheads costs. VIII. OPERATIONS The Program will combine investments in WASH and public health interventions especially in recognized cholera and AWD ‘hotspots’ and will target prevention, resilience building and outbreak-response preparedness activities. Health and hygiene behaviour change communication and marketing programs will also be implemented in target communities, including advocacy and support to cholera vaccination campaigns when planned or implemented. In terms of budget allocation, in most cases a significant portion of the investment will be in increasing sustainable WASH infrastructure or ‘hardware’ access typically representing as much as 50% of the budget allocation per project, the remainder directed to the to the public health, behavioural change “software” and project support activities. Following established best practice in Developmental and Sustainable WASH Programming, the Program will follow the Operational Norms as 11
follows, however with some country specific considerations according to context: Program Phase Description Timeline A Initial Consultation Consultation with Government, stakeholders and other 2-3 months actor in agreement with them identify target areas for One WASH Programming in any given country. Target areas identified are considered ‘at high risk’ from cholera/AWD or are recognized cholera/AWD ‘hot spots’. Secondary data will provide data on incidence severity and occurrence of cholera/AWD but also on WASH coverage and access to Primary Health Care which will aid specific project design and components according to context. B Project & Budget Approval Final detailed base line, proposal and budget approved 2-3 months by Governments and One WASH Steering Group and project inception date agreed upon. C Project inceptions Project inceptions/set-up varying according to context. 6 months During this period staff, volunteers and project team established and first ‘software’ teams mobilized and become active. Local office, logistics and procurement established. D Primary Implementation Primary Project Implementation Period (during which 3-5 years regular finance and narrative reporting undertaken (every 6 months); Mid-term review; end-line review. Regular steering group and stakeholder meetings under- taken. Combined ‘software’ and ‘hardware – infrastruc- ture works’ delivered and the Operation, Maintenance and management structures and capacities. Quality assurance mechanisms. E Wind-up Project wind-up and final handover and plans for 2-3 years post-implementation M & E framework agreed upon. F Lookback Lookback study and measurement of project outcomes. 3 years IX. EXPECTED OUTCOMES The Program has four cholera reduction Outcomes that are linked to SDG 3 and 6 and the GTFCC Cholera Roadmap. Each ‘One WASH’ Project will be designed specifically to meet the contextual requirements in each target area and country though all projects will have a similar generic approach, time frame and set of outputs and outcomes. It should be recognized at the outset that the target areas have at present in most cases exceptionally poor access to WASH services and this combined with poor knowledge of key public health awareness and practices relative to cholera and AWD identifies these target areas as cholera ‘hotspots’ or populations at ‘high risk’ from cholera. Most target areas will already have a history of recurring cholera or AWD outbreaks. As reflected in KPI 1 Outputs will be measured as an increase in access to WASH services for the target population. That is increasing access to a safe or improved water supply and basic sanitation to those presently unserved in the target area to reach an overall minimum of 80% of the total population. 12
This will be investment in WASH infrastructure typically construction of water supplies and sanitation systems (borehole drilling; surface water intakes; water treatment; water storage and distribution systems – con- struction of latrines and toilets; sewerage systems; sewerage treatment; training of WASH operations and maintenance staff). This will target the general population but also schools and health structures, such as clinics, in the target area. Outcomes will be measured by proxy accepting the fact that the overall health, incidence of disease, well-being and productivity of a targeted population will improve significantly if WASH coverage is increased to reach a minimum of 80% of the target population and preferably above that threshold if practical. As reflected in KPI 2 Outputs will be measured as an increase in the knowledge of WASH diseases especially cholera; increase in the knowledge, preparation and use of Oral Rehydration Solution; increase in the knowledge and acceptance of the use of Oral Cholera Vaccine when applicable; improvement in hygiene practices especially hand-washing, safe water and food storage and other personal and household hygiene habits; establishing community based cholera surveillance; establishing com- munity based cholera preparedness and response capacities (together with Government and other actors). The whole target population in the target area will be reached by public health campaigns (at house- hold. community level and in schools) primarily through the local Red Crescent or Red Cross Volunteer and Branch network including media campaigns and interaction with local Government, traditional and religious leaders and other actors. Outcomes will be measured by proxy accepting the fact that if the entire target population including schools is reached by this intensive public health campaign and over a five-year period their awareness of and participation in cholera prevention control and reduction will be achieved. 13
One WASH Generic KPI’s Outputs and Outcomes. Output Base line Output Means of Outcome Means of Outcome data at Project measured at Verification. Base line data Verification and measured at inception End-Line at Project data collection End-Line and Inception at Base line an 3 years beyond End-Line. End-Line at ‘Look Back’ KPI 1: Increase 1.1 – % of Target Pop- 1.1 – % increase in Scientific Sampling # of recorded cholera Secondary data from % reduction in access to sustaina- ulation with access Target Population Methodology (field or AWD outbreaks in Government, UNICEF, cholera and AWD ble WASH services to safely managed with access to safely survey). the Target Population WHO and other outbreak inci- (Water Supply) to the drinking water ser- managed drinking in the previous WASH and Health dence in the Target target population by vices or an improved water services or an Mid-Term, End-line 10 years or more actors/sources. Population WASH infrastructure drinking water improved drinking Reviews, ‘Look Back’ (Incidence of development. source (according to water source (ac- Studies. outbreaks) Clinical data from % reduction Cholera context) cording to context) the target area if and AWD related Scientific Sampling # of recorded cholera available. deaths in the 1.2 – % water sources 1.2 – % increase in Methodology (field or AWD deaths in the Target Population. meeting national wa- water sources meet- survey). Target Population Red Cross and Red ter quality standards ing national water in the previous ten Crescent cholera and % reduction in in the target area quality standards in Mid-Term, End-line years or more reflect- AWD Emergency Re- scale of suspected the target area Reviews, ‘Look Back’ ed in Case Fatality sponse Operational Cholera and AWD Studies. Rate CFR. (Severity Reporting. cases in the Target of outbreaks) Population. Mid-Term, End-line # of recorded Reviews, ‘Look Back’ suspected cholera Studies. or AWD cases in the Target Population in the previous ten years or more (Scale of out- breaks) KPI 1: Increase 1.3 – % of Target Pop- 1.3 – % increase in Scientific Sampling Ditto Ditto Ditto access to sustaina- ulation with access Target Population Methodology (field ble WASH services safely managed san- with access to safely survey). (Sanitation) to the itation services or to managed sanita- target population by improved sanitation tion services or to Mid-Term, End-line WASH infrastructure facilities (according improved sanitation Reviews, ‘Look Back’ development. to context) facilities (according Studies. to context) 1.4 – % Target Scientific Sampling Population with a 1.4 – % increase in Methodology (field handwashing facility Target Population survey). with soap and water with a handwashing on premises facility with soap and water on premises 14
Output Base line Output Means of Outcome Means of Outcome data at Project measured at Verification. Base line data Verification and measured at inception End-Line at Project data collection End-Line and Inception at Base line an 3 years beyond End-Line. End-Line at ‘Look Back’ KPI 2: Target popula- 2.1 – % of Target 2.1 – % increase of Scientific Sampling Ditto Ditto Ditto tion benefitting from Population with Target Population Methodology (field public health and knowledge and with knowledge and surveys) community- based awareness of cholera awareness of cholera interventions and and AWD symptoms and AWD symptoms Knowledge Attitude campaigns in cholera and common means and common means and Practices Survey and AWD awareness of transmission of transmission and mitigation. Secondary Data from 2.2 – % of Target 2.2 – % increase of Government, UNICEF, Population familiar Target Population WHO and GTFCC. with the importance familiar with the of using safe drinking importance of using Mobile Phone based water and storage, safe drinking water data collection using latrines or and storage, using system toilets and hand latrines or toilets Household Surveys washing at crucial and hand washing at and Focus Group times crucial times Discussions. 2.3 – % of Target 2.3 – % increase of Mid-Term, End-line Population with Target Population Reviews, ‘Look Back’ knowledge on the with knowledge on Studies. preparation and use the preparation and of Oral Rehydration use of Oral Rehydra- Red Cross/Red Solution or Salts tion Solution or Salts Crescent Volunteer (ORS) (ORS) Data Base. 2.4 – % of Target 2.4 – % increase of Population with Target Population knowledge of Oral with knowledge of Cholera Vaccine Oral Cholera Vaccine (OCV) (OCV) 2.5 – % of Population 2.5 – % increase of willing to accept OCV Population willing to if offered accept OCV if offered 2.6 – % of Target 2.6 – % increase of Population having Target Population received OCV in the having received OCV last three years in the last five years if they have been 2.7 – % of Target offered OCV Population registered and trained as Red 2.7 – % increase in Cross or Red Cres- Target Population cent health and/or registered and WASH Volunteers trained as Red Cross or Red Crescent health and/or WASH Volunteers * WASH coverage target will be increasing the coverage at baseline (typically between 30 and 60% for water and sanitation access) to a minimum of 80% coverage for the whole population at end line (year 5). Reaching that minimum 80% overall WASH coverage is represented here by achieving 100% of the target in the table. Every effort will be made to exceed that minimum target. 15
X. GEOGRAPHICAL FOCUS The Program is focused on the communities with the highest risks of cholera and other diarrheal outbreaks. Off the 29 OIC countries recog- nised as Cholera or AWD endemic that are targeted, a prioritisation analysis, based on available data on magnitude and urgency of needs, project readiness and country contexts, yielded a start up for 26 OIC countries within the next 2 to 3 years. * The list below is indicative and subject to final revisions upon field level appraisal of initial project concepts. 16
One WASH Projects for OIC Countries, Summary of Project Concept Notes (PCN’s): Region Country Project Contribution Proposed con- Total Proposed Proposed Number Number from IFRC and tribution from Project Budget Inception of people partners (20%) the One WASH USD Year (2020, targeted in USD Fund (80%) in 2021 or USD 2022) Africa Benin 001 290,400 1,161,600 1,452,000 2020 48,400 Burkina Faso 002 1,200,000 4,800,000 6,000,000 2020 150,000 Cameroon 003 2,300,000 9,200,000 11,500,000 2020 300,000 Comoros 004 600,000 2,400,000 3,000,000 2020 85,700 Cote d’Ivoire 005 660,000 2,640,000 3,300,000 2021 83,000 Guinea (Conakry) 006 1,000,000 4,000,000 5,000,000 2021 120,000 Mali 007 2,128,000 8,512,000 10,640,000 2020 250,000 Mauritania 008 400,000 1,600,000 2,000,000 2021 65,000 Mozambique 009 3,000,000 12,000,000 15,000,000 2020 250,000 Niger 010 4,620,000 18,480,000 23,100,000 2020 1,500,000 Nigeria 011 (900,000)* 3,600,000 4,500,000 2021 120,000 Sierra Leone 012 1,600,000 6,400,000 8,000,000 2020 200,000 Somalia 013 1,500,000 6,000,000 7,500,000 2020 200,000 Sudan 014 1,090,000 4,360,000 5,450,000 2021 120,000 Tchad 015 1,217,600 4,870,400 6,088,000 2020 173,000 Togo 016 600,000 2,400,000 3,000,000 2020 75,000 Uganda 017 1,200,000 4,800,000 6,000,000 2020 150,000 Asia/Pacific Afghanistan 018 1,000,000 4,000,000 5,000,000 2021 149,000 Bangladesh 019 1,026,375 4,105,500 5,131,875 2020 125,000 Pakistan 020 800,000 3,200,000 4,000,000 2021 120,000 Tajikistan 021 490,000 1,960,000 2,450,000 2020 70,000 MENA Algeria 022 1,000,000* 4,000,000 5,000,000 2021 80,000 Iraq 023 3,246,096 12,984,384 16,230,48 2020 350,000 Libya 024 2,000,000* 8,000,000 10,000,000 2022 120,000 Syria 025 9,936,590 39,746,360 49,682,950 2020 1,500,000 Yemen 026 2,000,000 8,000,000 10,000,000 2021 350,000 Total 45,805,061 183,220,244 229,025,305 — 6,754,100 USD USD USD Persons * All figures remain provisional at present subject to further review. 17
#ENDCHOLERA CONTACTS Mohamed Habib Ansari, Lead Strategist, IsDB – MAnsari@isdb.org Mohamed Amine Hillal, Lead Alternative Development Finance, IsDB – MHillal@isdb.org Ramya Gopalan, Global Innovation & Innovative Finance Coordinator, IFRC – ramya.gopalan@ifrc.org Simon Meldrum, Investment Specialist, IFRC and British Red Cross – smeldrum@redcross.org.uk Partners: 18
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