1. health and fitness
2. disease
3. cold and flu

Document of
The World Bank
FOR OFFICIAL USE ONLY
Report No: T7676
TECHNICAL ANNEX
ON A
PROPOSED CREDIT
IN THE AMOUNT OF SDR 3.3 MILLION
(USD 5.0 MILLION EQUIVALENT)
TO
BOSNIA AND HERZEGOVINA
FOR AN
AVIAN INFLUENZA PREPAREDNESS PROJECT
UNDER THE
G OBAL PROGRAM FOR AVIAN INFLUENZA AND HUMAN PA JDEh C
PREPAREDNESS AND RESPONSE (GPAI)
FOR ELIGIBLE COUNTRIES UNDER THE HORIZONTAL APL
May 29,2007
This document has a restricted distribution and may be used by recipients only in the
performance o f their official duties. I t s contents may not otherwise be disclosed without
World Bank authorization.
CURRENCY EQUIVALENTS
(Exchange Rate Effective, May 29,2007)
Currency Unit = Konvertible Mark
KM 1.46 = US$l
US$1.51 = S D R l
FISCAL YEAR
January 1
-
December 3 1
ABBREVIATIONS AND ACRONYMS
AI
AIPP
APL
BiH
CQ
CF
CP
EA
EC
EMP
ERA
ERL
FA0
FBiH
GDP
GPAI
H5N1
ICB
ILI
MAWMF
MCA
MoFTER
MoE
MoH
M&E
MoF
NCB
NGO
National Competitive Bidding
Non Governmental organization
OIE
PFD
PHI
PPE
World Organization for Animal Health
Program Framework Document
Public Health Institute
Personal Protective Equipment
Contingency Plan
Environmental Assessment
European Commission
Environmental Management Plan
Emergency Recovery Assistance
POM
QCBS
Project Operational Manual
Quality and Cost Based Selection
Emergency Recovery Loan
Food and Agricultural Organization
Federation o f Bosnia and Herzegovina
Gross Domestic Product
Global Program for Avian Influenza and
Human Pandemic Preparedness and
Response
RS
State
svo
Republika Srpska
Bosnia and Herzegovina
State Veterinary Office
TF
UNDP
Trust Fund
United Nations Development Program
USAID
WG
U S Agency for International Development
Inter-sectoral working group
WP
WB
Work Program
World Bank
WHO
World Health Organization
Avian Influenza
Avian Influenza Preparedness Project
Adaptable Program Loan
Bosnia and Herzegovina
Selection based on consultants’
qualifications
Counterpart Financing
Influenza A virus o f H5N1 type
International Competitive Bidding
Influenza-like illness
Ministry o f Agriculture, Water
Management and Forestry
Ministry o f Civil Affairs
Ministry o f Foreign Trade and Economic
Relations
Ministry o f Environment
Ministry o f Health
Monitoring and Evaluation
Ministry o f Finance
Vice President:
Country ManagerDirector:
Sector Manager:
Task Team Leader:
Shigeo Katsu
Orsalia Kalantzopoulos
Marjory-Anne Bromhead
David A. Bontemoo
B O S N I A AND HERZEGOVINA
Avian Influenza Preparedness Project
FOR OFFICIAL USE ONLY
CONTENTS
Page
.
A
.................................................................................
I.
Countly and Sector Background and Global. Regional and National Dimensions ......................................
ii
2.
Rationale for Bank involvement ....................................................................................................................
12
.
............................................................................................................................
13
1.
Lending Instrument .......................................................................................................................................
13
2.
Project Development Objectives .....
3.
Project Components...................................................................................................................................... 14
4.
Lessons learned and rejected in the project design .....................................................................................
17
B
C
D
............11
STRATEGIC CONTEXT AND RATIONALE
PROJECT DESCRIPTION
.
................
............
..................14
.....................................................................................................................................
18
1.
Partnership arrangements ............................................................................................................................
18
2.
Institutional and implementation arrangements
..........................................
19
3.
Monitoring and evaluation of outcornes/results............................................................................................
20
4.
Sustainability........
5.
Critical risks andpossible controversial aspects ......................................................
6.
Credit Conditions .......................................................................................................................................... 22
IMPLEMENTATION
.
APPRAISAL SUMMARY
............
....................................... 20
......21
..............................................................................................................................
23
1.
Economic analysis.........................................................................................................................................
2.
Technical
3.
Social............................................................................................................................................................. 25
4.
Fiduciary
5.
Environment ..................................................................................................................................................
26
6.
Safeguard Policies
....................................
27
7.
Policy Exceptions & Readiness............................................................................................................
..................................... 25
.................................................................................................
Appendix 2a: Detailed Project Description ............................................................................................................
Appendix 2b: Culling and Compensation Procedures..........................................................................................
Appendix 2c: Implementation Arrangements.........................................................................................................
Appendix 3: Project Costs and Financing Arrangements ....................................................................................
Appendix 4: Procurement Arrangements .............................................................................................................
Appendix 1: Results Framework and Monitoring
23
..........24
29
39
49
53
57
59
This document has a restricted distribution and may be used by recipients only in the performance o f
their official duties . I t s contents may not be otherwise disclosed without W o r l d Bank authorization .
............................................................................................
Appendix 6: Environmental and Social Issues.......................................................................................................
Appendix 7: Organization of the Veterinary Services and the Health Care System in B I H .............................
Appendix 8: Project Preparation and Supervision................................................................................................
Appendix 9: Documents in the Project File............................................................................................................
Appendix 10: Statement of Loans and Credits ......................................................................................................
Appendix 11: Country at a Glance ..........................................................................................................................
Annex 12: M a p IBRD 33375R .................................................................................................................................
Appendix 5: Financial Management Arrangements
63
71
73
77
79
83
85
87
BOSNIA AND HERZEGOVINA
AVIAN INFLUENZA PREPAREDNESS PROJECT (AIPP)
TECHNICAL ANNEX
EUROPE AND CENTRAL ASIA
ECSSD
Date: M a y 29, 2007
Country Director: Orsalia Kalantzopoulos
Sector Manager: Marjory-Anne Bromhead
Team Leader: David A. Bontempo
Sectors: General agriculture, fishing and forestry
sector (50%); Health (50%)
Themes: Natural disaster management (P); Other
communicable diseases (P); Rural policies and
institutions (S); Other environment and natural
resources management ( S )
Environmental screening category: Partial
Assessment
Project ID: P 1004 15
Lending Instrument: Emergency Recovery Loan
Project Financing D a t a
[ ] Loan [x ] Credit [IGrant [ 3 Guarantee
[ ] Other:
For Loans/Credits/Others:
Total Bank financing (US$m.): 5 .OO
Proposed terms: Proposed terms (IDA): Standard Credit Modified Terms: 2 0 years to maturity; 10 years
Source
Local
1.2
1.1
2.3
BORROWER
IDA
Total:
Foreign
0.2
3 -9
4.1
Borrower:
Ministry o f Finance and Treasury
Trg. BiHl, 7 1000 Sarajevo, Bosnia and Herzegovina
Responsible Agency: Ministry o f Foreign Trade
Federation Ministry o f Agriculture,
Water Management and Forestry
Sarajevo
Bosnia and Herzegovina
Federation Ministry o f Health
Sarajevo
Bosnia and Herzegovina
and Economic Relations at state level; and:
Ministry o f Agriculture, Water Resources
and Forestry
Republic o f Srpska
Banja Luka
Bosnia and Herzegovina
Ministry o f Health and Social Welfare
Banja Luka
Republic o f Srpska
Bosnia and Herzegovina
Total
1.4
5 -0
6.4
Does the project depart from the CAS in content or other significant respects? Re$
PAD A.3
Does the project require any exceptions from Bank policies?
Re$ PAD D. 7
Have these been approved by Bank management?
- I s approval for any policy exception sought from the Board?
Does the project include any critical risks rated “substantial” or “high”?
Re$ PAD C.5
Does the project meet the Regional criteria for readiness for implementation? Re$
PAD D. 7
[ ]Yes [XINO
[ ]Yes [XINO
]Yes [ IN0
[ ]Yes [XINO
[XIYes [ ] N o
[XIYes [ ] N o
Project development objective
The overall objective o f the Project i s to minimize the threat posed to humans and the poultry industry by
the Highly Pathogenic Avian Influenza (HPAI) infection and other zoonoses, by enhancing both animal
and human health infectious disease response and control capacities. To achieve this, three areas will be
supported by the project: (i)prevention, (ii) preparedness and planning; and (iii)response and
containment. Achieving these goals will contribute to diminishing the burden o f disease and loss o f
productivity, limiting the regional spread o f HPAI, and enhancing economic and social prospects at the
national, regional, and global levels.
Project description [Details can be found in Appendices 2 and 2a]
In addition to the Bank and government co-financing described below, various other international
organizations-including the European Commission (EC), World Health Organization (WHO), United
States Agency for International Development (USAID), United Nations Children’s Fund (UNICEF)-are
active in assisting the Government o f Bosnia and Herzegovina to address the threat o f Avian Influenza.
The Project has been designed in close cooperation with these organizations to leverage the maximum
financing possible and to avoid duplication o f efforts. The complementary activities o f these
organizations are briefly explained below. However, the exact levels o f financing o f these donor activities
i s not presented, as this i s not considered direct cofinancing o f the Bank-funded project (in all
descriptions, IDA total plus the Counterpart Financing (CF) is equal to total Componentjnancing).
Component 1: Strategic Communications and Public Information - U S $0.20 million
Financing
IDA Credit:
US$0.20 million
IDA Credit Proceeds
FBiH:
US$O. 11 million
RS
US$0.09 million
It i s o f critical importance that all sectors o f society are properly informed about the risks from HPAI, in
order that proper protective measures can be taken, and, as importantly, to reduce the risk o f unwarranted
fear about the disease (e.g., unnecessarily reducing consumption o f poultry products). This component
would provide support for a broad range o f information and communication activities, to increase the
attention and commitment o f government, private sector, and c i v i l society organizations, and to raise
awareness, knowledge and understanding among the general population about the risk and potential
impact o f the disease. Implementation o f the first phase o f the communications strategy has already been
completed, through UNICEF’s Sarajevo office. Bank financing would implement subsequent phases.
Component 2: Animal Health Protection and Disease Prevention and Control - U S $2.98 million
Financing
Gov’t. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
US$0.25 million
US$O. 17 million
US$O. 10 million
US$2.46 million
IDA Credit Proceeds
FBiH:
US$1.62 million
RS
US$0.84 million
The most effective way to reduce the threat from HPA, to both the economic sustainability o f domestic
poultry production and human health i s to prevent the disease from establishing i t s e l f in domestic poultry.
This component would support implementation o f disease prevention and control strategies at national and
entity levels to address short, medium and long-term needs. Areas for support are based on detailed
assessments o f (i)the epidemiological status o f H P A I in Bosnia-Herzegovina; (ii)the capacity o f the
State Veterinary Office (SVO) to cope with a highly pathogenic avian influenza (HPAI) epidemic,
including surveillance and diagnostic capacity at the national and entity levels; and (iii)the vulnerability
o f the poultry industry to newly emerging infectious diseases.
Implementation o f the Animal Health component will be assisted by the EC’s Twinning Arrangement
(financed by the Government o f the Federal Republic o f Germany) with the S V O to provide technical
assistance on institutional aspects o f the veterinary sector, particularly in food safety, inspections, and
support to laboratories. The E C will also finance a feasibility study o n large-scale animal waste disposal
Component 3: Human Health Protection, and Disease Prevention and Control - U S $1.98 million
Financing
Gov’t. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
IDA Credit Proceeds
US$0.22 million
US$O.10 million
US$O.lO million
US$1.96 million
PBiH:
RS
US$0.98 million
US$0.98 million
At present, there have been no human cases o f H P A I infection reported in BiH. However, it i s likely that
at some point in the future, suspected or confirmed cases will occur, and rapid and coordinated
interventions will be necessary. Under this component, the project will (a) help enhance the coordination
and planning o f human health related activities, (b) strengthen the capacity o f investigation teams and
virology laboratories in both entities, (c) help BiH rapidly j o i n the European Influenza Surveillance
Network, (d) help develop the capacity o f hospitals to adequately and safely isolate and treat (suspected)
human cases and, (e) finance the procurement o f seasonal flu vaccines and anti-viral drugs. Particular
attention will be paid to capacity building and the training o f staff at the various levels o f the health
system. This component contains support to the Ministry o f C i v i l Affairs at the State level, to enhance
their capacity to fulfill their mandate to coordinate human health policy and response for all of BosniaHerzegovina.
One o f the most crucial activities for preparedness in the Human Health sector i s the finalization o f a
National Contingency Plan (CP), which integrates the CPs already prepared by each Entity. Most
importantly the National CP will define a clear ‘Chain o f Command’ in the event o f a large-scale outbreak
affecting human health. W H O i s leading this effort, through a series o f workshops undertaken in June
2006. The final CP, integrating the two Entity-level plans has been completed, and i s awaiting
parliamentary ratification; the AIPP will provide financing for operationalization o f this plan. WHO has
also recently completed an assessment o f laboratories throughout BiH, which will form the basis for the
technical planning for the upgrade o f laboratories under the Project.
In addition, WHO, with EC support, i s working to strengthen the overall surveillance system for seasonal
flu, which will also help with faster identification o f any unusual flu strains which might arise.
Component 4: Poultry Culling Compensation Scheme - U S $0.75 million
Financing
FBiH
RS
IDA Credit:
US$O.lOmillion
US$O.lO million
US$0.55 million
IDA Credit Proceeds
FBiH
US$0.3 1 million
RS
US$0.24 million
Experience from world HPAI outbreaks has clearly shown that individuals are more likely to report sick
animals if they have credible assurances from government that they will be compensated in the event that
their animals must be killed to prevent further spread o f disease. Therefore, in order to provide sufficient
incentive for early reporting by citizens o f sick animals, and hence timely response by government
authorities, within this component funds for compensation will be provided. As evidenced by the
experience from the culling campaign (that followed the A I occurrence in wild birds in February 2006),
the compensation procedure prescribed and elaborated in the CP for A I ensures timely, efficient and
transparent compensation payment to farmers.
Component 5: Implementation Support, and Monitoring and Evaluation (M&E) - U S $0.45 million
Fin an cing
Gov’t. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
US$O.12 million
US$O. 15 million
US$O.15 million
US$0.03million
One o f the key characteristics o f the HPAI threat i s the difficulty in predicting the course the pandemic
will take. An important feature of the project, therefore, will be the flexibility to adapt to a changing
situation with the ability to reallocate funds between components and categories, and possibly draw up
new activities. The component would support costs associated with project management and coordination.
I t would comprise two sub-components: (i)Implementation Support to the Technical Support Group in the
Ministry o f Foreign Trade and Economic Relations; and (ii) Monitoring and Evaluation (M&E).
Which safeguard policies are triggered, if any? Re$ PAD 0.6, Appendix 8
Only the Environmental Assessment safeguard i s triggered by the Project. Since the Project i s being
processed under emergency procedures and i s assessed as a B-category project, a waiver was requested
and granted to permit preparation o f the Environmental Management Plan (EMP) after Appraisal. The
EMP has been finalized and disseminated. Formal adoption o f the EMP i s a condition for Effectiveness.
Significant, non-standard conditions, if any, for:
Re$ PAD C. 7
Board presentation:
There are no Conditions for Board Presentation. Bosnia-Herzegovina(BiH) fulfills the eligibility criteria
requirements for borrowing under the Global Program for Avian Influenza (GPAI). Specifically, BiH
should be considered, according to the G P A I Program document, as one o f the “countries at risk, with no
outbreak, o r that are at an early stage o f an outbreak”, government commitment and appropriate plan
o f early detection and rapid response, including appropriate implementation and monitoring arrangements
that the international agencies and donor community, including the Bank, could support.” (World Bank
Report Number 34386 -Program Framework Documentfor the GPAI, December 5,2005, page 14)
Loadcredit effectiveness:
N o non-standard conditions.
Covenants applicable to project implementation :
Conditions of Effectiveness:
Establishment by the Recipient o f the Technical Support Group in a manner and with the
(i)
composition and terms o f reference satisfactory to the Association;
(ii) The Annual Work Program for the first year o f the implementation o f the Project, satisfactory
to the Association, has been prepared and adopted by the Recipient and each Entity;
(iii) The Project Operational Manual, EMP and the FM Manuals, each satisfactory to the
Association, have been adopted by the Recipient and each Entity;
A Project Agreement has been executed on behalf o f the Association and an Entity, on terms
(iv)
and conditions satisfactory to the Association; and
A Subsidiary Agreement has been executed on behalf of the Recipient and the Entity
(v)
concerned, on terms and conditions satisfactory to the Association.
Conditions o f Disbursement:
a Project Agreement between the Association and the Entity responsible for implementing
(i)
Part 2 or Part 3 o f the Project, as the case may be, has been executed, on terms and conditions
satisfactory to the Association;
(ii)
a Subsidiary Agreement between the Recipient and such Entity has been executed, on terms
and conditions satisfactory to the Association;
(iii)
An opinion has been furnished to the Association stating that such Project Agreement and
Subsidiary Agreement have been duly authorized or ratified by the parties thereto and are
legally binding upon them in accordance with their respective terms;
(iv)
For expenditures under Component 4, adoption by the Recipient and each Entity of the
Poultry Culling Compensation Scheme Manual, satisfactory to the Association; and
(v)
Retroactive Financing under Categories 2 and 4, up to an equivalent of SDR 100,000
(vi)
The Federation o f Bosnia and Herzegovina has opened a Project Account with an initial
deposit equivalent to US$0.02 million.
(vii)
The Republika Srpska has opened a Project Account with an initial deposit equivalent t o US
$0.015 million
A.
STRATEGIC CONTEXT AND RATIONALE
1.
Country and Sector Background and Global, Regional and National Dimensions
(a)
Country and Sector Background
1.
Bosnia and Herzegovina has made remarkable progress in post-conflict reconstruction, social
integration and state building since the end o f the 1992-95 war. However, the economy stands at only
70% o f i t s prewar level. The business environment i s not as investor-friendly as it needs to be to attract
the levels o f investment required for sustained economic growth. Some 50% o f the 4.1 million
population i s at or near the poverty level. The lack o f employment opportunities i s a major factor limiting
the resettlement o f refugees and internally displaced persons.
2.
The composition o f GDP appears to have changed markedly in the post-war period. According to
official statistics, the share o f agriculture has declined significantly while the share o f services has
increased. While the overall trends follow a similar direction in both entities, there are notable
differences. The primary production sector (agriculture, fisheries and forestry) has remained an important
sector in Republika Srpska (RS) at 20 percent o f GDP, but has dropped to less than 10 percent in the
Federation o f Bosnia and Herzegovina (FBIH). Agricultural Gross Domestic Product (AGDP) makes up
about 14% o f the country’s overall GDP. It i s estimated that 18% o f the population i s employed in
agriculture.
3.
The poultry industry represents one o f the main agriculture sub sectors, and production currently
falls just short o f meeting the national market demand for i t s products. It i s estimated that BIH has
around 32 million broilers (estimated annual production capacity), 1 million laying hens, and
approximately 1 million animals raised in back yards. Annual production capacity for the industry i s 10
kg o f meat and 120 eggs per capita (annual consumption in BiH i s 14 kg o f poultry meat and 180 eggs per
capita). The total annual production o f poultry meat for 2004 i s estimated at approximately 43,000 tons,
and for the same year production o f eggs was around 450 million. Average market price for poultry meat
i s US$2 per kg, and the price o f an egg i s US$O.O8. Commercial poultry farming i s largely organized as
industrial production, primarily involved in the production o f eggs and fresh/frozen chicken meat and
processed meat products. The commercial poultry plants are enclosed operations which use modern
equipment and technologies. Other poultry are raised on small household farms limited to a few chickens
and/or other domestic birds.
(b)
International Dimension
4.
East Asia i s the region most affected by HPAI to date, with Cambodia, China, Indonesia,
Thailand, and Vietnam all reporting human infections. The number o f countries affected by HPAI in East
Asia has increased and now includes Cambodia, China, Indonesia, Japan, Lao PDR, Mongolia, South
Korea, Thailand, and Vietnam. The geographical spread o f HPAI, the human dimension and the potential
enormous social and economic impact are unprecedented. Despite control measures the disease continues
to spread, causing further economic losses and threatening the livelihoods o f hundreds o f millions o f poor
livestock farmers, jeopardizing smallholder entrepreneurship and commercial poultry production, and
seriously impeding regional and international trade, and market opportunities. With outbreaks rapidly
spreading in other regions such as Europe and Central Asia (ECA) and Africa, there i s a growing
realization that the international community faces several transnational challenges that do not emanate
directly from the policies o f individual states. Correspondingly, these challenges cannot be countered
solely by the actions o f individual states, because they present a threat to the entire world. A n important
emerging transnational threat i s the spread o f infectious diseases across national borders, which has the
11
potential to undermine countries’ stability, security, economic development, human capital accumulation,
and not least, the welfare o f the population.
(e)
Regional and National Dimension
5.
Until recently, avian flu outbreaks were limited to Southeast Asia. In July 2005, outbreaks were
registered in domestic poultry and fowl in seven regions o f Russia. Four months later, outbreaks in
poultry o f H P A I H5N1 were reported in four regions o f Kazakhstan. Since 2005, outbreaks o f avian flu
have occurred in many countries outside East Asia. After crossing from China into Russia and
Kazakhstan, outbreaks were reported in Albania, Azerbaijan, Austria, Bosnia and Herzegovina, Bulgaria,
Cyprus, Croatia, France, Greece, Germany, Italy, India, Iran, Romania, Serbia, Slovenia, Switzerland,
Turkey, and Ukraine. Seasonal migration o f birds contributes to transmission o f new strain variations to
different geographical regions. In October 2005, H 5 N l was reported among migrating swans in Croatia,
which lies on the northern border o f Bosnia and Herzegovina.
6. On February 16, 2006, four swans from Pliva Lake in Jajce Municipality were brought to the
Reference Laboratory o f the BiH State Veterinary Office (Poultry Center o f Sarajevo Veterinarian
Faculty) for testing. T w o o f the four swans tested positive in preliminary serologic tests; necropsy
findings for these two swans indicated the presence o f AI. State authorities subsequently mounted a
coordinated and thorough response to what was in essence a real-time emergency simulation. The
preparation mission o f March/April2006 was presented with substantial detail on this response, and noted
that implementation o f the veterinary control measures elaborated in the Contingency Plans (CP) appear
to have successfully halted any further spread o f the infection. In particular, the CP’s clear “chain o f
command” rules allowed local authorities to act with confidence. In addition, on March 9, 2006, a case o f
A I was confirmed in a rooster in the municipality o f Bajina Basta (Serbia). As a consequence, the nearby
community o f Bratunac in BiH was declared an endangered area, and measures were instituted as
prescribed by the CP. The infection also appears to have been halted in this area. N o new cases have
been reported since then.
7.
The emergence o f outbreaks in neighboring countries has had a negative impact on both poultry
production and consumption in BIH. Based on data from large-scale traders, poultry consumption
appears to have fallen by about 30-40 percent after the recent cases emerged in Croatia and Romania.
Official production fell by more than 50% in mid-2006, with some o f the major producers almost fully
halting production’. The decline in production and consumption have been accompanied by a drop in
market prices o f about 10 percent, while farm-gate prices o f chicken declined from 2.3 KM/kg to 1.4 1.5 KM/kg.
(d) Organizational Structure of the Health Care and Veterinary Systems (please refer to Appendix 9 )
2.
Rationale for B a n k Involvement
8.
HPAI control programs require a multi-disciplinary approach to integrate technical, social,
economic, political, policy, and regulatory issues in addressing a complex problem. Working in a
collaborative manner with other agencies (WHO, UNDP, UNICEF, EC, USAID), the Bank i s well-placed
to apply the evidence and lessons learned from international best practice in the various regions to help
ensure that BiH’s emergency preparedness plans and capacities are ready for the H P A I challenge. The
Bank has a strong comparative advantage in providing integrator skills and multi-sectoral perspectives,
I
As poultry production needs to be planned in such a way that 36 days old chicken are available daily, the
production chain cannot be stopped instantly. Therefore, the real extent o f the reduction can be seen only with a
two-month delay, time required to complete the full production cycle.
12
and in addressing the institutional dimensions o f the response to such emergencies. I t can also bring
extensive experience and skills in analyzing and addressing the social and economic impact. Importantly,
the Bank has a long record in BiH in bringing together the relevant ministries, government agencies, and
the donor community, and in helping ensure high level political coordination.
9.
Given the Bank’s work with local and international partners in B i H and at the international level
to address both preparedness and outbreaks and to assist with institutional assessments, the Bank can
assist Bosnia and Herzegovina in leveraging additional resources from other international and bilateral
agencies. In addition to its financial role, the technical assistance provided by the Bank has been
important in similar global or regional emergency situations such as SARS, Tsunami relief, and
HIV/AIDS. The Bank’s national and regional support will be closely linked with the activities o f FAO,
WHO, OIE and the EU, and the proposed project i s fully consistent with, and draws heavily on the global
strategies proposed by F A 0 and WHO.
B.
PROJECT DESCRIPTION
1.
Lending Instrument
10.
The project i s to be supported by a Credit from the International Development Association (IDA)
o f US$5 million equivalent. In addition, the Bank i s working on helping to mobilize additional resources
from bilateral and international agencies. Activities under the IDA-financed project will complement
activities supported by other international partners and donor agencies (EC, UNDP, UNICEF, USAID,
and WHO) and help ensure the availability o f adequate resources to fund the priority investments and
technical assistance which BIH has identified as critical needs in implementing i t s response to HPAI. The
Project i s supported by the Bank-financed Global Program for Avian Influenza Control and Human
Pandemic Preparedness and Response (GPAI) approved by the Bank’s Board on February 9,2006.
11.
As per the GPAI, a country will qualify for support under the GPAI when it demonstrates its
commitment and readiness to implement early detection and rapid response measures appropriate to the
specific country conditions. A country request for assistance would be eligible for financing under the
GPAI when it meets the following eligibility criteria:
(i) For countries in endemic situation where new human infections are being detected, it has prepared
and i s implementing an HPAI Control Strategy;
(ii)For newly infected countries with an active outbreak o f avian flu among poultry, but no human
infections, the existence of an appropriate program o f rapid response, detection and containment
measures, including appropriate implementation and monitoring arrangements that the international
agencies and donor community, including the Bank, could support.
(iii)For countries at risk, with no outbreak, o r that are at an early stage o f an outbreak, government
commitment and appropriate plan o f early detection and rapid response, including appropriate
implementation and monitoring arrangements that the international agencies and donor community,
including the Bank, could support.
(iv)For countries with very low income levels and very low capacity circumstances, including
LICUS countries, special criteria and waivers would apply if a full-blown human pandemic were to
materialize, to ensure that assistance would be available if and when needed, even ifthe country itself
would hardly be able to generate or mobilize any effective A I response, to safeguard the globalpublic-goodnature o f the global avian influenza objective.
13
12.
The joint BanWWHOAJNICEF pre-Appraisal mission o f MarcWApril 2006 made an assessment
o f the readiness o f BiH to proceed with a program o f support under the GPAI. I t concluded that BiH
meets the eligibility criteria as per (iii)above. The level o f commitment o f BIH i s high: (i)a letter
requesting the Bank’s assistance was received on February 24, 2006; (ii)draft assessment plans and
preparedness plans on the response to an avian influenza pandemic were prepared by the Government
prior to the appraisal mission; and (iii)appropriate implementation and monitoring arrangements have
been discussed and agreed.
13.
Project Characteristics. The financial assistance under the project will be provided as a Credit.
The Credit i s being processed as an emergency investment operation using procedures under OP 8.50 Emergency Recover Loan (ERL), and it meets all applicable Bank policies, practices and standards as
discussed below.
2.
Project Development Objectives
14.
The overall development objective i s to minimize the threat posed to humans and the poultry
industry by H P A I infection and other zoonoses, by enhancing both animal and human health infectious
disease response and control capacities. T o achieve this, three areas will be supported by the project: (i)
prevention, (ii)preparedness and planning; and (iii)response and containment.
3.
Project Components
15.
The project would finance activities under five components: (i)Strategic Communications and
Public Information; (ii) Animal Health Protection, and Disease Prevention and Control; (iii)Human
Health Protection, and Disease Prevention and Control; (iv) Poultry Culling Compensation Scheme; and
(v) Implementation Support, and Monitoring and Evaluation (M&E). Even though the activities are
organized by sectoral components, the project strongly endorses an integrated national plan that ensures
common objectives across sectors for dealing with the avian flu issue.
Component I: Strategic Communications and Public Information
Financing
IDA Credit:
- U S $0.20 million
IDA Credit Proceeds
FBiH:
US$O. 1 1 million
RS
US$0.09 million
US$0.20 million
16.
Building on the work initiated by the Entity Public Health Institutes with the support o f UNICEF,
several communications interventions will be financed, chief among them the further development and
implementation o f the already drafted communication strategy. The draft strategy includes, inter alia,
improved communications strategies between and across government agencies (National Communication
Plan); protocols for coordination o f the outbreak and crisis communication for professionals
(veterinarians, human health medical personnel, inspections, c i v i l protection, state border service, etc);
materials and targeted training for educators; capacity building in communication techniques for health
workers, teachers and media professionals; and, at the community level, awareness raising and
communication for behavior change activities through all appropriate communications channels. While it
i s crucial that each sector involved in public awareness and communications work under an overall
strategy and broader framework, the actual implementation o f communication and public information
activities w i l l necessarily be carried out sectorally with a core set o f common objectives (more details are
included in Annex 2A). U N I C E F took the lead role in implementation o f the first phase o f the
communications strategy, with financing from U S A I D in the amount o f US$0.21 million. IDA financing
would complement the planned UNICEFLJSAID interventions, especially after the first year o f
implementation. Three sub-components are foreseen:
14
0
Developing basic communication materials;
Developing and testing messages and materials to be used in the event o f a pandemic or emerging
infectious disease outbreak; and
Developing training courses in communications methodology for veterinary staff as well as for
health workers at the local levels.
-
Component 2: Animal Health Protection, and Disease Prevention and Control U S $2.98 million
Financing
Gov't. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
US$0.25 million
US$O.17 million
US$O. 10 million
US$2.46 million
I D A Credit Proceeds
FBiH:
US$1.62 million
RS
US$0.84 million
17.
The most effective way to reduce the threat from HPAI to both economic sustainability o f
domestic poultry production, and human health, i s to prevent the disease from establishing i t s e l f in
domestic poultry. This component will provide support to the implementation o f disease prevention and
control strategies established at national and entity levels to address short, medium and long-term needs.
Areas for support are based on detailed assessments of: (i)
the epidemiological status o f HPAI in BIH; (ii)
the capacity o f the State Veterinary Office (SVO) to cope with highly pathogenic avian influenza (HPAI)
epidemic, including surveillance and diagnostic capacity at the national and entity levels; and (iii)the
vulnerability o f the poultry industry to new emerging infectious diseases.
18.
The component would have four sub-components:
0
0
0
Enhancing HPAI prevention and preparedness capability;
Strengthening o f Veterinary Services, disease surveillance, diagnostic capacity and applied
research;
Strengthening H P A I control programs and outbreak containment plans as well as capacities to
implement those plans; and
Improving bio-security in poultry production and trade, and isolating i t s potentially adverse
effects on other aspects o f people's lives.
19.
The European Commission i s actively providing support to animal health objectives through a
twinning program with the SVO. This program i s under implementation, initially during 2007-2009 to
support capacity building with the SVO in the areas o f legislative reform, food safety, phytosanitary
regime, inspections, and laboratory upgrading.
Component 3: Human Health Protection, and Disease Prevention and Control - U S $1.98 million
Financing
Gov't. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
20.
US$0.22 million
US$O. 10 million
US$O.lO million
US$1.96 million
I D A Credit Proceeds
FBiH:
US$0.98 million
RS
US$0.98 million
Both Entities have developed contingency plans. With the aim to further improve planning and
coordination, the project w i l l (a) help conduct simulation exercises, (b) support the revision o f the plans
and (c) support the preparation o f social distancing plans and clean-out plans for hospitals. The
surveillance system w i l l be strengthened through: (i)the training and equipping o f investigation teams,
'
15
(ii) the equipping o f 1 virology laboratory in RS and two in the FBiH (one for virus typology in Sarajevo,
and one for virus identification in Mostar); and (iii)the strengthening o f the communicable diseases
monitoring and reporting system. It i s expected that all these efforts w i l l result in BiH joining the
European Influenza Surveillance Network. To help reduce the risk o f a genetic recombination/ mutation
o f the virus, the project will support the immunization against seasonal influenza o f populations at high
risk. The capacity o f the health sector to adequately isolate and treat suspected or confirmed human cases
o f avian flu will also be strengthened. Particular efforts will be made to train health staff at different
levels o f the health system, improve their knowledge o f infection control measures and facilitate the
adoption o f the most appropriate attitudes and behaviors so they can both protect themselves and
effectively take care o f their patients. The interventions supported under the Project w i l l be based on
BIH’s epidemiological and programmatic needs, and well-assessed options for meeting them. The
interventions will be grouped in three sub-components:
0
0
0
Enhancing public health program planning and coordination;
Strengthening o f the national public health surveillance system; and
Strengthening health system response capacity.
2 1.
The European Commission (EC) has allocated US$l80,000 equivalent from its ongoing project,
being implemented with WHO support, to continue strengthening the surveillance systems in the human
health sector. I n addition, for the period 2007-2009, the EC will contribute EUR 500,000 to strengthen
the overall human health laboratory system. This support will be complementary to the laboratory
upgrades provided under the AIPP.
Component 4: Support to the B i H Poultry Culling Compensation Scheme - U S $0.75 million
Financing
FBiH
RS
IDA Credit:
US$O. 10 million
US$O.lO million
US$0.55 million
22.
IDA Credit Proceeds
FBiH
US$0.3 1
RS
US$0.24
Experience from world HPAI outbreaks has clearly shown that individuals are more likely to
report sick animals if they have credible assurances from government that they w i l l be compensated in the
event that their animals must be killed to prevent further spread o f disease. As evidenced by the
experience from the culling campaign that had followed A I occurrence in wild birds in February 2006, the
compensation procedure prescribed and elaborated in the CP for A I ensures timely, efficient and
transparent compensation payment to the farmers. The CP contains the necessary forms and instructions
for personnel and institutions involved in culling, and ensures reimbursement o f the farmers within a
timeframe o f 7-10 days post-animal depopulation. The only factor that can compromise the effectiveness
o f the existing compensation procedure, and thereby decrease the incentive for farmers to participate in
A I control efforts, i s the limited budget available for this purpose. Currently, compensation costs related
to animal disease outbreaks are covered from the emergency fund (entity level budgets). Compensation
costs on the scale o f that needed for the A I outbreak. experienced in February 2006 can be easily covered
by the government. However, if AI would occur in an area close to large-scale poultry farms, the
available budget under the current culling arrangements would not come even close to covering the
resulting expenses. Therefore, in order to provide sufficient incentive for early reporting by owners o f
sick animals, and hence enable a timely response by government authorities, funds for compensation will
be provided within this component. A mechanism for the mobilization o f these funds w i l l need to be
agreed as a condition of disbursement (under the Animal Health Component), as well as distribution o f
the responsibility for repayment among national and entity governments.
16
Component 5: Implementation Support and Monitoring and Evaluation (M&E) - U S $0.45 million
Financing
Gov’t. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
US$0.12 million
US$O. 15 million
US$O. 15 million
US$0.03 million
23.
One o f the key characteristics o f the HPAI threat i s the difficulty in predicting the course the
pandemic will take. A n important feature o f the project, therefore, w i l l be the flexibility to adapt to a
changing situation with the ability to reallocate funds between components and categories, and potentially
to draw up new activities. The component would support costs associated with project management and
coordination. It would comprise two sub-components:
0
4.
Implementation Support to the Technical Support Group and PIU/PCU
Monitoring and Evaluation (M&E).
Lessons Learned and Reflected in the Project Design
24.
Relevant lessons for the design o f the proposed project have been drawn from implementation o f
projects in the agricultural and health sectors in Bosnia and Herzegovina. They have also been drawn
from the design o f previous World BanWIDA and FAO-supported emergency recovery projects. These
include the Vietnam Avian Influenza Emergency Recovery Project, which was the first Bank-financed
project in response to the Avian Influenza. I n addition, lessons have been drawn from the design o f the
Kyrgyz Republic A I project, which was the first country-specific project drawing from the GPAI, as well
as projects currently under implementation in Turkey, Azerbaijan, Armenia, Georgia, and Albania.
25.
Lessons learned indicate that project success depends to a large extent on the speed o f the
response provided. Particularly when dealing with smallholders’ production systems, a speedy, efficient
and transparent distribution o f suitable key inputs i s clearly a major factor in limiting the impact o f a
crisis and hastening recovery. A performance audit o f some o f the emergency projects supported by the
Bank in various regions drew the following general lessons: (i)emergency projects should avoid policy
conditionality; (ii)project design must be simple and take into account a realistic assessment o f the
existing Borrower’s capacity and other stakeholders capacity; (iii)a speedy project processing and
approval are crucial to provide a prompt response and a substantial contribution to project success;
(iv) procurement arrangements need to be flexible and should be finalized at an early stage;
(v) mitigation and prevention measures should be included in the design to minimize impacts of a
possible recurrence o f the disaster; and (vi) realistic assessments should be made o f counterparts’
absorption capacity, as well as o f the effective communications and coordination mechanisms among all
relevant stakeholders.
26.
The main recommendations arising from the first 18-month implementation period o f the
Vietnam Avian Influenza Emergency Recovery Project are:
(a) Preparedness i s a key factor. While Vietnam had a national strategy document to control avian
influenza in the domestic poultry population, it was not clearly understood and shared by all
relevant agencies and stakeholders, and some aspects o f the response were lagging behind.
(b) A two-pronged strategy i s recommended. This should include: (i)the control o f avian
influenza at the source in high-risk regions (through aggressive measures including culling,
movement control and vaccination campaigns for poultry and ducks); and (ii)simultaneously
17
prepared short and medium-term measures to minimize the risks to humans and prepare for an
eventual pandemic.
High level government commitment i s o f the essence. For implementation arrangements, it i s
important to have a coordination structure that i s empowered with multi-sectoral responsibilities,
along with full-time project coordinators to implement activities in a “crisis situation”.
Moreover, this level o f coordination would foster effective integrated national response, including
all technical ministries in charge o f agriculture/animal health and human health, as well as other
relevant sectors, at the national and sub-national level, in case o f a human epidemic.
H P A I Control Strategy and Preparedness Plans need to be linked to the broader agenda of
regulatory and institutional reforms. In particular, a revised “compensation framework” i s an
essential element to obtain real cooperation from affected stakeholders (farmers/producers) and to
ensure the efficacy o f the surveillance and diagnosis mechanisms. Other long-term reforms
include the restructuring o f the poultry industry and the development o f food safety regulations.
Technical, scientific and operational capacity o f the relevant participating agencies, and in
particular National Veterinary Services, should be strengthened. The AI crisis highlighted
several weaknesses in the animal health as well as public health services systems, including: poor
surveillance at the local level, weak diagnostic capacity, lack o f epidemiological expertise and
information system, and inadequate operating budget to bear the additional costs o f physical and
human cost to contain the spread o f the disease.
Control strategies must include awareness raising and public information campaigns. It i s
extremely important to raise awareness in the public and private sectors from the initial moments,
and to strengthen effective coordination mechanisms for the implementation o f the necessary
technical responses, involving the Government, the donor community, the private sector and the
civil society.
Regional collaboration i s critical. Attention should be given t o support the integration o f each
country to a regional and global framework for the control o f HPAI, and more broadly o f all
trans-boundary animal diseases and other emerging infectious diseases, to increase costeffectiveness and ensure the harmonization o f activities and responses.
Some important lessons learned from the response to the H I V / A I D S epidemic2 are incorporated
in the design o f the proposed project. They include:
I
e
0
e
e
0
The need for high level political commitment and leadership i s key.
A comprehensive multi-sectoral approach i s needed.
Monitoring and evaluation i s critical in the scaling-up o f a national response.
Stakeholders at the country and international levels, are important in dealing with the A I threat.
Building a strong fiduciary architecture i s essential.
C.
IMPLEMENTATION
1.
Partnership Arrangements
28,
The Bank and the international community can play a key role in the response to Avian Influenza,
especially at the country level where there i s a need to develop an overall framework to guide national
action plans that can be the basis for government and donor support. Such a framework should address
2
World Bank. 2005. Committing to Results: Improving the Effectiveness o f HIViAIDS Assistance. An OED
Evaluation o f the World Bank’s Assistance for HIViAIDS Control. Washington, D.C.
18
both animal and public health aspects as well as economic impact. Many o f the investments needed to
address this disease are core public health and animal health functions that are considered "global public
goods", thus, necessitating a global and regional response with support from the international community.
Such partnership arrangements have been developed in BIH with the technical agencies as well as with
bilateral agencies. Several meetings were organized prior to and during appraisal to brief the international
partners on the Bank's plans to work with the Government in the design of a country-specific project and
to confirm their interest in participating in the financing o f the project.
29.
BIH i s receiving support on the technical content o f an Avian Influenza response from key
technical agencies. International agencies and donors have been active through a Task Force established
in BIH for coordinated support o f AI. The European Commission (EC) has allocated US $180,000
equivalent from i t s ongoing project, being implemented with WHO support, to continue strengthening the
surveillance systems in the human health sector. In addition, the E C has allocated EUR 500,000 for the
2007-2009, to assist with provision o f biosafety equipment for human health laboratories and hospitals.
UNICEF has been working closely with the Inter-Sectoral Committee to design a draft communications
strategy. As importantly, UNICEF support for A I communications was funded by U S A I D in the amount
o f US $0.20 million. These activities are now nearly completed, and have delivered a wide range o f
communications tools to enhance the overall government response. U N D P has expressed i t s interest to
collaborate by making available US $100,000 to support A I activities. The aim o f the IDA-funded Project
i s to support an integrated response to AI with all international partners contributing and supporting
BIH's preparedness and control program. Further work in this regard will continue prior to effectiveness
and during implementation to ensure complementarity o f all such grant financing from international
partners.
2.
Institutional and Implementation Arrangements
30.
Because o f the inter-sectoral nature o f this project and potential for an A I outbreak or human
pandemic that i s national in scope, it i s critical that both animal and human health experts, as well as
communications specialists, work together closely at national and entity levels to perform the day-to-day
tasks o f implementing the Project. Implementation o f the Project will be undertaken by a Technical
Support Group (TSG) consisting o f technical advisors who are representatives o f the State Veterinary
Office (SVO)3 in the Ministry o f Foreign Trade and Economic Relations, Ministry o f Civil Affairs, F B i H
and RS Ministries o f Agriculture (Veterinarian Services), FBiH and RS Ministries o f Health, and
consultants for communications and monitoring and evaluation.
The representative o f SVO on the TSG will be a permanent civil servant and will serve as Project
Coordinator, reporting to the Minister o f MoFTER. The TSG will report to the Council o f Ministers
through MoFTER. The TSG government representatives will be responsible for coordinating with and
reporting to their relevant government departments, to guide and monitor implementation o f activities in
their respective areas. The TSG will be responsible for monitoring and evaluation, the preparation o f
annual work programs and budgets, preparation o f TORSand specifications for goods and works bidding
documents, and preparation o f quarterly and annual progress reports.
3 1.
32.
Procurement, financial management and financial reporting services for the project will be
provided by the P I U Forestry and Agriculture in Sarajevo, and by the Health Sector P C U in Banja Luka.
More details on the implementation arrangements are provided in Appendix 2c.
SVO has the mandate to coordinate veterinary services on behalf o f the Entity Ministries o f Agriculture, Water
Management and Forestry.
19
33 .
Overall responsibility for overseeing and coordinating institutional and implementation
arrangements will be vested with the Minister o f Foreign Trade and Economic Relations (MoFTER) on
behalf o f Council o f minister^.^
34.
At the cantonal and municipalities levels, implementation would be the direct responsibility of
each cantonal/municipal veterinary/health authority. Small coordination units should be established at the
local level comprising officials from healthheterinary services to work under the supervision and
guidance o f the entity ministries.
35.
T o facilitate the management and implementation o f the Project, a Project Operational Manual
(POM) satisfactory to the Association i s to be prepared by the TSG as a Condition o f Effectiveness.
3.
Monitoring and Evaluation of OutcornesDtesults
36.
M&E activities related to the project will be the responsibility o f Technical Support Group (TSG)
supported by the PIU/PCU. These activities could be carried out by the regular staff o f the agencies (with
technical assistance from the project) or by contracting out these functions with specialized
agenciedinstitutes when appropriate.
Monitoring project progress and the achievement o f objectives will entail a process o f
continuously and systematically reviewing the various project implementation activities. The objectives
o f the M&E activities are to: (i)measure input, output and outcome indicators (see Appendix 1); (ii)
provide information regularly on progress toward achieving results and facilitating reporting to the
government and IDA; (iii)
alert government authorities and the international partners to actual or potential
problems in implementation so that adjustments can be made; (iv) determine whether the relevant
stakeholders are responding as expected and intended by the project; (v) provide a process whereby the
implementation agencies can reflect and improve on their performance; and (vi) enable the project to
make necessary changes should the situation evolve.
37.
38.
The results o f relevant M&E activities will be reflected in the quarterly and annual progress
reports. A section o f the progress reports will be devoted to issues identified during project
implementation and the strategies and actions to be taken to resolve such issues that affect progress.
4.
Sustainability
39.
Critical to the sustainability o f the Project will be the continuous ownership o f this initiative by
the various stakeholders, coupled with strong political support and the availability o f an adequate flow o f
financial resources to carry out project activities. In addition, institutional sustainability would be ensured
by: (i)strengthening o f programs to maintain public awareness o f the threat o f avian influenza and other
rapidly spreading infectious diseases; (ii)sustained surveillance and prevention and control activities,
particularly in high risk regions; (iii)strengthened country capacity to manage at national and local levels
the risk factors associated with the spread o f avian influenza and other infectious diseases; and (iv)
effectiveness o f programs to control the spread o f avian influenza from birds to the general population.
4
An inter-sectoral Crisis Committee was established in November 2005 under the chairmanship o f the MoFTER to
oversee the HPAI control and containment effort and to provide general policies and guidance for avian influenza
control. An Inter-Sectoral Working Group (ISWG) was established by the MoFTERto provide technical response to
the A I outbreak in February 2006, and led project preparation for the BiH. Both the Crisis Committee and the
ISWG may continue to function as circumstances warrant. However, neither would have a role in implementation
o f the Project.
20
5. Critical Risks and Possible ControversialAspects
Risk
From Outputs to Objective
Decline in political commitment to addressing
Avian Influenza and the threat o f a Global
Influenza Pandemic.
Rating
Mitigation Measure
S
Continuing support for inter-sectoralcollaboration
through information exchanges and dialogue and
operationalization o f the Technical Support Group,
which i s to provide liaison with the BiH and entity
implementingagencies.
Adequate implementation arrangements are being
put in place as a pre-condition o f Bank financing;
careful monitoring o f leadership and project
management during project implementation;
technical assistance and training.
The TSG will inter alia, ensure coordination and
linkages across relevant agencies and international
partners. I n addition, an inter-sectoralworking
group was established by the Chair o f the
Committee as the counterpart team to work with
the Bank and other donors in project design and
will continue to play a role if needed during project
implementation,.
Implementationmechanisms explicitly address the
link between the required centralized decision
making (the principle o f ‘direct chain o f
command’) with the needed local-level
implementation, communication strategies will
include local-level implementing actors as targets;
capacity building includes periphery.
Project implementing agencies do not have
sufficient authority, leadership, and capacity to
take leading role in Avian Influenza prevention
and control.
S
Inadequate or lack o f multi-sectoraland intraEntity participation
S
Low cantonal/municipality level commitment
means that strong central commitment does not
translate into action on the ground.
S
From Components to Outputs
Controlling the spread o f the pandemic may
expose the government to criticism for the
curtailment o f civil rights due to the adoption o f
quarantines and other related measures.
Inadequate institutional capacity to manage the
project.
Financial resources not accessible in a timely
manner, weak procurement management
M
S
M
Lack o f timely and predictable access to expert
advice and technical support
M
Low priority given to public accountability and
transparency in program management
Overall Risk Rating:
M
Project will support advocacy and coalition
building to sensitize key groups including policy
makers and the media. This will be complemented
by carefully designed communication campaigns to
build support for the project among the wider
population.
Capacity building and institutional development i s
one o f the project’s key objectives.
Procurement and financial management
arrangements will be handled by experienced staff
which will receive support from consultants.
Project activities are being designed with assistance
from leading multilateral agencies such as F A 0
and WHO. Arrangements in place for provision o f
expert resources (OIEIWHOIFAO) during
implementation.
Publication o f audit results and achievements;
transparency in decision and resource allocation.
S
Risk Rating - H (High Risk), S (Substantial Risk), M (Modest Risk), N (Negligible or Low Risk)
21
Possible ControversialAspects
40.
The Project will support the implementation o f immediate t e r m responses to a global influenza
pandemic -- the classic “social distancing measures”-- such as quarantine, bans on mass gatherings, and
travel restrictions that may be politically and socially controversial. This means that dialogue and
compromises are needed among different stakeholders, backed by a well-designed communication
strategy. A high degree o f political commitment to preventing and controlling the spread o f infectious
diseases such as a global influenza pandemic would be needed for managing controversies that will
undoubtedly arise.
6.
Credit Conditions
4 1.
The key conditions needed to minimize the risks to the Project would be addressed by the country
meeting the eligibility requirements for entering the Global APL. Specific provisions have been
developed to meet the standard requirements covering organizational and staffing arrangements, as well
management, procurement and financial management arrangements. These have been addressed during
appraisal and were confirmed prior to Negotiations. Conditions of Effectiveness for the project would
be: (a) Establishment by the Recipient o f the TSG in a manner and with the composition and terms o f
reference satisfactory to the Association; (b) The Annual Work Program for the first year o f the
implementation o f the Project, satisfactory to the Association, has been prepared and adopted by the
Recipient and each Entity; (c) the Project Operational Manual, the EMP, and the FM Manuals, all
satisfactory to the Association, have been adopted by the Recipient and each Entity (d) a Project
Agreement has been executed on behalf o f the Association and each Entity, on terms and conditions
satisfactory to the Association; (e) for each Entity, a Subsidiary Agreement has been executed on behalf
o f the Recipient and the Entity concerned, on terms and conditions satisfactory to the Association.
42.
Conditions of Disbursement comprise: (i)execution o f a Project Agreement between the
Association and the Entity; (ii)execution o f a Subsidiary Agreement between the Recipient and the
Entity; (iii)for expenditures under Component 4, adoption by the Recipient and each Entity o f the Poultry
Culling Compensation Scheme Manual; (iv) provisions for Retroactive Financing under components 1, 2,
3, and 5; and (v) the opening o f Project Accounts (for the Federation o f Bosnia and Herzegovina, the
initial deposit i s to be equivalent to US $0.02 million; for Republika Srpska, the initial deposit i s to be
equivalent to U S $0.01 5 million).
43.
Financial Covenants. The Federation P I U in the Ministry o f Agriculture and the RS PCU
established in the Ministry o f Health will maintain financial management systems acceptable to the Bank.
The project financial statements, summary reports and the designated account will be audited by
independent auditors acceptable to the Bank on terms o f reference acceptable to the Bank. The annual
audited statements and audit report will be provided to the Bank within six months o f the end o f each
fiscal year.
44.
The audits will be conducted in accordance with International Standards on Auditing (ISA) as
issued by the I F A C and on terms of reference acceptable to the Bank.
The P I U and P C U will appoint an acceptable firm o f auditors under terms o f reference acceptable
45.
to the Bank to carry out operational review o f the compensation payment system as part o f the annual
audit when compensation claims have been made.
22
D.
APPRAISAL SUMMARY
1.
Economic Analysis
46.
The poultry industry in BH i s relatively small. Overall 2004 production amounted to
24.5 million kilograms. O f that, about half i s produced by large commercial poultry farmers and the rest
by individuals, mainly subsistence farmers (Table 1). Exports have been negligible, largely because o f
lack o f veterinary certification.
47.
Poultry accounts for a relatively small part o f households’ consumption. In 2004, overall
consumption o f poultry amounted to 38.2 million kilograms, domestic production meeting 64 percent o f
consumption needs and imports accounting for the rest. One-half o f imports originated from Croatia.
Overall poultry consumption amounted to about 1.3 percent o f GDP, 3 percent o f total food expenditures
and slightly over 1 percent o f overall household consumption. Together with the consumption o f eggs
and processed poultry products, consumption o f poultry and poultry-related products amounted to about
K M 3 5 0 million in 2004, equivalent to 2.6 percent o f GDP and 2.1 percent the overall household
consumption.
Table 1. BH: Poultry Production and Consumption, 2004
Million o f
chicken
Production
large farmers
own-use
informal sector
Exports
Imports
officially registered
informal sector
Informal sector
ConsumDtion
17.1
8.1
*’
5.8
3.2
Million
I’
kg
24.5
11.7
8.4
4.4
0.0
0.0
9.3
6.1
3.2
6.3
26.3
13.7
9.3
4.4
8.7
38.2
1/ Exports are negligible
21 Includes registered market-oriented production
Economic Impact Analysis
48.
The economic analysis considers the short-term financial benefits and costs o f the project and the
associated program under a with-project and without-project scenarios. The analysis should be
considered as setting only the lower bound on the potential economic benefits that would accrue. The
analysis does not attempt to quantify the costs and benefits preventing the spread o f the virus to humans.
The analysis considers two events. One i s sporadic outbreak o f disease, as occurred in early
49.
2006, and the other i s a catastrophic outbreak. Table 2 lists the key assumptions o f the analysis. The
probability o f a sporadic outbreak i s assumed equal to 100 percent without a project, constant every year,
while the probability o f a catastrophic outbreak i s assumed to increase from 40 percent to 50 percent over
time. Both the probabilities o f sporadic and catastrophic outbreaks are assumed to be smaller and
declining under the with-project scenario. Further, it i s assumed that a sporadic outbreak will cause 5
percent o f poultry to perish, while a catastrophic event will result in a 25 percent death rate.
23
Table 2. Assumptions for the Economic Analysis
Year Year Year
Without Project
Sporadic contained outbreaks
Widespread outbreak
100%
40%
100%
45%
100%
50%
90%
38%
85%
30%
80%
30%
With Project
Continued sporadic contained outbreaks
Widespread outbreak
Percent o f stock lost during sporadic contained outbreaks
Percent o f stock lost during catastroDhic outbreaks
5 yo
25%
50.
Under these assumptions, the N e t Present Value (NPV) o f the project using a discount rate o f
10 percent i s $0.3 million. The IRR for this project i s unique and equal to 25 percent.
As indicated above, the project presents the lower bound o f benefits to society. The estimated
5 1,
economic benefits would be substantially larger if the costs and benefits o f averting human hospitalization
are taken into account. For example, were an outbreak o f avian flu to result in human infection, the cost
o f hospitalization and possibly death would be substantial.
2.
Technical
52.
Animal Health. Successful implementation o f the project depends on a phased multidisciplinary strategy based on a sound epidemiological approach to control H P A I outbreaks. This
strategy has to take into consideration the range o f epizootic and epidemiological scenarios that exist or
may arise in BiH, as well as the different poultry production systems within the country, and different
levels o f incidence (ranging from high incidence with variable flock outbreaks, through l o w frequency
disease outbreaks with partial flock immunity, to sporadic outbreaks). A balanced combination o f
appropriate disease control options, tailored to the specific characteristics and needs o f BiH, i s therefore
essential for the achievement o f the project objectives.
53.
K e y technical issues being addressed by the project include: (i)
capacity o f the public and private
veterinary services; (ii)adequate regulatory and incentive framework (including sub-laws); (iii)
regulations and protocols in accordance with OIE standards and guidelines); (iv) adequate laboratory
facilities and staff capabilities; (v) harmonization o f disease information systems to improve BiH’s
capacity to participate in the World Animal Health Information System (WAHIS) o f the OIE; (vi) biosecurity measures; (vii) minimizing contact between potential infected wild birds and domestic poultry;
and (viii) coordinating among public agencies and with the private sector to improve long-term planning
for infectious disease control.
54.
Human Health. So far, no human H P A I cases in humans have been reported in BiH. However,
the existence o f free-ranging poultry in backyards and close contact between human and poultry put BiH
at relatively high risk o f transmission o f the virus to humans. The assessments carried out show that the
capacity o f the MOHs, Public Health Institutes (PHIS) and other stakeholders to: (i)rapidly and accurately
detect H P A I cases in humans; (ii)adequately isolate and treat suspected or confirmed cases o f A I in
humans; and (iii)protect from the A I virus and other communicable diseases both populations at high
risks and the general population i s s t i l l relatively limited.
24
55.
First, the chain o f command i s insufficiently defined, which could lead to many problems and
delays, even in case o f a limited crisis. Second, while investigation teams do exist at the Entity level
PHIs, and cantonal and regional PHIs, their capacity to quickly and effectively investigate and respond to
local outbreaks appears too limited. Third, although efforts are being made by both Entities, the ability o f
health services to effectively isolate and treat suspicious or confirmed A I human cases i s at present
extremely limited. This i s even true at the level o f tertiary hospitals, where appropriately organized and
equipped isolation rooms do not exist at present. Fourth, the investigation teams as well as laboratory and
medical personnel lack protective equipment and clothing and the current stocks o f antiviral drugs appear
too limited. Fifth, health services will rapidly become unable to cope with an explosive increase o f the
number o f patients.
In such a context, priority needs to be given to: (i)the strengthening o f the capacity o f Entity and
local investigation teams through training and the provision o f necessary equipment, notably personal
protective equipment; (ii)the creation o f isolation rooms in hospitals, for effective isolation o f the first
cases o f HPAI in humans; (iii) the training o f health workers in infection control measures; and (iv) the
preparation o f plans to "clean out" hospitals in case o f a severe outbreak and the identification o f
culturally and socially appropriate social distancing measures in case o f a pandemic. In parallel, actions
should be taken to help: (a) strengthen the system for the surveillance o f communicable diseases and help
BIH become part o f the European Influenza Surveillance network; and (b) build-up adequate human
microbiology and virology laboratory capacity in each Entity.
56.
3.
,
Social
57.
Although there are several large and a number o f medium-size commercial poultry producers,
about 25% o f poultry are kept by smallholders in their backyards and managed by women with the help o f
children. Such families are disproportionately likely to be in the lower income quintiles.
58.
The central roles o f women and children in managing backyard poultry have important
implications for the project:
0
4.
Given the involvement o f children managing domestic birds (feeding, egg collection, herding
geese and ducks, etc.), awareness and educational efforts need to ensure that children are
effectively targeted and reached with appropriately designed messages, through the schools.
Reaching women with critical A I awareness messages and information will, similarly, require
specific targeting and utilization o f suitable dissemination and outreach channels. School-age
children can bring leaflets to their mothers.
In the event o f culling, compensation will need to be provided to women owners, and the project
will ensure that mechanisms are in place to ensure this.
Fiduciary
59.
The financial management arrangements o f the project are acceptable to the Bank. The overall
F M risk for the project i s moderate except for the Poultry Culling Compensation Scheme that i s
considered to be high risk. However adequate mitigation measures and internal controls are required prior
to the disbursement o f funds and some o f the key controls are included below (appendix 5). The financial
management arrangements o f the Federation PIU in Ministry o f Agriculture and the RS PCU established
in the Ministry o f Health have been assessed and continuously monitored as part o f project supervision,
and have been found to deliver high quality fiduciary services to the projects. They have both established
and maintained good financial management system for the implementation of the Bank financed projects.
The financial management systems will be expanded to support the proposed project and additional
25
expertise in financial management will be engaged and financed under this project. The internal control
and fund flow arrangements are yet to be finalized for the cash grants/Poultry Culling Compensation
Scheme component, but the basic control procedures for the existing compensation system for Avian
Influenza described in 2005 i s a valuable basis for finalizing the procedures with the added complication
with additional sources o f financing for the compensation from this project. The flow o f funds under the
cash grantsPoultry Culling Compensation Scheme sub-component w i l l only begin after appropriate
internal control and fund flow procedures have been documented in the financial manual that will be part
o f the Project Operational Manual and after the Bank has assessed the internal control arrangements as
satisfactory. Appropriate flow o f fund mechanisms i s a condition o f disbursement. Detailed financial
management arrangements are described in Appendix 5 .
60.
Procurement. The capacity o f the PIUPCU to conduct procurement under Bank guidelines has
been assessed as satisfactory under the Forestry/Agriculture and Health Projects, respectively..
Procurement functions will be strengthened by the recruitment o f an additional procurement specialist to
be responsible for procurement under this project in the PIU and PCU. Activities to be financed from the
Credit shall be undertaken in accordance with the procedures set forth in the Bank "Guidelines Procurement under IBRD Loans and IDA Credits" dated May 2004 (the Procurement Guidelines).
Similarly, the selection and employment o f consultants' services shall be governed by the "Guidelines:
Selection and Employment o f Consultants by World Bank Borrowers" dated May 2004 (the Consultant
Guidelines). Details on procurement arrangements are provided in Annex 4. The procurement plan will
be finalized during Appraisal.
5.
Environment
Environmental assessment
Environmental Category
PI
61.
The two safeguard issues which pertain to the Project are those o f environmental assessment for
methods to be deployed for disposal o f culled poultry and o f mitigating the negative impacts o f mandated
culling o f poultry on small scale backyard poultry producers. A delay in the completion and disclosure o f
the Environmental Assessment from the normal appraisal stage has been approved, instead making this a
condition o f disbursement for Component 2 - Animal Health, and Component 3 - Human Health. The
draft EMP has been completed, with the public consultation held on July 20, 2006 in Sarajevo. Following
this, the EMP was finalized in end-September 2006. Nevertheless, prior to Effectiveness, evidence of the
adoption of the EMP by the Recipient and each Entity needs to be provided to the Association.
Activities under the proposed project are not expected to generate any significant adverse environmental
effect, as a large part o f the project i s geared to support prevention activities. Overall, the project would
have positive environmental and social impacts. The primary potential environmental risks can be
grouped into three categories:
(a) Inadvertent human exposure and spread o f the virus due to: improper culling and disposal o f dead
birds (wild birds, sick and dead birds from backyard and commercial poultries); lack of, or
improper use o f personal protection equipment (PPE); improper disposal o f farm waste (i.e.,
bedding, manure, washings, etc. during and/or after an outbreak); and inadequate lab biosafety
protocols.
(b) Inadvertent release o f chemicals in the environment from unsatisfactory decontamination
procedures (for personnel, poultry sheds, and transport vehicles, etc.).
(c) Release o f chemicals and infectious agents into the environment from inadequate laboratory and
medical facility waste management.
26
62.
Building capacity for collection and testing o f Avian Influenza virus. The Project’s
investments in facilities, equipment, and training for laboratories will improve the effectiveness and
safety over existing avian influenza handling and testing procedures by meeting international standards
established by OIE. Upgrading for laboratories will include provision o f appropriate facilities and training
for waste management and for bio-safety level 2 and 3 operations. Medical waste generated in health care
facilities will be managed using existing guidelines in BiH, which have been found satisfactory under
previous projects. The Project would also support updating these guidelines, training o f health care
workers to manage medical waste following these guidelines, and, as appropriate, purchase o f equipment
for the proper handling and disposal o f medical waste in participating facilities. These provisions would
be included in the Project Operational Manual to be prepared prior to effectiveness.
63.
Overall, the Project w i l l assist the government to develop a strategy for managing future
emerging and re-emerging zoonotic and infectious diseases outbreaks. As such, the project would
improve environmental and social safeguards, in two areas: (i)mainstreaming environmental safeguards
into protocols and procedures for the culling and disposal o f animals during an outbreak, in particular by
adopting OIE standards in these areas, and improving bio-medical waste management systems in health
facilities and laboratories; and (ii)development o f policies on compensation for poultry farmers affected
by future outbreaks.
6.
Safeguard Policies
Safeguard Policies Triggered by the Project
Environmental Assessment (OP/BP/GP 4.0 1)
Natural Habitats (OP/BP 4.04)
Pest Management (OP 4.09)
Cultural Property (OPN 1 1.03, being revised as OP 4.1 1)
Involuntary Resettlement (OP/BP 4.12)
Indigenous Peoples (OD 4.20, being revised as OP 4.10)
Forests (OP/BP 4.36)
Safety o f Dams (OP/BP 4.37)
Projects in Disputed Areas (OP/BP/GP 7.60)
Projects on International Waterways (OP/BP/GP 7.50)
Yes
[XI
[I
[I
[I
[I
[I
[I
[I
[I
[I
No
[I
[XI
[XI
[XI
[XI
[XI
[XI
[XI
[XI
[XI
64.
Since the Project i s assessed as a B-category project, an Environmental Management Plan (EMP)
would be implemented with project support (see project components). The EMP addresses safe culling
practices, and disposal o f carcasses, laboratory wastes, and medical waste. This EMP also covers the
clean up o f animal wastes o f culled poultry by the local public veterinary services and minor civil works
supported under the Project.
7.
Policy Exceptions & Readiness
65.
The only policy exception requested has been with regard to the waiver o f the completion of the
E A and EMP per para. 12 o f OP 4.01. As noted above, evidence o f the adoption o f the EMP i s a
condition for Effectiveness. The project meets the regional criteria for readiness for implementation.
27
28
Appendix 1: Results Framework and Monitoring
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project
Project Development
0 bjective
The overall objective o f the Project
i s to minimize the threat posed to
humans and the poultry industry
by the HPAI infection and other
zoonoses, by enhancing both
animal and human health
infectious disease response and
control capacities.
Outcome Indicators
With regard to awareness o f HPAI threat and
how to prevent it:
Behavior changes among key veterinary
and public health personnel
Improved public awareness o f how to
prevent spread increases, and behavior
changes.
Use o f Outcome Information
YR1 - gauge effectiveness o f
government HPAI strategy
YR2 - determine if government
HPAI strategy needs to be changed
YR3 - mainstream lessons learned
from HPAI strategy into animal
health and public health systems.
With regard to HPAI outbreaks among
poultry:
Government culls birds at the infection
points following internationalbest practice
Government provides timely
compensation to farmers for culled birds
With regard to HPAI outbreaks among
humans:
Infection diagnosed and contained
Patients receive effective treatment for
HPAI infection
Use o f Intermediate
Outcome Monitoring
Intermediate Outcome
(One per Component)
Intermediate Outcome Indicator (*)
Component 1: Target population
informed about public health risks
and procedures associated with
HPAI.
50% percent o f at-risk population
practicing safe handling procedures with
respect to poultry and poultry meat.
YR1-YR3. N o change in behavior
indicates need to review media and
messages.
Component 2.A: National policy
framework defined and national
strategy developed to prevent,
control, and eradicate HPAI
among the animal population.
Component 2.B: Animal disease
surveillance and diagnostic
capacities strengthened and
training o f the veterinary services
designed and completed.
Relevant legislation - for registration o f
poultry farms, biosafety, and surveillance
and monitoring - including all necessary
sub-laws, regulation, protocols and
guidelines, prepared and adopted
Laboratory equipment and materials are
procured, distributed and installed;
Staff i s trained in surveillance and
diagnostic methods;
Reporting and reaction time for suspected
cases of A I i s reduced to the minimally
acceptable levels;
75% average monitoring coverage in atrisk areas.
Outbreak Containment Plan conforms
with the guidelines o f FAO/OIE and
GPAI;
Chain o f command and coordination
arrangements in place and functional.
Emergency supplies procured and
YRl-YR2: Identify gaps and needs
for additional support. Determine if
plans need to be changed.
Component 2.C: Outbreak
Containment Plan prepared and
activated as needed in response to
A I outbreaks
0
0
0
29
YR1-YR3: Verify compliance with
procedure and identify needs for
changes and training
YR1-YR2: Identify gaps and needs
for additional support. Determine if
plans need to be changed.
YRl-YR2: Identify gaps and needs
for additional support. Determine if
plans need to be changed.
Intermediate Outcome
(One per Component)
Component 3.A: Better managed
public health agencies through
improved planning and
coordination
Component 3.B: Strengthened
surveillance o f influenza-like
illnesses
Intermediate Outcome Indicator (*)
available at strategic locations in the
field;
If appropriate, ring vaccination around
infected areas completed;.
Culling, disposal and disinfection
activities completed as needed;
Compensation provided to poultry owners
rapidly and transparently. (in conjunction
with Component 4)
Chain o f command and coordination
arrangements in place and functional
Detailed response plan prepared,
including a detailed implementation plan
for social distancing
Simulation exercise conducted each year
and report produced and disseminated to
all stakeholders.
Notification o f Influenza like syndromes
improved and early warning system
functioning.
X personnel trained in influenza
surveillance and control
Use o f Intermediate
Outcome Monitoring
YR1-YR2: Identify gaps and needs
for additional support. Determine if
plans need to be changed
YR2-YR3: Review and evaluate
plan and modify as necessary
YW-YR3: Results o f simulation
exercises and actual investigationo f
outbreaks used to identify need for
information, training and equipment
YR1-YR2: identification o f gaps and
needs for additional suppodtraining.
Y E - Y R 3 : Assess need to revise the
strategy for alert, investigationo f
outbreaks and response.
National Influenza Laboratory
(NIL) safely collects, manipulates
and tests HPAI specimens.
At least one laboratory able to type and
subtype influenza viruses and at least at
bio-safety level 2 each entity.
YRI-YR3 Inability to achieve biosafety levels indicates need to
review investment, staffing,
protocols and procedures
Timely transmittal o f specimens to
the UK reference laboratory
Maximum5 days elapse between
collection and transmittal o f specimens to
reference laboratories for confirmation.
Y R l -YR3: Verify compliance with
procedure and identify needs for
changes and training
National and regional teams able
influenza outbreaks
At least one team in each Entity able to
properly respond to outbreak within 24
hours after notification/alert.
Component 3.C: Public health
system responds to suspected or
actual HPAI cases in humans
Staff guidelines for immunization against
both seasonal flu and HPAI completed
and disseminated
YR2-YR3: Assess guidelines to
ensure sufficient immunization
coverage o f populations at risk.
100 percent o f PHI, hospital, and PHC
service personnel vaccinated against
seasonal influenza.
YRl-YR3: Review procedures and
modify to meet targets
30 percent o f population at high risk
vaccinated against seasonal influenza
YR1-YR3: Review procedures and
modify to meet targets
to investigate and respond to
30
YRl-YR3: Verify capacity to
respond to suspected outbreaks.
Identify needs for training and
additional support.
Intermediate Outcome
(One per Component)
Intermediate Outcome Indicator (*)
Use o f Intermediate
Outcome Monitoring
2000 units o f anti-viral drugs stockpiled YR2-YR3: Review procurement and
in each Entity and operational plan to storage procedures
rapidly
procure
anti-viral
drugs
Y2: Review plan and modify as
completed
necessary
Isolation
rooms
established
and
adequately equipped in at least 2 YR2-YR3: Assess progress in
Hospitals in each Entity with staff trained establishing rooms and revise
(andor re-trained). Safety measures well procedures if objectives not met
know and PPE available. Prepare hospital
clean out plans in cases o f serious YR2-YR3: Assess guidelines and
dissemination methods
outbreaks or pandemic.
Guidelines on the use o f antiviral and on
isolation and care produced and
disseminated to staff.
50 percent o f staff in Entity, cantonal
and RS hospitals knowing how to protect
themselves and patients against the HPAI, use
anti-viral drugs and adequately treat patient
with HPAI.
Y2-YR3 Assess capacity o f hospital
staff to isolate and treat first cases o f
patients. Identify alternative
strategies
Y2-YR3 Assess capacity o f hospital
staff to isolate and treat first cases of
patients. Identify alternative options
to take care o f large numbers of
patients in case of large outbreaks or
a pandemic.
Component 4: Poultry Culling
Compensation Scheme
operational, including agreed
procedures for compensation o f
both small-scale producers
("backyard"), and large-scale
commercial producers
In the event of outbreak, timely
compensation provided to all farmers
whose animals are culled
Compensation procedures subject to
regular updating, based on results o f
each compensation event
Component 5.A: Coordination
and management o f project
activities carried out as planned.
Progress reports, financial monitoring,
procurement and disbursement reports,
audits, management and financial reports
prepared and submitted periodically.
Baseline developed for monitoring and
evaluating Project impact six months after
Credit effectiveness.
Methodology defined and monitoring and
evaluation periodically undertaken.
Y 1 - Review comprehensiveness
and timeliness o f reports and make
adjustments as required
Component 5.B:
Coordination and management o f
project M&E activities carried out
in a professional manner, as
planned.
Y 1-Y2 Assess quality o f data
collected through M&E activities
and define what program
adjustments are needed.
NOTE: Should any disease outbreak occur (avian flu or another communicable disease), the
response o f the health system will be examined, both for results monitoring and to ensure that
lessons learned will inform further implementation o f this operation.
31
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Appendix 2a: Detailed Project Description
BOSNIA AND HERZEGOVINA: Avian Influenza PreparednessProject
1.
The project would finance activities under five components: (i)Strategic communications and
public information; (ii)animal health protection and disease prevention and control; (iii)human health
protection and disease prevention and control; (iv) poultry culling compensation scheme; and (v)
implementation support, monitoring and evaluation. It should be emphasized that even though the
activities are organized by sectoral components, the Project calls for, and strongly endorses an integrated
national plan that ensure common objectives across sectors for dealing with the threat o f HPAI.
In addition to the Bank and government co-financing described below, various other international
organizations -- including the European Commission (EC), World Health Organization (WHO), United
States Agency for International Development (USAID), United Nations Children’s Fund (UNICEF) - are
active in assisting the Government o f Bosnia-Herzegovina to address the threat o f Avian Influenza. The
Project has been designed in close cooperation with these organizations, to leverage the maximum
financing possible, and to avoid duplication o f efforts. With the exception o f UNICEF, the exact level o f
financing o f these donor activities i s not presented, as this i s not considered direct cofinancing o f the
Bank-funded Project,
COMPONENT1: STRATEGIC COMMUNICATION AND PUBLICINFORMATION
- U S $0.20 million
Financing
IDA Credit:
IDA Credit Proceeds
FBiH:
US$O. 1 1 million
RS
US$0.09 million
US$0.20 million
2.
I t i s o f critical importance that all sectors o f society are properly informed about the risks from
HPAI, in order that proper protective measures can be taken, and, as importantly, to reduce the risk o f
unwarranted fear about the disease (e.g. unnecessarily reducing consumption o f poultry products). This
component would provide support for a broad range o f information and communication activities, to
increase the attention and commitment o f government, private sector, and civil society organizations, and
to raise awareness, knowledge and understanding among the general population about the risk and
potential impact o f the disease.
3.
Building on the work initiated by the Entity Public Health Institutes with the support o f UNICEF,
numerous communications interventions will be financed, chief among them the further development and
implementation o f the already drafted communication strategy. The draft strategy includes, inter alia:
improved communications strategies between and across government agencies (National Communication
Plan); protocols for coordination o f the outbreak and crisis communication for professionals
(veterinarians, human health doctors, inspections, civil protection, state border service, etc); materials and
targeted training for educators; capacity building in communication techniques for health workers,
teachers and media professionals; and, at the community level, awareness raising and communication for
behavior change activities through all appropriate communications channels. A local Communications
Specialist will be hired to work in the Technical Support Group to coordinate activities under this
component. He/she will be assisted by short-term consultants to be engaged as needed t o address specific
communications issues. In order to assist with the above tasks, three types o f activities are being
considered for financing:
39
0
0
A.
Developing basic communication materials, including developing and testing messages and
materials to be used in the event o f a pandemic or emerging infectious disease outbreak;
Developing training courses in communications methodology for veterinary staff as well as for
health workers at the cantonal and municipal levels; and
Collaboration among stakeholders, including state level authorities such as the Ministry o f
Foreign Trade and Economic Relations, the Ministry o f Civil Affairs, the Ministry o f Security, as
well as veterinary and public health authorities at the state, entity and municipality levels.
Developing Basic Communication Materials
4.
Activities to be supported would include developing and testing messages and materials to be
used in the event o f a pandemic or emerging infectious disease outbreak, and further enhancing the
infrastructure to disseminate information at the state and local levels and between the public and private
sectors. Communication activities w i l l support cost effective and sustainable methods such as marketing
o f “handwashing” through various channels through the delivery o f handwashing messages via mass
media, counseling, schools, etc. Communication materials would be integrated into Avian Flu specific
interventions as well as ongoing outreach activities o f ministries and sectors, especially ministries o f
health, education, agriculture, security and transport. Specifically, support would be provided for: (i)the
development and distribution o f basic communication materials (such as question and answer sheets and
fact sheets) on influenza, influenza vaccine, antiviral agents, and other relevant topics; (ii)general
preventive measures such as “do’s’’ and “don’t’s” for the general public. Support would also be provided
for information and communication activities to increase the attention and commitment o f government,
private sector, and civil society organizations, and to raise awareness, knowledge and understanding
among the general population about the risk and potential impact o f the pandemic and to develop multisectoral strategies to address it.
B.
Developing Training Courses in CommunicationsMethodology
5.
This sub-component would support the development and implementation o f training courses in
communications methodology for veterinary staff as well as health workers at the State and local levels.
I t will include the preparation and dissemination o f information materials, and the provision o f
communications and information equipment for use at the state and local levels. Specifically, support
would be provided for (i)information and guidelines for health care providers; (ii)training modules (webbased, printed, and video); (iii)presentations, slide sets, videos, and documentaries; (iv) and symposia on
surveillance, treatment and prophylaxis. In addition, support would be provided to strengthen networks
o f communication offices, as well as mechanisms to increase coordination and consistency o f messages
among risk communication managers. Training would be provided under this sub-component for spokepersons from priority sectors in managing the media, partnering with the electronic and print media with a
view to highlighting the national response, as well as accurately reporting on the monitoring,
preparedness, containment and mitigation plans, as the case may be. The Ministry o f Education and
relevant partners w i l l participate in the development o f educational materials to be used in schools.
C.
Collaboration with Stakeholders
6.
The multi-dimensional problems associated with HPAI infection necessitate collaboration from a
wide range o f stakeholders within each country, which has to be supported by broad communications and
information campaigns to improve public awareness. The major stakeholders include various ministries
(Finance, Agriculture, Health, Transport, veterinary services, national research institutions and diagnostic
laboratories), NGOs and civil society organizations, private sector companies and associations (e.g. large
poultry producers, farmers’ associations, veterinarians and farmer involvement at the grass roots level).
40
The sub-component would support activities designed to improve the effective coordination and
collaboration among these stakeholders.
-
COMPONENT 2. ANIMAL HEALTH
PROTECTION AND DISEASEPREVENTION AND CONTROL $2.98 million
Financing
Gov’t. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
US$0.25 million
USO.17 million
US$O. 10 million
US$2.46 million
us
IDA Credit Proceeds
FBiH:
US$1.62 million
RS
US$0.84 million
7.
The project would support a program to develop and implement H P A I prevention, containment,
control, and eradication activities in the livestock sector, specific to the needs o f BiH in the short, medium
and longer term. These activities reflect an assessment o f the particular risks, conditions, constraints,
needs and possibilities in the country, including a rapid assessment o f the veterinary services.
Government contribution to this Component will consist primarily in o f consumables (e.g. personal
protective equipment and supplies), minor goods, running costs o f various reporting systems, and in-kind
staff costs.
A.
Enhancing H P A I Preparedness and Prevention Capability (US $0.31 million)
8.
A l : Strengthening the National Policy and Regulatory Environment. The project w i l l
support activities aimed at improving the policy, legal and regulatory framework that governs the national
capability to implement the recommended disease detection, control, prevention, containment, and
eradication measures in a uniform and effective way and in accordance with OIE standards and
guidelines. The project includes support for a detailed review o f current policies and the existing legal
and regulatory environment and for the drafting, as may be warranted, o f legal amendments, regulations
and implementation guidelines and manuals. Staff o f the Ministries o f Agriculture, SVO, and other
concerned agencies will, in topical working groups and with support by international experts on
veterinary laws and regulations, review the relevant laws and regulations governing animal disease
control and will draft the necessary legislative amendments, regulations and implementation guidelines.
Particular emphasis w i l l be placed on regulations concerning the control o f notifiable diseases, the
delineation o f the respective responsibilities o f the veterinary authorities, private veterinary service
providers and farm owners. Specific areas o f emphasis are:
0
Development o f legislation establishing a national program for registration o f poultry farms.
Data related to farm location, type o f production and capacity (number o f animals, production
output) will be necessary for planning, implementation and evaluation o f AI preparedness and
control activities. This information will also be necessary for efficient indemnification o f losses
incurred from the destruction o f livestock.
0
Development o f legislation regarding biosafety requirements/conditions necessary for
establishing and maintaining poultry farms. The capacity of relevant agencies should be increased
to provide extension services/education to producers in support o f biosafety requirements.
Development o f legislation mandating surveillance activities. This legislative framework w i l l
need to incorporate equitable solutions for distributing costs and responsibilities for surveillance
between government and producers.
41
Strengthening of Veterinary Services, Diagnostic Capacity, Applied Research, and Disease
B.
Surveillance (US $2.3 million)
9.
B1: Strengthening Veterinary Services and Diagnostic and Applied Research Capacity.
There are wide divergences in the capacities o f the individual animal health laboratories within the
country. None o f the laboratories have an appropriate biosafety environment for handling A I agents. The
short term goals for the system include developing appropriate capacities and biosafety levels (BSL) in
regional laboratories involved in routine monitoringlscreening for AI. An evaluation o f capacities and
procedures in existing laboratories, to include biosafety protocols, will precede the determination o f the
specific steps that will be required to develop laboratory capacities.
10.
The longer-term goal i s to upgrade all laboratories to at least Biosafety Level 2 and, depending on
the overall financing that becomes available, to establish one B S L 3 lab, which could handle not only
HPAI, but any other highly pathogenic organisms which need to be tested. Project financing w i l l provide,
inter alia: civil works for rehabilitation and modernization o f the National Animal Health Laboratories
network (likely to focus on 5-7 labs); crucial diagnostic equipment; waste decontamination and disposal
equipment; refrigerators and microbiological cabinets; computers and software; and basic laboratory
furnishings. Additional support for laboratories would be provided under the proposed IDA-financed
Agriculture and Rural Development Project.
1 1.
B2: Strengthening Animal Disease Information Systems. The effectiveness o f an AI control
program will dependent upon the establishment o f a well functioning surveillance system, fed by valid
data collected in the field. This surveillance system should permit rational allocation o f resources,
creation o f alternative actions, and objective evaluation o f activities performed. Surveillance programs
should be differentiated between wild and domestic birds and further delineated within the domestic
population between free-range and commercial poultry. In order to achieve optimization o f surveillance
efforts, risk areas (wild bird habitat) must be expanded and a scientifically based sampling scheme must
be developed for domestic poultry. This will require assistance in obtaining sampling equipment,
developing arrangements for sample transportation, obtaining personal protective equipment and training
local staff.
12.
Support will be provided for basic equipment, training, surveillance, and integrated reporting
systems, for improved monitoring o f w i l d bird migration and “resting” points. This activity will be
coordinated with technical professionals from the biological sciences, with training focused on disease
recognition, safe handling o f potentially infected wild birds, and public communications.
C.
Strengthening H P A I Control and Outbreak Containment Capacity (US $0.30 million)
13.
Project support will be made available for the implementation o f H P A I outbreak containment
actions, as set forth in the draft national action plan and to be further specified in the final plan and
associated implementation guidelines and manuals. The national action plan specifies the responsibilities
and functions o f a National Disease Crisis Coordination Center (NDCCC).
It also defines the
composition and responsibilities o f Local Disease Crisis Coordination Committees (LDCCCs) that will be
formed and trained now, and activated in any location where an outbreak i s suspected andor confirmed.
14.
The project will finance and support activities related to the implementation o f the plan,
including, inter alia, technical assistance and training for enhanced emergency response, outbreak control,
data collection and interpretation, early warning systems, and basic epidemiology, as well as equipment
such as personal protective equipment for field and laboratory epidemiological staff, culling equipment,
and disinfection sprayers. In addition, a specific unit for epidemiological communications will be
established.
42
D.
Improving Biosecurity in Poultry Production and Trade (US $0.07 million)
15.
Support will be provided for a training program on farm biosecurity practices. This training w i l l
be primarily oriented towards smallholder operations, as larger commercial farms generally have quite
good biosecurity. However, large operations will also be targeted, particularly where they are nearby to
significant poultry populations in “backyards”.
COMPONENT 3: HUMAN
HEALTH
PROTECTION AND DISEASEPREVENTION AND CONTROL $1.98 million
Financing
Gov’t. of Bosnia and Herzegovina
FBiH
RS
IDA Credit:
us
IDA Credit Proceeds
US$0.22 million
US$O. 10 million
US$O.lO million
FBiH:
RS
US$0.98 million
US$0.98 million
US$1.96 million
16.
This component would support a program to further plan and implement preparedness, and
improve surveillance and prevention as well as response and containment activities in the human health
sector in the short, medium and longer term.
17.
On the basis o f the country’s epidemiological needs and assessment o f the particular conditions,
constraints, needs and possibilities in BiH, initial support under the project will concentrate on a few
essential areas. These will include the further refinement o f the contingency preparedness plans and the
establishment o f a clear chain o f command and coordination mechanisms, the rapid strengthening o f
capacities in intervention epidemiology (including simulation exercises), the expansion o f seasonal flu
vaccinations, and the strengthening o f the health sector capacity to isolate and adequately treat a few
suspected or confirmed cases o f A I in humans. In parallel, the project will help plan and support the
strengthening o f the surveillance system for communicable diseases and o f laboratory capacity as well as
o f the capacity o f the health sector to prevent the spread o f the A I virus among humans and to protect
groups at high risk. Finally the project would also support efforts to prepare for social distancing and
other interventions measures in case o f a pandemic.
18.
Activities to be supported under the project would be grouped in three sub-components: (a)
enhancing public health program planning and coordination; (b) strengthening o f public health
surveillance system; and (c) strengthening health system response capacity. Government contribution to
this Component would consist primarily o f laboratory and hospital consumables (e.g. personal protective
equipment and supplies), minor goods, and in-kind staff costs.
A.
Enhancing Public Health Program Planning and Coordination (US $0.13 million)
19.
Legal aspects regarding communicable diseases (including highly pathogenic infections) are
covered by the Laws on the protection o f the population from infectious diseases, which were adopted in
1995 in RS and M a y 2005 in FBiH. Current institutional arrangements for addressing Avian Influenza in
Humans in BiH parallel the organization o f the health system and responsibilities lie with the entities.
20.
In the past year, both Entities have made significant efforts to plan and coordinate activities. The
RS Preparedness Plan was adopted by the Government in October 2005. The FBiH “preparedness plan
for expected emergence o f the Pandemic Influenza” has been revised in February 2006, and has now been
approved by the Federation Government. In any case, these plans have now been superseded by the
creation o f a National Contingency Plan, produced through a series o f multi-stakeholder workshops
43
sponsored by WHO. The National CP contains clear chain o f command and individual responsibilities
and (b) the measures to ensure coordination between stakeholders working on animal and human health in
M O H s and between MOHsAPHS and other actors within the health sector. The National CP i s not yet
formally ratified by the full BiH Parliament; this i s expected to be completed by mid-2007. The subcomponent would support the following three activities:
22.
A l : Refining Plans and Strengthening the Chain o f Command. As noted, the W H O has
sponsored a series o f workshops which have led to an integrated National Contingency Plan (CP), which
addresses the shortcomings noted above. T o help prepare all stakeholders t o better cope with outbreaks
and ensure that individual responsibilities and procedures to be followed are well known, the project
would finance the conducting o f simulation exercises at the State, Entity and local levels, once the new
National CP i s approved.
23.
A2: Review and Amendments o f Laws and Bylaws. The project would finance technical
support to review and prepare necessary amendments to current laws and bylaws. More specifically,
assistance will be given for the review and/or preparation of, inter alia: (i)statutory provisions regarding
quarantine laws and how they apply in a public health emergency, (ii)laws and procedures for closing
businesses and schools and suspending public meetings during a declared state o f emergency, (iii)
medical volunteer licensure, liability and compensation for retired and non medical volunteers; and (iv)
worker’s compensation laws as they apply to heath care and other essential workers.
24.
A3:
Social Distancing.
The project would support the development o f a detailed
implementation plan for so-called “social distancing” measures to be activated in case o f an epidemic.
Social distancing measures will typically be activated on advice from health professionals and
institutions, although they will not be the enforcing agencies. The implementation plan will have
therefore to explicitly define institutional responsibilities for activation and enforcement o f social
distancing measures and for inter-agency and inter-ministerial coordination. Training will also be
provided to “enforcement agents” such as the police and military in safe, efficient implementation o f
social distancing measures in ways that do not induce panic. Additional preventive actions that will
complement social distancing (such as personal hygiene promotion through various communication
channels, including hand-washing and proper cooking, and distribution and use o f masks) will also be
supported.
25.
A4: Clean Out Plans for Hospitals (Preparing for Coping with Severe Outbreaks and a
Pandemic). The project will also support the preparation o f plans and measures to be implemented in
case o f larger outbreaks or a pandemic. While a full-scale pandemic will rapidly overwhelm hospital
capacity, there i s a need to prepare hospital “clean-out’’ plans to help create a buffer for localized
outbreaks. Specifically, the project will support the preparation o f plans to reorganize and clean out
infectious clinics and other departments in hospitals to make them able t o cope with an increase o f
suspected or confirmed A I cases. The plans will necessarily include measures to evacuate hospitals o f non
acute cases through, for instance, the canceling o f elective procedures or finding alternative
accommodation for non-emergency admissions.
B.
Strengthening National Public Health Surveillance Systems (US $0.95 million)
26.
At this point in time, there i s no national surveillance system for communicable diseases. The
surveillance systems in place at the Entity level are based on routine health facilities reports for 62
diseases, which are compiled and analyzed by the hygiene and epidemiological departments o f the IPHs’.
’ See the WHO report titled “assessment o f the national surveillance system for communicable diseases” and dated
September 2004. A new assessment o f the national laboratory capacity will be conducted by WHO in June 2006.
44
Except in the case o f suspected or confirmed outbreaks, reports are sent weekly t o the intermediary level
(regional or cantonal PHIS) and monthly to the Entity level. N o specific surveillance system i s in place
for influenza and influenza-like (ILI) illness and BiH i s not part o f the European Influenza Surveillance
network.
27.
Investigation and response teams exist at the Entity level (2 in RS in Banja Luka and Doboj and 1
in FBiH) and additional capacity can be mobilized at regional or cantonal level. These teams, however,
lack protective personal equipment, spraying devices and disinfectant. Efforts to train staff in
intervention epidemiology have already started and recently (2005), 24 epidemiologists attended the
EPIET course organized by WHO with EU financial support. However, there i s an obvious need to
further build-up capacity in intervention epidemiology and t o train and/or retrain investigation and
response teams.
28.
There i s no national or Entity Influenza Laboratory and or no capacity in the health sector for
typing and sub-typing o f influenza virus strains. As indicated in the 2004 report on laboratory capacity in
BiH6, the capacity o f existing microbiology and virology laboratories need to be significantly improved
before the country can be considered to have an effective communicable diseases surveillance system.
Basic facilities and good expertise exists in the country. However, the existing laboratory capacity i s
highly fragmented and the lack o f training and investment in the past 15 years have left the laboratories
operating at a level far below EU standards and the minimum bio-safety level 2 required for manipulating
highly pathogenic viruses. Three interventions are planned.
29.
B1: Improvement o f Capacity in Intervention Epidemiology. The project will first strengthen
the capacity to investigate and respond to outbreaks, including: (a) investigation and collection o f
specimens in areas where A I in birds or poultry are reported, (b) safely and rapidly transport o f specimens
to laboratories (including to the UK reference laboratory) for diagnostic testing and virus sub-typing and
confirmation o f results and, (c) outbreak investigation and containment measures in areas with suspected
or confirmed human cases. T o this end and building on activities supported by WHO (with financing
from EC), the project will support the Public Health Institute and regional/cantonal epidemiological
investigation and response teams through: (a) the re-training o f staff, (b) the provision o f personal
protective gears and other equipment and consumables (sprayers, disinfectants), the provision o f materials
and bio-safety boxes for the collection and transport o f samples and, (c) communications equipment.
30.
B2: Strengthening the Surveillance o f Influenza and Communicable Diseases. In parallel
with activities listed in B 1 above, the project will complement the EU/WHO current efforts and pilot
project aiming at the strengthening o f the communicable diseases surveillance system. In particular, the
project will provide part o f the necessary I T equipment (computers, servers, software) and will contribute
to the building o f capacity for reporting and analysis o f epidemiological data. In this framework,
particular attention will have to be paid to the active surveillance o f influenza with a view to help BIH
rapidly j o i n the European Influenza Surveillance network.
B3: Strengthening the Laboratory Capacity. The project will contribute to building the
laboratory capacity and network. More specifically, the project w i l l contribute to efforts towards
upgrading two laboratories ( 1 in each Entity) to bio-safety level 2 and make them able to type and subtype influenza virus strains. In addition, the Project will assist with upgrading the laboratory in the P H I in
Mostar, to enable it to provide virus identification capacity. T o this end, the project will finance part of
the necessary studies, limited c i v i l works and equipment as well as kits, reagents and other consumables
and personal protective equipment (PPE) for laboratory staff. The project will also finance training and
31.
6
Laboratory capacity in BiH- April 2004- (Ray Sanders and Bernardus Ganter)
45
retraining o f laboratory staff. If needed, the project would also finance appropriate sterilization
equipment and incinerators for the management and disposal o f contaminated lab materials.
C.
Strengthening Health Care Response Capacity (US $0.9 million)
32.
A t this point in time, the BIH health sy,stem appears relatively unprepared to immediately and
adequately respond to even a limited outbreak, not talking o f coping with a pandemic. Seasonal influenza
vaccination remains limited and MOHs have only very limited stocks o f anti-viral drugs (only 400 and
1000 antiviral treatments are available in respectively RS and the FBiH).
33.
While the hospitals where the first A I suspected or confirmed human cases would be hospitalized
have been identified, these facilities are not ready to appropriately and safely taking care o f highly
infectious patients. Isolation rooms need to be established and properly equipped and health workers
from these facilities need to be trained or re-trained in many areas and t o be provided with personal
protective equipment. Three types o f intervention are proposed:
34.
C1: Emergency Measures. Under the project, assistance will rapidly be provided to ensure that
optimal medical care to A I suspected or confirmed human cases can be offered and to provide essential
services to the community in case o f a pandemic. Towards this aim, the project will provide support for
the: (a) establishment o f isolation capacity in the hospitals and infectious clinics that have been already
identified (Banja Luka and Foca for RS; Sarajevo and Tuzla for the FBiH); (b) equipment o f the isolation
rooms; (c) emergency stocks o f medicines and consumables, (d) protective equipment for health workers
and; (e) training and retraining o f staff. In addition, an enhanced triage capacity will be supported for the
Clinical Center in Mostar.
35.
In case o f a declared influenza pandemic, this sub-component w i l l finance emergency imports
identified as necessary under a well-defined preparedness and response program to be prepared as part o f
project implementation. These imports are likely to include: (i) pharmaceuticals and vaccines, (ii)
medical supplies and equipment, (iii)communication equipment, supplies and information campaigns,
(iv) food and water containers, and (v) protective clothing. Particular attention will be paid to the
definition o f measures towards the protection o f health care workers and t o ensure that they will be
willing and can continue to be at work in a pandemic situation (including protection and compensation
measures for the risks involved).
36.
C2: Vaccination. This sub-component will help expand regular seasonal flu vaccination for
targeted priority groups’ (as defined in the contingency plan). In view o f financial constraints as well as
the anticipated limited quantities o f seasonal flu vaccines available on the international market, the project
w i l l more specifically focus on the immunization o f the most at risk populations (poultry farmers and
veterinarians) and o f health care workers. It would also finance the development o f a detailed logistical
(procurement and distribution) plan for mass vaccination should an H P A I vaccine become available.
37.
C3: Anti-Viral Drugs: Under this sub-component, the project will finance the stockpiling on
anti-viral drugs (Oseltamivir or others). I t i s plan to help increase buffer stocks o f Tamiflu up to 3000
treatments for the Federation and to 1000 treatments for RS.
7
Including poultry farmers, veterinarians, health staff and persons with chronic disorders o f the pulmonary and
cardio-vascular systems andor chronic metabolic and immunologic disorders. To a l l the extent possible, vaccines
will also be provided for the immunization of children below 5 and persons over 65 years o f age
46
COMPONENT 4: POULTRY
CULLING COMPENSATION SCHEME - U S $0.75 million
Fin an cing
FBiH
RS
IDA Credit:
US$O. 10 million
US$O. 10 million
US$0.55 million
IDA Credit Proceeds
FBiH
US$0.3 1
RS
US$0.24
38.
Early detection and reporting as well as rapid response depend critically on the incentives for
poultry owners to report very quickly any sick and dead poultry to their veterinarians. Without adequate
compensation arrangements in place, poultry owners have no incentive to do so, but must fear that their
animals w i l l be destroyed and they lose this valuable capital.
39.
The June 2002 Veterinary L a w in BiH confirms the right o f farmers to compensation for the
elimination o f contagious animals, and determines the procedures for culling and compensation. The value
o f culled animals i s determined by Entity Veterinary Services, according to the damage appraisal l i s t
prepared by the appraisal commission. In the case o f Avian Influenza, the commission also confirms the
number o f culled poultry. These procedures have been successfully employed for the recent outbreak o f
H P A I in Jajce and Jezero.
40.
In the event o f further HPAI outbreaks in BiH, the Project will provide support for culling and
elimination o f infected and at-risk poultry, with compensation to farmers and commercial poultry producers
based on the existing legal framework and the A I contingency plan. The order for culling and
compensation will determine in advance the compensation value by type o f poultry (rather than requiring a
commission to determine the value on a case-by-case basis). Accurate lists will be kept o f all poultry
culled, so that the culling committee can calculate the compensation that will go to each poultry owner.
Strict requirements will apply to recording, reporting and verification o f poultry culling, compensation
claims and payments.
41.
Bosnia-Herzegovina’s current capacity to compensate farmers for culled animals w i l l be
enhanced by the provision o f US $0.55 million from the Project. This will be split evenly between the
Entities, with each Entity provided matching funds o f US $0.1 million. Access to the Bank portion o f
these funds will be conditional on the modalities for operating the Fund being approved by IDA. Key
parameters guiding this effort are provided in Appendix 2b.
COMPONENT 5: IMPLEMENTATION SUPPORT AND MONITORING
AND EVALUATION
U S $0.45 million
Financing
Gov’t. o f Bosnia and Herzegovina
FBiH
RS
IDA Credit:
A.
US$O. 12 million
US$O. 15 million
US$O. 15 million
US$0.03 million
Implementation Support
42.
This sub-component would support costs associated with project management and coordination,
including costs associated with the Technical Support Group to be established to support project
coordination and management, and costs associated with the PIU/PCU for procurement and financial
management services. An inter-sectoral Crisis Committee was established in November 2005 under the
chairmanship o f the Minister o f Foreign Trade and Economic Relations (MoFTER) to oversee the H P A I
control and containment effort and to provide general policies and guidance for avian influenza control.
This Committee will operate as needed in the event o f further A I outbreaks to ensure coordination and
47
linkages across relevant agencies and with international partners. Implementation arrangements are
discussed in Annex 2c below.
B.
Monitoring and Evaluation (M&E)
43.
B1: Training. This sub-component would support training in monitoring and evaluation at all
administrative levels, mid-term evaluation workshop, and development o f an action plan for M&E and
replication o f successful models. It would support the following activities:
Training in M&E;
0
Implementation o f baseline studies;
0
Mid-Term evaluation o f the project;
On-going part'icipatory monitoring and evaluation; and
0
Final project evaluation.
44.
B2: Project Monitoring and Impact Evaluation. Support would be provided to develop project
monitoring and impact evaluation assessments. Two types o f M&E are envisaged:
45.
B2(i): Monitoring o f project implementation. This i s a function o f the TSG, which would
collect relevant data from line ministries and other implementation agencies and then compile them into
quarterly progress reports focusing on status o f physical implementation by component, use o f project
funds (based on data provided by the PIUPCU) and monitoring indicators. Specific surveys can be
conducted to obtain data for this purpose. Annual expenditure reviews would be conducted to assess
government commitment to strengthen the public health functions as measured by budgetary allocations
and their distribution by activity.
46.
BZ(ii): Impact evaluation. The aim o f evaluation i s to find out whether the interventions are
effective or the program i s having the desired impact. The evaluation will include both quantitative and
qualitative aspects and be conducted on a yearly basis. The quantitative aspects w i l l rely on new
information systems and surveys implemented as part o f the various components o f the project, currently
existing data sources, and primary evaluative data collection efforts. The goal o f the qualitative aspect o f
the evaluation will be to document perceptions o f program managers, staff, patients, and local and
national leaders. Qualitative information will be collected using site-visit interviews, focus groups, and
respondent surveys.
48
Appendix 2b: Culling and Compensation Procedures
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project
Table 1: 2004 Production and Consumption o f poultry in BH/l
Million o f c h i c k e n
Million kg
Production
13.9
20.1
offic iaV2
8.1
11.7
ow n - u s e
5.8
8.4
Imports
6.1
9.3
I n f o r m a l sector/3
6.3
8.7
Consumption
26.3
38.2
/ 1 E x p o r t s are negligible
/2 I n c l u d e s registered m a r k e t - o r i e n t e d p r o d u c t i o n
13 I n c l u d e s u n o f f i c i a l d o m e s t i c p r o d u c t i o n and unregistered i m p o r t s
Poultry Culling Compensation Scheme
1.
Early detection and reporting, as well as rapid response, depend critically on the incentives for
poultry owners to report very quickly any sick or dead poultry to veterinarians. Without adequate
compensation arrangements in place, poultry owners have no incentive to do this, and will fear that with
the destruction o f their animals they will lose this valuable capital.
2.
The June 2002 Veterinary Law in BiH confirms the right o f farmers to compensation for the
elimination o f contagious animals, and determines the procedures for culling and compensation. The
value o f culled animals i s determined by Entity Veterinary Services, according to the damage appraisal
list prepared by the Appraisal Commission. In the case o f Avian Influenza, the Commission also
confirms the number o f culled poultry. These procedures have been successfully employed for the
February 2006 outbreak o f HPAI in Jajce and Jezero.
3.
In the event o f further HPAI outbreaks in BiH, the Project will provide support for culling and
elimination of infected and at-risk poultry, with compensation to farmers and commercial poultry
producers based on the existing legal framework and the A I contingency plan. The order for culling and
compensation will determine in advance the compensation value by type o f poultry (rather than requiring
a commission to determine the value on a case-by-case basis). Accurate lists will be kept of all poultry
culled, so that the culling committee can calculate the compensation that will go to each poultry owner.
Strict requirements will apply to recording, reporting and verification o f poultry culling, compensation
claims and payments.
4.
The Poultry Culling Compensation Scheme will be financed by an IDA credit o f US$0.55
million, conditional on IDA’Sapproval of the modalities for operating the Fund.-In addition, each Entity
would contribute US $0.10 million, as part o f the regular emergency fund allocation provided to the
animal health sector.
Village and Backyard Poultry Culling
5.
Compensation for AI-infected poultry in Jajce and Jezero followed the procedures provided by
the contingency plan. In future cases o f AI, the same approach should be taken. After official
confirmation o f an outbreak, the State Veterinary Office authorizes the local veterinary stations to
undertake necessary measures for control o f the disease. First an inventory o f all poultry i s done within a
radius o f 3 km. Then, the actual culling i s undertaken. After the culling, the owner and assessor sign a
49
form defined in the Contingency Plan (Form 6 in Annex IV) in three copies. One copy i s kept by the
owner, one copy i s submitted to the Entity Ministry o f Agriculture, and the third copy i s submitted to the
Technical Support Group. Pre-numbered forms will be given to the Local Disease Crisis Coordination
Committees (LDCCCs)' based on the inventory o f poultry in the at-risk region. The signed Form 6 will
be the basis for payment o f farmers. The payments will be made with cash transfers through the
municipal treasury systems. After culling, owners to be compensated in each municipality and the
amounts to be paid will be announced in a public place.
Commercial Poultry Culling
6.
At commercial poultry enterprises and other large producers the culling will be conducted in the
presence o f the owner by a team designated by the LDCCC. All will sign a form (in 3 copies) listing the
culled birds. One copy o f the form will be kept by the owner o f the commercial enterprise; a second copy
will be kept at the entity Ministry o f Agriculture and the third will be sent to the TSG. The compensation
payments to commercial poultry enterprises will be made through bank wire transfers. The forms will be
pre-numbered.
Database and Forms
7.
Forms will be printed, pre-numbered and kept with the Technical Support Group. The TSG will
keep the database o f the forms sent to each municipality, owner and commercial producers.
Compensation Payments
8.
The parameters for payments will include the following:
0
0
Compensation to farmers will made be in cash through transfers to the respective
municipalities; farmers will receive the compensation amounts from the municipality cashier.
Appropriate procedures for supervising and verifying payments are specified by the
Contingency Plan for A I and will be undertaken by the PIU/PCU at the direction o f the TSG.
Full details regarding these procedures will be addressed in the Project Operational Manual.
For small farmers, compensation per bird will be 100 percent o f the market price o f the laying
hens as reported by the entity agriculture statistical directorate/or competent authority during
the month preceding that in which the culling took place.
For commercial producers, compensation will be provided by bank transfer. Compensation
will be for reasonable replacement cost, Le., for birds less than 3 months old at the cost o f
one-day-old chicks, and for birds older than 3 months at the cost o f 3-month-old birds, as
reported by the entity agriculture statistical directorate/or competent authority during the
month precedingthat in which the culling took place .
9.
I f and when an HPAI outbreak occurs, the Entity Ministry of Agriculture will issue an ordinance
for the use o f funds for compensation including the parameters o f compensation amounts. These amounts
will be posted in a public place in the municipality. I t i s strongly recommended that the parameters
for compensation are coordinated by both entities.
8
The project proposes using the exact same form defined in the BIh Contingency Plan - Annex I V : Form 6
50
Flow o f Funds
10.
Procedures on flow o f funds should minimize delay but ensure maximum transparency. As stated
above, compensation payments will be made through: (i) wire transfers to municipalities which will pay
in cash for the compensation amounts to the farmers, and (ii) wire transfers to the accounts o f commercial
poultry producers.
11.
The State Veterinary Office, through the Technical Support Group, will verify that forms are
complete, and on the basis o f Form 6 and the farmers paying lists, will direct the PIUPCU to prepare the
withdrawal application with the necessary supporting documents for submission by the Ministry o f
Agriculture to the State MoF to the Association for reimbursement, with instructions in the withdrawal
application to transfer the payment directly to the Entity MOA.
12.
The Entity MOA then transfers the funds to the municipality treasury, which processes the
payments to the owners. On payment o f the compensation, the owner signs a payment receipt form,
copies o f which are forwarded by the municipality to the Entity MOA,Entity MoF and the PIU/PCU.
After the completion o f the payments, the municipality will submit payment lists to the TSG.
13.
The PIU and PCU provide the TSG with reports on the payments on a quarterly basis, as part of
the regular financial management reporting. A Poultry Culling Compensation Scheme database for each
Entity will be maintained by the respective PIU/PCU to facilitate record keeping, claim verification,
payment facilitation, monitoring and auditing.
14.
Further detail regarding flow o f funds under the Poultry Culling Compensation Scheme can be
found in Appendix 6 on Financial Management. These procedures will be fully elaborated in the Project
Operational Manual.
15.
Based on the law, the payment should be completed within 30 days. However, it would be highly
desirable for compensation to be completed in a shorter time span, for example, no longer then seven
days. After the HPAI outbreak in Jajce and Jezero, both Entities were able to compensate farmers within
seven days o f culling.
16.
Table 2 below illustrates the funds required to compensate farmers, both commercial and noncommercial (Le,, backyard or village, for personal consumption) if x percent o f all poultry in the state
were lost to A I culling, given a price o f 10 KM per free range (backyard) chicken and 5 KM for
commercial poultry and assuming a compensation scheme o f 100% reimbursement for non-commercial
farmers and 50% reimbursement for commercial farmers.
51
Table 2: Funds required to secure percentage of State poultry stock, by type of farmer
Total # of
poultry
(millions)
Total Value
( I O Kh4
noncommercial;
5
commercial)
Value
O f 1%
Value
O f 2%
Value
O f 3%
Value
O f 4%
Value
O f 5%
Non-commercial
5.8
58.0
0.580
1.160
1.740
2.320
2.900
Registered commercial
8.1
40.5
0.405
0.810
1.215
1.620
2.025
Total
13.9
98.5
0.985
1.970
2.955
3.940
4.925
0.360
0.719
1.079
1.438
1.798
0.611
1.221
1.832
2.443
3.054
Type of farmer
Total Value
in USD
($6.20 noncommercial)
Non-commerciaL
5.8
36.0
Total
52
Appendix 2c: Implementation Arrangements
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project
Technical Support Group
1.
Implementation o f the Project will be undertaken by a Technical Support Group (TSG) consisting
of technical advisors who are representatives o f the State Veterinary Office (SVO) in the Ministry o f
Foreign Trade and Economic Relations’, Ministry o f Civil Affairs, FBiH and RS Ministries o f Agriculture
(Veterinarian Services), FBiH and RS Ministries o f Health, a full-time consultant for communications and
a part-time monitoring and evaluation consultant (see organizational chart below). SVO has the mandate
to coordinate veterinary services on behalf o f the Entity Ministries o f Agriculture, Water Management
and Forestry. The representative o f SVO on the TSG will be a permanent civil servant and will serve as
Project Coordinator, reporting to the Minister o f MoFTER. The Project Coordinator will be supported by
one full-time administrative assistant. The Administrative Assistant could be a civil servant, but would
more likely be a short-term contracted position. The Terms o f Reference (TOR) would include assistance
with office management, record-keeping, correspondence, drafting o f minutes o f meetings, translations
and interpretation, and general organizational matters. The TSG will report on project implementation
progress to the Council o f Ministers through MoFTER. The TSG government representatives will be
responsible for coordinating with and reporting to their relevant government departments, to guide and
monitor implementation o f activities in their respective areas. Except for the Project Coordinator and the
communications specialist, the TSG members will serve on a part-time basis, retaining their regular civil
service positions and responsibilities in their home agencies.
2.
To facilitate the management and implementation o f the Project, a Project Operational Manual
(POM) i s to be prepared by the TSG as a Condition o f Effectiveness. The TSG will operate as a virtual
office, with daily communications via telephone, fax and e-mail, and will meet regularly on a schedule
and in locations to be specified in the POM. The TSG will be responsible for preparation o f annual work
programs and budgets, preparation o f TORSand specifications for goods and works bidding documents,
monitoring and evaluation o f project activities, and preparing quarterly and annual progress reports to the
Association. The TSG shall take decisions on the basis o f consensus. The detailed procedures governing
the functioning o f the TSG will be described in the POM.
Local Level Implementation
3.
At the cantonal and municipalities levels, implementation would be the direct responsibility o f
each cantonal/municipal veterinary/health authority. Small coordination units should be established at the
local level comprising officials from healthheterinary services to work under the supervision and
guidance o f the entity ministries.
P I U and P C U
4.
Procurement, financial management and financial reporting services for the project will be
provided by the PIU Forestry and Agriculture in Sarajevo, and by the Health Sector PCU in Banja Luka.
For procurement, the PIU and PCU will prepare bidding documents or requests for proposals based on
technical specifications or TORSprovided by the TSG, conduct tenders, organize evaluation committees,
and process payments to consultants and contractors after acceptance and approval o f the goods, works or
services by the TSG. TSG members or specialists identified by the TSG will be invited by the PIU and
9
I t i s noted that when the planned state-level Ministry for Agriculture and Rural Development (exact legal name
TBD) i s created, the SVO will move from MoFTER to this new ministry.
53
PCU to participate in proposal and bid evaluations.
arrangements are found in Appendix 5 below.
Further details regarding project procurement
5.
The PIU and PCU will be responsible for financial management under the Project. They will be
responsible for ensuring that each Entity establishes and maintains: (i)adequate accounting systems and
procedures; (ii)flow-of-funds mechanisms facilitating timely disbursement o f funds and timely payments
for goods, works and services; (iii)regular reporting on the use o f funds; and (iv) appropriate
arrangements for regular financial audits. The PIU and PCU will prepare quarterly financial monitoring
reports to the TSG and the Association. These responsibilities are described further in Appendix 6
(Financial Management Arrangements) below, and will be described in detail in the manuals o f financial
procedures and summarized in the Financing Agreement. The PIU and PCU have experience with
financial management under Bank-financed projects and have established sound internal control
mechanisms on the application and use o f funds.
Operating costs
6.
Most o f the operating costs o f the TSG, PIU and PCU w i l l be provided by the Entities as part o f
the counterpart contribution to project funding. Operating costs may include (i)maintenance and
operation o f equipment and vehicles procured or used for the management o f the Project; (ii)staff
salaries; (iii)travel costs and per diems; (iv) consumable office supplies; (v) communication, printing and
publications; (vi) costs o f translation and interpretation; (vii) bank charges; and other miscellaneous costs
as may be agreed.
Poultry Culling Compensation Scheme
7.
Both the TSG and the PIU/PCU as well as government at the municipal, entity and State levels
will be involved in administration and reporting on payments under the Poultry Culling Compensation
Scheme that are financed from the Credit proceeds. Access to proceeds from the IDA credit for eligible
Compensation payments will operate under the following procedures:
(a) In the event o f an A I outbreak and culling o f poultry, local veterinary services officials provide
compensation application forms and instructions to owners
(b) Copies o f the forms are provided by vet services to the owner, the Entity M O A and SVO
(c) SVO through the TSG directs the PIU/PCU to prepare the withdrawal application with necessary
supporting documents for submittal by the Entity MOAto the State MoF to the Association for
reimbursement, with instructions in the withdrawal application to transfer the payment directly to
the Entity M O A .
(d) The Entity MOAtransfers the funds to the municipality treasury, which processes the payments to
the owners
(e) On payment o f the compensation, the owner signs a payment receipt form, copies o f which are
forwarded by the municipality to the Entity MOA,Entity MoF and the PIU/PCU. The PIU and
PCU provide the TSG with reports on the payments on a quarterly basis, as part o f the regular
financial management reporting.
(f) A Poultry Culling Compensation Scheme database for each Entity will be maintained by the
respective PIU/PCU to facilitate record keeping, claim verification, payment facilitation,
monitoring and auditing.
(g) Operation o f the Poultry Culling Compensation Scheme w i l l be monitored and evaluated by the
TSG as part o f the overall project M&E arrangements
54
8.
Further details on the Poultry Culling Compensation Scheme are provided in Appendix 2b. In
addition, the internal financial control procedures and flow-of-funds arrangements to be implemented by
the PIU and PCU will be incorporated into the financial management section o f the POM.
Project Implementation Arrangements
Solid Lines indicate Reporting Responsibilities
Dashed Lines indicated Functional Coordination Responsibilities
Council of
Ministers
b
MoFTER
PT Tech Advisor
Communications
*For purposes of simplicity, organizational "boxes" are not presented for each governmental
authority: this chart assumes that all members of the Technical Support Group continue to fulfill
their normal reporting responsibilities to their relevant minist eriallgovernmental authorities
In addition to the above implementation structures, the natiodl Crisis Committee (ad hoc body) will provide
political leadership as necessary
Compensation Fund activities will be coordinated through entlbyldget structures, as at present
55
56
Appendix 3: Project Costs and Financing Arrangements
B O S N I A AND HERZEGOVINA: Avian Influenza Preparedness Project
U S $6.4 m i l l i o n
(Note: Component totals below f o r Components 2 and 3 do n o t precisely match the totals in the
preceding text. Because o f their larger size, and the likelihood that i t i s under these components
where contingencies will be required, this table subtracts a p o r t i o n o f the total component cost
(approximately 15%), and places it in the Contingencies allocation.)
COMPONENTS
Local
Foreign
Total
1. Strategic Communications and Public Information
1. A Capacity Building
2.B Information and Communication Services
Sub Total
0.06
0.23
0.29
0.03
0.09
0.12
0.09
0.32
0.4 1
2. A n i m a l H e a l t h Protection, and Disease Prevention and
Control
2.A Enhancing HPAI Prevention and Preparedness
2.B Strengthening Disease Surveillance
2.C Strengthening H P A I Control Programs
2.D Improving Bio-security in Poultry Production
Sub Total
0.06
0.42
0.09
0.05
0.62
0.40
1.27
0.16
0.01
1.84
0.46
1.69
0.25
0.06
2.46
3. H u m a n Health Protection and Disease Prevention and
Control
3 .A Enhancing Public Health Program Planning
3 .B Strengthening o f Health Surveillance Systems
3 .C Strengthening Health System Response Capacity
Sub Total
0.10
0.1 1
0.08
0.29
0.14
0.60
0.65
1.39
0.24
0.71
0.73
1.68
4. Poultry Culling Compensation Scheme
0.75
0.00
0.75
5. Implementation Support and M o n i t o r i n g & Evaluation
5.A Project Management
5 .B Monitoring and Evaluation
Sub- Total
0.20
0.10
0.30
0.00
0.00
0.00
0.20
0.10
0.30
~
Total Base Costs
Physical Contingencies
0.30
0.10
5.6
0.4
Price Contingencies
TOTAL PROJECT COSTS
0.20
2.75
0.20
3.65
0.4
6.4
57
Total project costs have been estimated at approximately US$6.4 million, o f which US $5.0
million (78.1 % o f total project costs) would be financed by an International Development Association
(IDA) Credit. The Government would finance approximately US $1.4 million (21.9%).
58
Appendix 4: Procurement Arrangements
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project
1.
As described in OP 8.50 for Emergency Recovery Assistance (ERA), in addition to emergency
assistance, the Bank may support operations for prevention and mitigation in countries prone to specific
types o f emergencies. Such operations could assist in: (a) developing a national strategy, (b) establishing
an adequate institutional and regulatory framework, (c) carrying out studies o f vulnerability and risk
assessment, (d) reinforcing vulnerable structures, and (e) acquiring hazard-reductiontechnology.
2.
Given the threat that HPAI may pose to the economic and social fabric o f the country, as well as
to the health o f the population because o f the risk o f an influenza pandemic, the proposed Project would
be financed through a Credit to be approved following ERA procedures.
A.
Procurement
3.
Procurement under the Project will be carried out in accordance with the Bank’s “Guidelines:
Procurement under IBRD Loans and IDA Credits” dated May 2004, and “Guidelines: Selection and
Employment o f Consultants by World Bank Borrowers” dated May 2004, and with the provisions
stipulated in the Legal Agreement. Agreements covering procurement methods, thresholds, and other
conditionality will be consistent with ERA assistance guidelines and determined for the Kyrgyz Republic
according to its capacity and experience with Bank procurement.
4.
The activities covered under the Project will be implemented on the basis o f annual work plans to
allow for needed flexibility in adjusting activities to account for in-country experience and the lessons
from implementation by other countries participating in the multi-country GPAI. Accordingly, the
following approach to procurement will be adopted.
5.
Implementing Agency Assessment. The Bank has carried out a procurement capacity assessment
o f the PIU for the World Bank-funded Forest Development and Conservation Project (FBiH), and the
PCU for the World Bank-funded Health Sector Enhancement Project (RS) which will be responsible for
fiduciary tasks, including procurement, and found them satisfactory. Procurement staff in the PIU are
experienced with procurement following World Bank guideless, including with all the procurement
methods to be included under the Project. The same qualified staff will be responsible for procurement
under this Project. However, given the country conditions, the Project has been classified in category
“C”, signifying high risk (A low, B medium, and C high risk). The annual Procurement Plan (PP) would
define thresholds for prior review appropriate to the category; these thresholds would be determined so as
to minimize prior review as appropriate to the level o f risk.
6.
Procurement Plan. A Procurement Plan (PP) covering the initial 12 month period o f Project
implementation will be prepared by Negotiations. The updated PP for each subsequent year will be
submitted to the Bank for approval before the end o f the previous year and would use a pre-defined
standard format which would list as a minimum: (i) goods and services to be procured during the
following calendar year, (ii) their value; (iii) the method o f procurement; and (iv) the timetable for
carrying out the procurement. At the time o f approving the annual work program, the Bank would agree
on the consistency with the application o f the Bank procurement guidelines to the specific procurement
lots expected during the year and their methods o f procurement. If needed, the plan could be revised and
re-submitted. A format for a typical PP would be agreed at Negotiations.
59
Procurement Methods and Thresholds. The Credit Agreement would define the appropriate
methods and thresholds for International Competitive Bidding (ICB), National Competitive Bidding
(NCB), Limited International Bidding (LIB), or Shopping in accordance with ERA guidelines.
Thresholds for project procurement methods and prior review requirements have been indicated on the
basis o f the Bank’s assessment o f the capacity o f the P I U which will be responsible for procurement, the
estimated risks o f corruption in BiH, and the country’s capacity o f construction and manufacturing
industries.
7.
I
I
Quality and Cost Based
Selection (QCBS) for
Consultant Services
Selection Based on
Consultants’ Qualifications
Individual Consultants
I
I
>us$200,000
(International shortlist)
<us$200,000
(National shortlist)
<us$200,000
Services for assignments that meet the
requirements set forth in the first sentence o f
para 5.1 o f the Consultant Guidelines.
Services for tasks in circumstances which
meet the requirements o f para. 3.10 o f the
Consultant Guidelines, with the Bank’s prior
agreement.
Single-Source Selection
8.
Prior Review by the Bank. The Procurement Plan shall set forth those contracts which shall be
subject to the Bank’s prior review process. All other contract shall be subject t o post review.
9.
Advertisement. The General Procurement Notice (GPN) shall be published in the on-line edition
o f Development Business following Project approval by the World Bank Board o f Directors. Special
Procurement Notices (SPN) for all I C B goods contracts and Requests for Expression o f Interest for
consulting assignments with firms exceeding the value o f US$lOO,OOO equivalent shall be published in
the Public Procurement Bulletin, a local newspaper o f a wide circulation and the on-line edition o f the
UNDB and posted on the websites o f the State Veterinary Office, the Ministries o f Agriculture and o f the
Ministries o f Health.
10.
These agencies will allocate a part o f their respective websites for posting information on contract
awards, including the name o f each bidder who submitted a bid, bid prices as read out at public bid
opening, name and evaluated prices o f each bid that was evaluated, name o f bidders who were rejected
60
and the reasons for rejection, the name o f the winning bidder and the price it offered. A l l contracts
awarded through direct contracting (irrespective o f the amount) shall be listed on the websites.
Information on the contracts awarded as a result o f an I C B and results o f selection o f consultant firms for
contracts exceeding US$lOO,OOO will also be posted on the World Bank web-site by submitting the
information to the World Bank Country Office in Sarajevo.
11.
The P I U would follow the World Bank anti-corruption measures and would not engage services
o f firms and individuals debarred by the Bank. The listing o f debarred firms and individuals i s located at:
littp://www.worldbank.ora/html/o~r/~rocure/debarr.html
12.
Procurement under Emergency Assistance Provisions. Following ERA procedures, the Project
i s likely to include financing for items included on a positive list o f imports identified as necessary under
a well-defined preparedness and response program to be prepared as part o f project implementation. In
case o f a declared global influenza pandemic, which will trigger disbursement conditions for critical
imports, support would be provided under the Project for the procurement o f a positive list o f critical
imports. These may be procured under Modified International Competitive Bidding (MICB), according
to paragraphs 2.66 and 2.67 o f the Procurement Guidelines. Also, commonly traded commodities may be
procured through organized international commodity markets or other channels o f competitive
procurement acceptable to the Bank, in accordance with the provision.
13.
The positive l i s t o f critical inputs to be prepared by Bosnia-Herzegovina or to be purchased by the
Borrower from the private sector, based on historical imports during national emergencies, would include:
0
0
0
0
0
Pharmaceuticals and vaccines
Medical and veterinary supplies and equipment
Communication equipments, supplies, and public awareness campaigns
Food and water containers
Protective clothing and gear
14.
Disbursements for items procured under emergency assistance provisions can be made for up to
100 percent o f import costs. N o more than 20 percent o f the Credit proceeds may be used for retroactive
financing o f expenditures, and the payments must have been made after the appraisal mission.
15.
Procurement Audits. Because the Project would have a strong decentralized implementation
element, and to help the Bank to carry out post-reviews o f procurement actions, consultants would be
contracted as a cost to the Project to carry out annual procurement audits o f a sample o f contracts, under
Terms o f Reference acceptable to the Bank.
61
62
Appendix 5: Financial Management Arrangements
BOSNIA AND HERZEGOVINA: Avian Influenza PreDarednessProiect
Country Issues
1.
A Country Financial Accountability Assessment (CFAA) for BiH was carried out in 2001. An
update o f the C F A A has recently been finalized. The C F A A identified systemic and structural weaknesses
in public sector budgeting, accounting, reporting, and auditing. However, there have been several positive
developments in the past four years, most notably, implementation o f a fully automated treasury system
across all the Cantons in the Federation and all the regions in the RS. The introduction o f the on-line
treasury system has brought about a major improvement in the accounting and reporting o f budget
execution at the State, entity, and cantonal levels. The Bank’s Country Financial Management Strategy
(CFMS) envisages mainstreaming o f project management into Ministries and Departments, and abstain
from creating new stand-alone Project Implementation Units (PIUs) outside the ministries for
implementation o f Bank-financed projects. This project accordingly will use the Federation P I U in the
Ministry o f Agriculture and the RS P C U established in the Ministry o f Health for the purpose o f
delivering fiduciary services to the project and securing the necessary reporting.
Risk Analysis and Conditions
The risk analysis from the Financial Management Questionnaire i s as presented below. (Note:
The project’s financial management risks are not considered to be significant enough to warrant inclusion
in section C5 o f the TA).
2.
Risk
.
.
Entity Level
Project Level
Control Risk
Budgeting
Risk
Rating
S
M
S
Incorporated
Mitigating Measures
Risk
financed projects
As mentioned above
The coordination made by
the Technical Support Group
need to rely fully on the two
PIU/PCUs for fiduciary
aspects
Only issue would be if funds
are not allocated by the
entities for the Poultry
Culling Compensation
Scheme, as the funds are
reimbursed by the bank. This
63
Conditions of Negotiations,
Board or Effectiveness
None
None
None
Risk
Risk
Rating
M
H
Accounting
Internal Control
1
Financial
IM
M
I
I
Incorporated
Risk
Mitigating Measures
will be followed closely by
the task team
N o issues to mitigate
Only the internal control risk
for the Poultry Culling
Compensation Scheme i s
high. The Poultry Culling
Compensation Scheme
manual on the financial
management parts needs to
be finalized before
disbursement starts.
N o issues - following well
established procedures
N o issues - following well
established procedures
Following well established
procedures. Adding an
operational review o f the
project.
Conditions of Negotiations,
Board or Effectiveness
None
Disbursement condition
None
None
None
Strengths
3.
Both PIUs have extensive experience in implementing Bank-financedprojects. The two financial
managers have been working in their capacity six and seven years respectively.
Weaknesses and Action Plan
4.
Financial management arrangements o f the AIPP are generally adequate, but a number o f actions
are required to ensure that arrangements are fully satisfactory for the project, with i t s specific F M needs,
especially with respect to the Poultry Culling Compensation Scheme. The following action plan was
discussed with the Recipient during Negotiations. Satisfactory implementation o f the action plan will
ensure the establishment o f a financial management system that fully meets requirements o f the Project
and o f the Bank.
1
2
Action
Implementation of appropriate
internal control procedures and
fundflow arrangements for the
Poultry Culling Compensation
Scheme component
Responsibility Due Date
PIU/PCUs
with input
Condition for the
from TSG
Poultry Culling
Compensation
Scheme
component
Staffing of the FM Units.
Recruitment o f two
Financial/Disbursement
SDecialists. This i s onlv an action
PIU/PCUs
~
64
To be ready
before project
implementation
I Remarks
Compensation Scheme
sub-component will be
disbursed after the
APIU has implemented
appropriate internal
control and fund flow
procedures.
Done
for capacity building and not a
F M condition.
FM Procedures Manual. Revise
existing manual to fully document
the procedures for accounting and
internal control, including
disbursement and flow o f funds
(including flow chart), financial
reporting, including IFR, annual
reports and audit. This i s only an
action for capacity building and
not a FM condition.
Project Accounting and
Financial Reporting System.
Upgrade existing accounting
software, to reflect requirements
o f the new project, including
capacity to generate FMRs
without manual summarization in
Excel; test the accounting and
reporting system by producing
sample FMRs for submission to
the Bank for review and
comments. This i s only an action
for capacity building and not a
F M condition.
PIU/PCUs
To be ready
before project
implementation
PIUPCUS
To be ready
before project
implementation
A manual already exists
and will require only
minor updates to reflect
the characteristics o f
the project, including
flow o f funds and
accountability for cash
grants/ Poultry Culling
Compensation Scheme.
I
Done
Implementing Entity
5.
The main implementation responsibility o f the project i s with the Technical Support Group
consisting o f broad technical participation from a l l involved institutions dealing with the activities o f this
project. However, all financial management responsibilities as well as procurement responsibilities will
be given to the Federation PIU in Ministry o f Agriculture and the RS PCU established in the Ministry o f
Health.
Budgeting
6.
The two PIU/PCUs will prepare annual plans based on the implementation program, including the
procurement plan. RS and FBiH will allocate budget funds to cater for the Poultry Culling Compensation
Schemes according to already established procedures.
Accounting
7.
Both the PIUs have implemented computerized accounting systems using locally developed F M
software, which i s used in several Bank-financed projects and have been found to be reliable and
responsive to Bank-needs. The PIU/PCU will be using the same software for accounting for this project.
8.
Accounting procedures for the two PIU/PCUs are set out in their respective Financial
Management Manuals. The manual contains procedures for flow o f accounting information, invoice
verification procedures, payment controls, and reporting formats. The manuals are satisfactory and the
risk associated with the accounting policies and procedures i s negligible. The existing manuals will
65
,
require only minor updates to reflect the characteristics o f this project. A separate manual on the Poultry
Culling Compensation Scheme will be finalized before disbursement starts for this part o f the project, see
further details below.
9.
The staffing o f the existing Federation PIU in Ministry o f Agriculture and the RS PCU
established in the Ministry o f Health are considered adequate to implement this new project at the initial
phase, but additional staff might be needed to strengthen the existing capacity, to monitor the financial
management o f the Poultry Culling Compensation Schemes, and to allow for periodic visits to the village
level to review the Poultry Culling Compensation Schemes. The additional staff, if needed, would report
to the PIUPCU’s financial managers and would be responsible for disbursement functions as well as
project accounting-maintaining books o f accounts, reporting day-to-day transactions and preparing
accounting reports and financial statements, as well as monitoring financial flows to project beneficiaries.
The financial manager will have primary responsibility for the quarterly financial reports (Interim unaudited Financial Reports - IFRs) and will prepare the annual financial statements for audit.
Internal Control & Internal Auditing
10.
With the exception o f the Poultry Culling Compensation Scheme component, for which the AIPP
does not have previous experience, the PIU/PCUs have maintained an effective internal control system to
ensure that project expenditures are properly authorized, supporting documents are maintained; accounts
are reconciled periodically; project assets, including cash, are safeguarded, and cash compensation grants
are properly accounted for.
Although project accounting will be on a cash basis, detailed
assetiinventories register will be maintained as part o f the project internal control procedures. The AIPP
will implement appropriate controls over inventories o f drugs, vaccines, medical equipment, and other
sensitive and/or expensive assets will be especially important for the project.
1 1.
Since the Federation PIU and the RS PCU are part o f the government set-up, they are subject to
an audit by the respective Supreme Audit Institution o f the entities. Currently, neither entity has enacted
law on internal audit in the public sector. However, establishment o f internal audit units within ministries
i s a long term process and has not been factored into while assessing internal control environment for the
project.
12.
Poultry Culling Compensation Scheme. The Governments have established Poultry Culling
Compensation Schemes from which the owners o f animals culled will be compensated (see Annex 2B).
The Veterinary Law provides the legal basis to do so, but the required implementation arrangements still
need to be refined and put in place, and the Project will provide technical support to do so. The necessary
details will be developed and agreed upon during the first months o f project implementation and will be
included in the Operational Manual.
13.
As a condition of disbursement o f funds under the Poultry Culling Compensation Scheme
component, the PIUiPCUs will implement appropriate internal control procedures and flow-of-funds
arrangements acceptable to the Bank and documented in the Poultry Culling Compensation Scheme
manual. The Project will provide US $0.55 million to finance and operate these Funds.
14.
Internal Control Arrangements for the Poultry Culling Compensation Scheme. Annex 2B sets
forth the procedures for recording poultry culled under government orders and for establishing and
recording poultry owner’s claims for compensation payments. A number o f minimum internal control
procedures and risk mitigation measures will be implemented with respect to recording and verifying
poultry culling and claims for compensation payment before any flow o f funds i s initiated.
66
15.
The financial and operational manuals will detail the mechanisms, as described in Annex 2B, for
identifying those eligible for compensation payments, ensuring that there w i l l be no multiple claims. A
Poultry Culling Compensation Scheme database will be maintained by the Project to facilitate record
keeping, claim verification, payment facilitation, monitoring and auditing.
16.
In the event o f government-ordered culling o f poultry, the culling and the preparation and
processing o f culling records and compensation claims will be done in accordance with the procedures
detailed in Annex 2B.
17.
A l l forms to be used to record poultry cullings and compensation claims w i l l provided by the
Project. They w i l l be pre-numbered and recorded in the database o f the Poultry Culling Compensation
Scheme. A l l unused forms, as well as any invalid or incorrectly completed forms, must be returned to the
Poultry Culling Compensation Scheme when the culling records are submitted.
18.
Compensation payment to poultry owners will be by cash, bank transfer or postal transmission.
There will be no vouchers or animal replacements. Payment will be made within four weeks from the
date o f culling.
19.
The owners o f village and backyard poultry will, at the time o f culling, receive a Culling
Certificate noting the date and the type and number o f birds culled. Each certificate will be signed by all
four members o f the Community Culling Supervision Committee (CCSC) or assessor and countersigned
by the poultry owner. The certificate will be completed in three copies: one for the poultry owner, one for
the local government administration, and one will be attached to the village summary culling record
compiled by the CCSC and sent by the local government administration to the Poultry Culling
Compensation Scheme through the TSG. Certificates not signed by all members o f the CCSC and the
poultry owner are invalid.
20.
Based on the individual poultry owner certificates, the CCSC w i l l compile a Village Summary
Poultry Culling Record. All four CCSC members will sign and the poultry owners will countersign this
l i s t o f birds culled and their owners. Forms not signed by all four members o f the CCSC are invalid, and
all claims included on an invalid Village Summary Poultry Culling Record are rendered invalid as well.
The village summary culling record i s the official record that establishes the poultry owners’ right to
compensation from the Poultry Culling Compensation Scheme. I t will be completed in eight identical
copies: one will be posted in a weather-protected public location in the village. Attached to the copies
that are sent by the local government administration to the Poultry Culling Compensation Scheme and to
the PIU/PCUs must be copies o f all individual owners’ culling certificates that form the basis for the
compilation o f the village summary culling record.
21.
The local government administration compiles a Summary Report on the basis o f all village
summary poultry culling records, listing all villages and for each village the total number o f different
poultry culled. This report i s made out in five copies and signed by the mayor o f the local government.
Attached to the copies sent to the PIU/PCUs and to the Poultry Culling Compensation Scheme are the
village summary poultry culling records and copies o f a l l individual owners’ culling certificates.
22.
For medium- and large-scale poultry operations with more than 200 birds, the owner or manager
will, at the time o f culling, receive an Enterprise Poultry Culling Record, signed by the veterinarian and
an official from the local government administration, and certified by an audit firm acceptable to the
Bank. The ownedmanager countersigns. There will be five identical copies. This document i s the
official record that establishes the poultry owners’ right to compensation. Actual compensation payments
will be based, however, on the lower o f (a) the number o f birds reported by the enterprise to the Poultry
Culling Compensation Scheme at the end o f the quarter preceding the mandatory culling and for which
67
the required fee has been paid to the Poultry Culling Compensation Scheme or (b) the number o f birds
reported and certified on the Enterprise Poultry Culling Record. If all or part o f the fee due to the Poultry
Culling Compensation Scheme i s overdue by more than three months, no compensation will be paid.
Flow-of Funds Arrangements for the Poultry Culling Compensation Scheme. Flow-of-funds
arrangements for making compensation payments are designed to minimize the number o f stages through
which funds will need to pass before reaching the intended beneficiaries, while ensuring maximum
transparency. Once authorized by the PIU/PCUs, compensation payments w i l l be effected by the Poultry
Culling Compensation Scheme through the banking system or through the Postal Service.
23.
24.
Payment to the poultry owners will be made by the local government administration and
supervised by the two community representatives on the CCSC, based on the village summary culling
record kept by the local government and cross-checked against that kept in the village. To receive
payment, each poultry owner will be required to present hidher culling certificate; the date and amount o f
payment will be recorded on the certificate and countersigned by the poultry owner.
25.
A l l payments made to individual poultry owners are recorded on both copies o f the village
summary poultry culling record kept by the local government administration, and each poultry owner
must sign for the payment received on both copies to confirm receipt o f payment. These two copies o f
the village summary poultry culling record thus become the “village culling-and-payment record”. They
must be signed by the local government representative and the two community representatives on the
CCSC. The local government administration then completes the Summary Report by entering in the final
column for each village the amounts paid, by village and by type o f poultry. The local government
administration keeps one copy o f the completed Summary Report and submits the other to the Poultry
Culling Compensation Scheme, with a copy o f each village’s culling-and-payment record attached.
26.
For medium- and large-scale poultry enterprises the compensation payments w i l l be made
through the banking system. The Poultry Culling Compensation Scheme w i l l transfer the funds to the
credit o f the account(s) o f the eligible recipients. Banking fees associated with this service w i l l be
financed by the Project. The Poultry Culling Compensation Scheme w i l l inform the PIU/PCUs o f the
dates and amounts o f payments made, with appropriate documentary evidence. For enterprises that have
no bank account or that failed to provide the necessary account details at the time o f culling, the payments
will be made through the Postal Service. The Poultry Culling Compensation Scheme will provide the
necessary information and instructions to the Postal Service, with the name and address o f the eligible
recipient, and the amount o f payment. The Postal Service w i l l obtain confirmation from the recipient that
the payment has been received and will submit this confirmation to the Poultry Culling Compensation
Scheme. The Poultry Culling Compensation Scheme in turn will inform the PIU/PCUs o f the dates and
amounts of payments made, with appropriate documentary evidence.
27.
Funds Flow and Disbursement Arrangements. The Recipient w i l l establish two Designated
Account (previously called Special Accounts), one for each Entity, in commercial banks, acceptable to
IDA. Disbursements from the IDA Credit will follow the transaction-based method, Le., traditional Bank
procedures: Advance documented with Statement o f Expenditures and other records, Direct Payments,
and Special Commitments. For certain payments, above the Minimum Application Size as specified in
the Disbursement Letter, the AIPP would submit withdrawal applications to the Bank for payments to
suppliers and consultants directly from the Credit proceeds. Disbursement to the Poultry Culling
Compensation Schemes w i l l be made on reimbursement basis. Withdrawal applications and
documentation will be checked by the PIU/PCUs before submission to the Bank.
In case o f declared emergency, following procedures agreed with IDA, additional funds
may be deposited to the Designated Accounts A and B, the ceiling to which may be increased up
28.
68
to EUR 500,000. The declaration o f a national emergency would be a disbursement condition for this
element o f the project. Upon declaration o f an emergency, the Recipient would submit to the Bank an
initial recovery plan documenting the disaster declaration, the related budget appropriation and the
proposed use o f the funds. The PIUs will keep the Bank informed o f updates in the recovery plan as the
emergency response operations unfold.
Allocation of Credit Proceeds
Expenditure Category
1. Goods, Works, Services, and Operating
Costs - FBiH
Amount in US$ million
2. Goods, Works, Services, and Operating
Costs - RS
3. Unallocated- FBiH
4. Unallocated- RS
TOTAL AMOUNT
Financing Percentage
2.55
100%
1.65
100%
0.4
0.4
5.00
29.
Financial Reporting. For project monitoring purposes, quarterly interim un-audited financial
reports (IFRs) will be required. The AIPP will be responsible for designing appropriate IFRs to include:
(a) Project Sources and Uses o f Funds, (b) U s e s o f Funds by Project Activity, (c) Special Account/Local
Bank Account Statements, (d) Physical progress report, and (e) Procurement report. These financial
reports will be submitted to IDA within 45 days o f the end o f each quarter. The first quarterly IFR will be
submitted after the end o f the first full quarter following the initial disbursement. Formats o f the annual
financial statements and the IFRs are incorporated in the Financial Management Manual. The accounting
software currently used by the PIU/PCUs will need to be upgraded to have the capacity to prepare IFRs
incorporating all components, sub-components and expenditure categories, as may be appropriate.
30.
Financial Audits. There will be annual audits o f the project financial statements, covering all
aspects o f the project, including specific requirements for the Poultry Culling Compensation Scheme.
The audits will be performed by independent auditors acceptable to the Bank, and in accordance with
International Standards on Auditing (ISA), and the Bank's guidelines on auditing as stated in the
guidelines: Annual Financial Reporting and Auditing for World Bank-financed Activities (June 2003).
The auditors' TOR will be prepared by the PIU/PCUs and cleared by the Bank before the engagement o f
the auditor. They will include both the audit o f financial transactions, an assessment o f the internal
control, funds flow mechanisms, and the reasonableness o f the accounting, reporting and internal controls
in respect o f the Poultry Culling Compensation Scheme, The annual audit reports will consist o f a single
opinion on the financial statements o f the project, incorporating the project accounts, including
Designated Account Reconciliation, and SR Withdrawal Schedule; as well as a Management Letter. The
audit reports will be submitted to the Bank not later than six months after the end o f the fiscal year to
which they relate. The cost o f the audits will be eligible for financing from the Credit. The AIPP will
provide the auditor with full access to project-related documents and records, including the compensation
claims database, and with the information required for the purpose of the audit. Sample TORSfor project
audit will be included in the Financial Manual.
3 1.
The PIU/PCU will carry out, or will arrange to have carried out, as part of the annual audit when
compensation claims have been paid out, additional checks to ensure that the eligible poultry owners, and
only they, are paid and are paid in full. This will include, but not be limited to, operational reviews to
confirm the validity and legitimacy o f the compensation payments made. The reviewers would be
required to verify compensation claims and payments made in randomly selected samples o f villages.
69
This verification w i l l include: checking against the database maintained by the Poultry Culling
Compensation Scheme, collecting and verifying information available and obtained at the village level,
checking with individual poultry owners, checking forms and reports, etc. Any significant weaknesses
identified will be promptly rectified in close consultation with the Bank. In addition, the external
independent auditors would be asked to provide an opinion on the reasonableness o f the accounting,
reporting and internal controls in respect o f the operations o f the Poultry Culling Compensation Scheme,
and the audit TORS(acceptable to IDA) would include these specific requirements. All ineligible claims
would be refunded to the Poultry Culling Compensation Scheme and to IDA.
32.
Supervision Plan. During project implementation, the Bank will supervise the project’s financial
management arrangements in two main ways: (i)review the project’s quarterly interim un-audited
financial reports as well as the project’s annual audited financial statements and auditor’s management
letter; and (ii)during the Bank’s supervision missions, review the project’s financial management and
disbursement arrangements (including a review o f a sample o f Statement o f Expenditures and movements
on the Designated Account) to ensure compliance with the Bank’s minimum requirements. As required, a
Bank-accredited Financial Management Specialist w i l l assist in the supervision process.
70
Appendix 6: Environmental and Social Issues
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project
1.
The Bosnia and Herzegovina Avian Influenza Preparedness Project has been assigned World
Bank environmental category B, since it involves moderate environmental impacts that can be mitigated
during implementation o f the project. Although project activities supporting A I prevention, preparedness
and planning, response and containment are not expected to generate significant adverse environmental
effects, they do present a moderate environmental risk from inadvertent spread o f the A I virus and waste
management. Overall the A I prevention and response-focused activities are expected to have a positive
environmental impact, as the investments in facilities, equipment, and training for veterinary and public
health service staff and laboratories w i l l improve the effectiveness and safety over existing avian
influenza handling and testing procedures by meeting international standards established by OIE and
WHO. This would be reinforced by the mainstreaming o f environmental safeguards into protocols and
procedures for the culling and disposal o f animals during A I outbreaks.
2.
This environmental management plan (EMP) will address the moderate adverse environmental
effects of the Animal and Human Health Components. For the Animal component, the EMP will address
zoonotic disease containment and waste management as pertain to disposal o f special waste, emissions
and materials at laboratories, and training for veterinary services workers, to include procedures for safe
handling o f A I materials, safe culling o f infected and at-risk poultry and disposal o f carcasses. For the
Human Health component, the EMP will focus on equipment, refurbishing and training for laboratories
and medical facilities to include key environmental issues in zoonotic disease containment and waste
management. The EMP will provide mitigation plans and monitoring plans to ensure appropriate
attention to environmental issues, and tracking progress or problems in their management. A delay in the
completion and disclosure o f the Environmental Assessment from the normal appraisal stage has been
approved, instead making this a condition o f disbursement for Component 2 - Animal Health, and
Component 3 - Human Health.
3.
The main areas o f environmental risk from project activities are the inadvertent spread o f the AI
virus during culling, transport and disposal o f carcasses, animal waste, litter, and used protective gear;
contamination o f surface and groundwater from use o f disinfectants; and laboratory bio-safety and waste
management. In addition, minor environmental disturbances may occur during renovation o f laboratories.
4.
Strategic Communications: N o environmental issues, but an important component for design
and delivery o f communications tools for good hygiene, safe culling and disposal o f animal carcasses,
animal waste management.
5.
Animal Health: Equipment, refurbishing and training for regional laboratories and border
inspection to include key environmental issues in zoonotic disease containment and waste management
as pertain to special waste, emissions and materials; training for veterinary services and poultry sector
workers to include procedures for safe handling o f A I materials; safe culling o f infected and at-risk
poultry and disposal o f carcasses. Formal compensation for culled animals should target owners/primary
beneficiaries (e.g., specifically including women where they are the primary backyard producers).
Human Health: Equipment, upgrading, refurbishing and training for national reference and
6.
regional diagnostic laboratories to include key environmental issues in zoonotic disease containment and
waste management
71
72
Appendix 7: Organization o f the Veterinary Services and the Health Care System in B I H
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project
A.
Veterinary Care
Veterinary Services
1.
The veterinary service o f BiH, as it currently exists (see Figure, page 64), i s the combination o f a
recently created system (incorporated in the country’s administrative structure as o f 1995) and remnants
o f the former (Yugoslavian) legislative and institutional framework. Veterinary services at the state level
in BiH fall primarily under the responsibility o f the senior veterinary agency in the country, the State
Veterinary Office (SVO). SVO operates under the Ministry O f Foreign Trade and Economic Relations
(MoFTER) o f the national government (Council o f Ministers (COM) o f B&H).
2.
The state o f BiH consists o f two administrative units called entities, the Republika Srpska (RS)
and the Federation o f BiH (FBiH). Each entity has i t s own Minister o f agriculture, forestry and water
management (MAFW), under which the entity veterinary service operates. Both veterinary services are
directly subordinated to the SVO BiH.
3.
FBiH i s composed o f ten cantons, each with i t s own government, Ministry o f agriculture and
veterinary service. Cantonal veterinary services are subordinated to the MAFW o f the FBiH. The
smallest administrative units are municipalities. At that operative level, veterinary service i s established
through municipality veterinary practices.
4.
The ongoing evolution and development o f the BiH veterinary service i s primarily motivated by
increased awareness o f the significance o f animal health and production issues for public heath and food
safety. I t i s also driven by concern for economic development and food security. Further, the country’s
overall developmental direction i s toward full accession to the EU, which will require updating o f
veterinary services and harmonization o f related legislation with current EU requirements.
5.
Current issues related to the global spread o f H P A I have emphasized the need for strengthening
capacities and coordination within the veterinary service. Since institutional arrangements within this
sector are complicated and heterogeneous, placement o f the managing authority for veterinary services
(State Veterinary Office) at the national level (within MoFTER) clearly provides benefits towards a
coordinated national response to AI threats.
6.
At this point, the H 5 N 1 strain has only been confirmed in two wild birds in BiH. The resources
that were required to address this discovery were, on an economic and human resources scale, relatively
small, and the country’s veterinary services were able to provide a response that was adequate to prevent
further spread. However, veterinary services in BiH are inadequately equipped and experienced to cope
with a large scale H P A I outbreak. This i s evident across the entire range o f critical capacities, including:
surveillance and diagnosis, implementation o f response and control measures and applied research
capability necessary t o understand the etiology o f the disease.
7.
Further strengthening and capacity building will require assistance to the BiH SVO, as the
national competent authority, in developing animal health legislation related t o avian influenza (further
addressed in separate section). This includes expanding human resources, developing competency, and
providing necessary equipment to support SVO staff.
73
8.
T o ensure efficient implementation o f plans and programs developed and adopted at a national
level, regional (entity) and local (cantons/ municipalities) veterinary services must be strengthened as
well. This w i l l require assistance in organizing training (possibly through SVO B&H) o f regional and
local staff and assistance in equipping them with PPE and other required equipment.
Figure: H i e r a r c h y o f the Veterinary Service o f Bosnia-Herzegovina
B.
Health Care System
9.
Organization, financing and provision o f health care in BiH are the responsibilities o f the two
Entities, and the ten autonomous Cantons in FBIH. Therefore, the health care system in BiH consists o f
13 heath sub-systems to cover approximately 3.9 million people. At the BiH level, the Ministry o f Civil
Affairs (MCA) i s the only State body with responsibilities for coordinating the health sector. The legal
basis for M C A i s provided by the BiH L a w on Ministries (March 2003) authorizing M C A to represent
BiH at international level, to establish the basic principles for co-ordination and to co-ordinate plans of
entities and other governmental bodies.
Federation of Bosnia and Herzegovina (FBiH)
10.
F B i H occupies approximately 51% o f the total territory o f BiH and has a population of
approximately 2.3 million. Administratively, it i s divided into 10 cantons, each having i t s own
Government and Assembly. The cantons are sub-divided into 79 municipalities.
74
11.
The health care system in FBiH i s decentralized with most competencies (functions and
responsibilities) allocated to the cantons. However, the Federation Ministry o f Health (FMOH) and the
Health Insurance and Reinsurance Fund (HIF) have the function to define the health care network with a
view to optimize i t s capacity for the provision o f medical services. While FMOH has the functions o f
formulating health policy and drafting laws, these functions are doubled by the cantons. Determination o f
health service needs and functions related to provision o f health care services (such as founding o f
institutions) are assigned to the cantons but, in principle, the co-ordination function lies within the
Government o f FBiH.
Organization of the Health Sector in FBiH
12.
The structure o f the health sector in FBIH consists o f 11 ministries o f health (10 Cantonal and 1
Federal), 11 health insurance funds (10 Cantonal, and 1 Federal Health Insurance and Reinsurance Fund)
and 11 Public Health Institutions (10 cantonal P H I and 1 Federal). The Health care provider network
consist o f 280 public and 333 private institutions (including pharmacies) employing altogether about
23,800 persons, out o f which 3.270 are medical doctors, 5 10 dentists, 260 pharmacists, 1 1,180 nurses,
286 health consultants and 7,606 non medical staff.
Distribution of functions
13.
The F M o H i s responsible for functions that cannot be executed at the Cantonal level:
Borders’ sanitary inspections;
Developing legislation at federal level;
Developing health policy for the FBIH
Planning o f the health care facilities network;
Capacity building;
Health inspections;
Developing and regulating o f compulsory health insurance; and
Monitoring and evaluating the health status o f the population.
14.
The Cantonal Insurance Funds are responsible for financing the health service at the cantonal
level. The Federal Health Insurance and Reinsurance Fund was established in January 2002 to address
some o f the problems associated with a highly decentralized system related to an unequal economic basis
and lack o f cross-canton health insurance coverage. The Federal Health Insurance and Reinsurance Fund
i s entitled to receive 8% o f all contributions collected by the cantonal HIFs.
15.
As noted earlier, the basic financial functions o f the health care system in FBIH i s placed within
the cantons. Each o f the cantons has i t s o w n Health Insurance Fund responsible for the overall financing
o f the health care services. The bulk o f the income for the Cantonal HIF comes from health contributions.
Health insurance contributions are based on gross salary and amount to 17%. Cantons are authorized to
define their own contribution rates within the upper ceiling o f 17%.
The FPHI i s the leading research and educational institution in the field o f public health. I t s
16.
functions also include health promotion and monitoring o f the health status o f the population. In the area
o f monitoring and research, especially in the field o f health statistics and epidemiology research (also
with respect to data collection o f the 25 indicators needed for W H O reporting), there i s collaboration
between the federal P H I and the Cantonal PHIS.
75
17.
Health ministries at the Cantonal level are in charge o f Cantonal health legislation, advising on
technical matters, implementing regulations, organizing health care services and health policy planning
mostly related to the Cantonal hospitals, the health centers ( D o m Zdravlja -DZ), ambulantas (health
posts), pharmacies and other Cantonal health institutions.
18.
Import, procurement, distribution and control o f pharmaceutical products are under control o f the
Department for Drugs within the FMOH. This department i s also responsible for drug registration,
control o f drugs and herbal products, the issuing o f work permits for pharmacies, controlling and issuing
import permits for drugs and herbal products in FBiH.
Republika Srpska
19.
The Republika Srpska (RS) with approximately 1.4 million inhabitants occupies approximately
49% o f the total BiH territory. RS consists o f four regions: Banja Luka (630,000 citizens), DobojBijeljina (420,000 citizens), Sarajevo-Zvornik (230,000 citizens) and Trebinje/Foca/Srbinje (120,000
citizens) and 54 municipalities.
20.
The health care system in RS in centralized with the overall power concentrated within the
Ministry o f Health and Social Welfare (MOH), the Public Health Institute (PHI), and the Health
Insurance Fund (HIF). In addition, the Drug Agency o f RS, and the Agency for Accreditation and
Quality Improvement were established in the past 2-3 years.
Organization of the Health Sector in RS
2 1.
Health care services are provided by a network consisting o f 63 D o m Zdravlja (DZ), (including
spas and emergency centers), 16 secondary level health institutions (including psychiatry hospitals and
rehabilitation centers) and 2 tertiary level clinical centers. Altogether, 1 1,2 10 people are employed in the
health care sector out o f which 7,177 are medical staff (1,783 medical doctors) and 4,034 are non-medical
staff.
Distribution of Functions
22.
The M O H i s responsible for the health sector in RS and has the following functions: Policy
making, strategy development, health care facilities, network planning, sanitary inspections, health
inspections and co-coordinating health issues in RS.
23.
The P H I i s responsible for functions such as research and education in the field o f public health,
health promotion and monitoring o f the health status o f the population. The P H I also collects data for the
25 indicators needed for WHO reporting.
24.
The Health Insurance Fund (HIF) has as main functions the collection o f health insurance
contribution (however this does not include contribution payment) and financing and contracting health
care services. The organizational structure consists o f eight regional offices and the head office o f the
HIF in Banja Luka with four departments: Economy, Legal, Medical and Information Technology (IT)
department. Health insurance contribution amounts to 15% o f the net salary.
76
Appendix 8: Project Preparation and Supervision
BOSNIA AND HERZEGOVINA: Avian Influenza PreDaredness Proiect
Preparation
Appraisal
Negotiations
Board
Planned date o f effectiveness
Planned date o f mid-term review
Planned closing date
Planned
March 27,2006
M a y 17,2006
September 2006
October 2006
December 2006
June 2008
April 3 0 20 10
Actual
March 27, 2006
M a y 18,2006
M a y 9,2007
June 19,2007
October 3 1, 2007
June 2009
December 3 1,20 10
K e y institutions responsible for preparation 'of the project:
Inter-sectoral Working Group
Bank staff, consultants, and other international partners who worked on the Project included:
Name
David A. Bontempo
Mirjana Karahasanovic
Samra Bajramovic
Francois Decaillet
Betty Hanan
Bekim Imeri
Ivailo Izvorski
k i n a Smirnov
Srecko Lata1
Danielle Malek
Nikola Kerleta
Olav Rex Christensen
Jose-Manual Bassat
Nicholay Chistyakov
Amy Evans
Tanja Bijev
Leigh Hammill
Sabina Seric
Helena Eversole
Caroline Brown
Boris Rebac
Haris Hajrulahovic
Nela Kacmarcik
Selena Bajraktarevic
Title
Team Leader
Operations Analyst
Program Assistant
Lead Health Specialist
Implementation Specialist - Consultant
Social Scientist - Compensation Issues
Sr. Economist
Research Analyst
Public Relations Specialist
Lead Counsel
Procurement Analyst
Senior Financial Management Specialist
Senior Communications Officer
Senior Finance Officer
Environmental Consultant
Interpretor/Translator
Sr. Program Assistant
Veterinary (Consultant)
UNICEF Resident Representative
Communicable Diseases Specialist
Health Specialist
Liaison Officer
Communications Officer
Health Officer
Bank funds expended to date on project preparation:
1. Bank resources: $80,000
2. Trust funds:
$0
3. Total:
$80,000
4. Estimated annual supervision cost:
$100,000
77
Unit
ECSSD
ECSSD
ECCBA
ECSHD
ECSSD
ECSSD
ECSPE
ECSPE
ECCBA
LEGEC
ECSPS
ECSPS
EXTCD
LOAGl
ECSSD
Consultant
ECSSD
ECSSD
UNICEF
WHO
WHO
WHO
UNICEF
UNICEF
78
Appendix 9: Documents in the Project File
BOSNIA AND HERZEGOVINNA: Avian Influenza Preparedness Project
BANK
Guidance notes to country teams on responding to A I
Rapid assessment o f the economic impact o f public health emergencies o f international concern the example o f SARS - Milan Brahmhatt
Vietnam Avian Influenza Emergency Recovery Project - Memorandum of the President and
Technical Annex
Minutes o f the meeting on the Emerging zoonoses and pathogens: A Global public goods concern
- implication for the World Bank, April 19, 2005
Issues Note on Avian Influenza in Africa, September 27, 2005. - Franqois L e Gall and Ok
Pannenborg
Minutes o f the Review Meeting to discuss the horizontal APL.
Project Framework Document for the Global Program for Avian Influenza Control and Human
Pandemic Preparedness and Response (GPAI)
Avian and Human Influenza Financing Needs and Gaps
Aide Memoire o f preparation mission
GOVERNMENT
Avian Influenza Assessment for Bosnia and Herzegovina, November 2005 - Seric and Cavaljuga
Avian Influenza, Plan of Measures in Case o f Appearance o f Avian flu in Bosnia and
Herzegovina
The National Readiness Plan for Pandemic Flu in Republika Srpska, October 2005
Preparedness Plan for Expected Emergence o f the Pandemic Influenza for the Federation o f BiH,
March, 2006
FBiH Law on Protection o f Population from Communicable Diseases, (dated May 18, 2005)
RS Law on Protection o f Population from Communicable Diseases (dated June 22, 1995)
A Draft Outline o f National Communications Plan for Prevention o f Human Avian Influenza in
Bosnia and Herzegovina
OTHER DONORS
A global strategy for the progressive control o f HPAI - FAO/OIE in collaboration with WHO May 2005
FAO’s response to the avian influenza crisis - September 19,2005
Technical Cooperation Program - Project descriptions for East Africa, West Africa, Europe and
Central Asia, North Africa, and the Middle East - WHO 2005
Assessment o f the National Surveillance System for Communicable Diseases - WHO September
2004
WHO/EU Project Support to Health Care reform in BiH (focus on Communicable Disease
Surveillance)
Summary o f an ongoing and planned assistance o f the European Commission in BiH on
prevention and combating o f Avian Influenza (Veterinarian and Health Sector)
UNICEF in Bosnia and Herzegovina and Avian Influenza - Concept Paper
UNICEF Timeline - Avian Influenza Communications
79
D.
PUBLIC H E A L T H RELATED
Global
avian
influenza
information
from
WHO
Web
site
at
www.who,int/csr/disease/avian-influenza
Information
on
U.S.
influenza
preparedness
available
at:
www.hhs.gov/nvpo/pandemics/dhhs.htmland www.cdc.gov/flu/avian
WHO. 2005. Responding to the avian influenza pandemic threat. Recommended strategic
actions. Geneva.
WHO. 2005. WHO global influenza preparedness plan. The role o f WHO and recommendations
for national measures before and during pandemics. Geneva.
United States Department o f Health and Human Services. 2005. Pandemic Flu Fact Sheet.
United States Department o f Health and Human Services. 2004. Pandemic Influenza
Preparedness and Response Plan. Draft.
Browner, J., and Chalk, P. 2003. The Global Threat o f New and Reemerging Infectious Diseases.
Reconciling US. National Security and Public Health Policy. Santa Monica, CA: RAND.
Dowdle, W.R. 1997. The 1976 Experience. J. Infect Dis 1997; 176 (suppl. 1): S69-72.
Garcia-Abreu, A., Halperin, W., Dane1 I.2002. Public Health Surveillance Toolkit. A guide for
busy task managers. Washington, D.C.: World Bank.
Huffman, S., on the basis o f report by Daniel Miller and Asel Ryskulova. 2005. Epidemiologic
Surveillance Systems in Eastern Europe and Central Asia: An Overview. Washington, D.C.:
World Bank.
Neustadt, R.E., Fineberg H.V. 1982. The Epidemic That Never Was. Policy Making and the
Swine Flue Scare. Vintage Books.
E.
ANIMAL H E A L T H RELATED
OIE website on Avian Flu Official reporting, scientific information, Standards, Guidelines, and
Recommendations (www.oie.int)
F A 0 website on Avian Flu General information, Communication, Publications, Projects
proposals and reports (www.fao.org)
FAOIOIE. February 2005. Second FAO/OIE Regional Meeting on Avian Influenza Control in
Asia. Ho Chi Minh City.
FAO/OIE. February, 2004. Recommendations o f the Joint FAOIOIE Emergency Regional
Meeting on Avian Influenza Control in Animals in Asia. Bangkok.
FAO/OIE. March 2005. Summary Report o f the First Regional Steering Committee o f GF-TADS
(Global Framework for the Progressive Control o f Transboundary Animal Diseases) in Asia and
the Pacific. Tokyo.
FAOIOIEIWHO. February, 2004. FAO/OIE/WHO Technical Consultation on the Control o f
Avian Influenza, 3-4 February, 2004: Conclusions and Recommendations.
OIE. May, 2005. OIE Report o f the First Meeting o f the Steering Committee o f the Joint
OIE/FAO Network o f Expertise on Avian Influenza (OFFLU). OIE. Paris.
OIEIASEAN. August 2005. The Southeast Asia Foot and Mouth Disease Campaign: Business
Plan for Phase I11 (2006-2008).
OIEIFAO. Network o f Expertise on Avian Influenza (OFFLU). Paris.
OIEIFAO. April, 2005. International Scientific Conference on Avian Influenza, OIE Paris, France
7-8 April 2005: Recommendations. Paris.
80
F.
Bibliography o f Recent Reports & Other Documents
8
8
8
8
8
8
8
8
Bell, Clive and Maureen Lewis. October 2004. The Economic Implications o f Epidemics Old and
New. Working Paper Number 54, Center for Global Development. Washington, DC. (See also
powerpoint presentation, “Economic Implications o f Epidemics Old and New”).
OIE. 2004. Emerging Zoonoses and Pathogens o f Public Health Concern. Rev. sci. tech. Off. int.
Epiz., 2004, 23 (2).
FAOIOIE. February 2005. Second FAO/OIE Regional Meeting on Avian Influenza Control in Asia.
Ho Chi Minh City.
FAO/OIE. February, 2004. Recommendations o f the Joint FAO/OIE Emergency Regional Meeting
on Avian Influenza Control in Animals in Asia. Bangkok.
FAOIOIE. March 2005. Summary Report o f the First Regional Steering Committee o f GF-TADS
(Global Framework for the Progressive Control o f Transboundary Animal Diseases) in Asia and the
Pacific. Tokyo.
FAOIOIEIWHO. February, 2004. FAO/OIE/WHO Technical Consultation on the Control o f Avian
Influenza, 3-4 February, 2004: Conclusions and Recommendations.
Ferguson, N e i l et al. 2005. Strategies for Containing an Emerging Influenza Pandemic in Southeast
Asia. Nature.
OIE. May, 2005. OIE Report o f the First Meeting o f the Steering Committee o f the Joint OIE/FAO
Network o f Expertise on Avian Influenza (OFFLU). OIE. Paris.
OIE/ASEAN. August 2005. The Southeast Asia Foot and Mouth Disease Campaign: Business Plan
for Phase 111(2006-2008).
OIEIFAO. Network o f Expertise on Avian Influenza (OFFLU). Paris.
OIE/FAO. April, 2005. International Scientific Conference on Avian Influenza, OIE Paris, France
7-8 April 2005: Recommendations. Paris.
Sandman, Peter and Jody Lanand.2005. Bird Flu: Communicating. Perspectives in Health, Vol. 10,
No. 2. Pan American Health Organization. Washington, DC.
Schudel, A. August 2005. Tackling Avian Influenza at Source. Avian Influenza Technical
Discussion & Coordination Meeting (powerpoint presentation). Washington, DC.
Smolinski, Mark, Margaret A. Hamburg, and Joshua Lederburg (Editors). 2005. Microbial Threats
to Pandemic Influenza. National Academies Press. Washington, DC.
WHO. 2005. WHO Global Influenza Preparedness Plan: The Role o f WHO and Recommendations
for National Measures Before and During Pandemics. Department o f Communicable Disease
Surveillance and Response, Global Influenza Program. Geneva.
WHO. January 2005. Influenza Pandemic Preparedness and Response: Report by the Secretariat.
Executive Board, 1 15th Session, Agenda Item 4.17. Geneva.
World Bank. July 2, 2004. Technical Annex for a Proposed Credit o f SDR3.5 million to the
Socialist Republic o f Vietnam for an Avian Influenza Project. Washington, DC.
81
82
Appendix 10: Statement of Loans and Credits
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Proiect
~~~
~
Difference between
expected and actual
disbursements
Original Amount in US$ Millions
Project ID
FY
PO88663
2005
PO83353
PO79226
PO84596
Purpose
IBRD
IDA
Orig
Frm Rev’d
Cancel
Undisb
000
000
1634
223
0 00
0.00
0.00
0.00
18.89
-0.87
0 00
0.00
0.00
0.00
9.78
0.00
0.00
12.00
0.00
0.00
0.00
10.64
0.74
-0.68
0.00
34.00
0.00
0.00
0.00
23.93
4.45
0.00
0.00
51.00
0.00
0.00
0.00
50.63
24.00
0.00
1.44
0.00
SF
HLT SEC ENHANC
000
1700
000
2005
URB INFRA & SERV DEL
0.00
20.00
2005
EDUC RESTRUCTURING
0.00
10.00
2004
EMPLYMT 2
0.00
PO71039
2004
ECON MGMT SACiIBTA
PO70992
2004
SOSAC 2
GEF
7.00
0.00
0.00
0.00
8.01
0.00
3.75
0.00
0.00
0.00
3.40
1.50
0.00
0.00
12.00
0.00
0.00
0.00
9.04
-1.86
0.00
BUS ENABLG ENV SAC
0.00
44.00
0.00
0.00
0.00
29.33
-20.02
0.00
2002
ROAD MGMT SAFETY
0.00
30.00
0.00
0.00
0.00
11.86
-2.32
0.00
2002
SOLID WASTE MGMT
0.00
18.00
0.00
0.00
0.00
25.87
-2.93
0.00
4.59
4.23
PO7 1004
2003
SOC I N S TA
0.00
PO7916 1
2003
FOREST DEVTKNSRV TA
PO55434
2003
SM SC COM AGRIC
PO71001
2002
PO71347
PO57950
PO70995
2001
COMM DEVT
0.00
15.00
0.00
0.00
0.00
6.71
PO709 17
200 1
PRIV TA
0.00
19.80
0.00
0.00
0.00
19.39
16.37
0.00
PO70079
2001
TRADE & TRANS FACIL IN SE EUR
0.00
11.00
0.00
0.00
0.00
0.07
1.60
0.00
PO58521
200 1
ELEC PWR 3 RECN
0.00
35.00
0.00
0.00
0.00
8.15
4.22
0.00
0.00
339.55
0.00
0.00
0.00
252.04
33.14
3.55
Total:
83
STATEMENT OF IFC’s
Held and Disbursed Portfolio
I n Millions of US Dollars
Disbursed
Committed
IFC
IFC
FY Approval
Company
Loan
Equity
Quasi
Partic.
Loan
Equity
Quasi
Partic.
1985
Energoinvest
9.49
0.00
0.00
0.00
9.49
0.00
0.00
0.00
1997
Enterprise Fund
0.00
1.52
0.00
0.00
0.00
0.94
0.00
0.00
2002
FCL
12.11
0.00
0.00
2.48
12.11
0.00
0.00
2.48
2004105
H V B CPB
0.00
4.06
0.00
0.00
0.00
4.06
0.00
0.00
2001
PBS-SPV
0.00
0.00
0.71
0.00
0.00
0.00
0.00
0.00
1997/99/01102
Procredit Bosnia
3.63
0.00
0.00
0.00
3.63
0.00
0.00
0.00
2002105
Raiffeisen-BOS
14.53
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1998
SEF Akova
0.59
0.00
0.00
0.00
0.59
0.00
0.00
0.00
1999/01/05
SEF Bosnalijek
9.08
0.00
0.00
0.00
3.63
0.00
0.00
0.00
2.23
0.00
0.00
0.00
0.00
1998
SEF Lignosper
2.57
0.00
0.00
0.00
1999
SEF Lijanovici
0.85
0.00
0.00
0.00
0.85
0.00
0.00
1977
T K A Cazin
4.12
0.00
0.00
0.00
4.12
0.00
0.00
0.00
1998
Wood Agency-AL
5.53
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Wood Konjuh
2.16
0.00
0.00
0.00
1.85
0.00
0.00
0.00
Wood Kozara
1.95
0.00
0.00
0.00
1.64
0.00
0.00
0.00
Wood Podgradci
1.34
0.00
0.00
0.00
1.09
0.00
0.00
0.00
Wood Vrbas
1.95
0.00
0.00
0.00
0.39
0.00
0.00
0.00
5.58
0.71
2.48
41.62
5.00
0.00
2.48
Total portfolio:
69.90
Approvals Pending Commitment
F Y Approval
Company
2002
Lukavac
Loan
0.01
Total pending commitment:
84
0.01
Equity
Quasi
Partic.
0.00
0.00
0.00
0.00
0.00
0.00
Appendix 11: Country at a Glance
BOSNIA AND HERZEGOVINA: Avian Influenza Preparedness Project
Bosnia Europe 8
and Central
Asia
Herzegovina
POVERTY and SOCIAL
2003
Population, mid-year (millions)
GNI per capita (Atlas method, US$)
GNI (Atlasmethod, US$ billions)
Lowermiddleincome
4.1
1,540
6.4
473
2,570
1,2l7
2,655
1,480
3,934
2.1
2.3
0.0
0.2
0.9
1.2
20
44
74
t5
4
63
69
31
50
69
32
11
81
Development dlamond'
Life expectancy
?
--
A v e r a g e annual g r o w t h , 1997-03
Population (%)
Laborforce (%)
M o s t recent e s t i m a t e ( l a t e s t year available, 1997-03)
Poverty (%of population belo wnational po verfyline)
Urban population (%of to tal populatio n)
Life expectancyat birth (years)
infant mortality (per I000 live births)
Child malnutrition (%of children under5)
Access to an improvedwatersource (%ofpopulation)
Illiteracy (%ofpopulation age 15+)
Gross primary enro llment (% o f school-age populatlo n)
Male
Female
5
91
3
x)3
x)4
x)2
GNI
per
capita
Gross
primary
enrollment
1
1
Access to improved water source
0
112
113
111
----Bosnia
andHerzegovina
____ Lo uer-mlddle-income group
KEY ECONOMIC R A T I O S and LONG-TERM T R E N D S
1983
1993
2002
2003
E c o n o m i c ratios'
GD P (US$ billions)
Gross domestic investment/GDP
Ekports o f goods and services/GDP
Gross domestic savings/GDP
Gross national savings/GDP
Current account balance1GDP
Interest payments/GDP
Total debt/GDP
Total debt service/ekports
Present value of debtlGDP
Present value o f debtlekports
1983-93 1993-03
(average annualgrowth)
GDP
GDP percapita
- -
..
..
17.8
15.4
5.6
19.6
24.5
-17.1
-2.5
7 .O
19.9
25.2
-14.0
0.9
-22.2
1.0
45.8
7.1
29.2
PO.8
-19,0
2002
2003
5.5
4.4
2.7
2.4
0.8
41.3
7.1
23.8
,093
1
Indebtedness
2003-07
4.2
3.6
-Bosnia
and Herzegovina
Lo uer-middle-income a m u ~
P
STRUCTURE o f the ECONOMY
1983
1993
2002
2003
(%of GDP)
Agriculture
Industry
M anufactunng
Services
14.9
32.1
15.2
52.9
14.9
31.9
15.1
52.8
Private consumption
General government consumption
Imports of goods and services
92.3
24.8
61.2
91.8
22.3
59.2
1 9 8 3 - 9 3 1993.03
2002
(average annualgrowth)
Agriculture
industry
Manufacturing
Services
Private consumption
General government consumption
Gross domestic investment
imports of goods and services
Trade
2003
2.5
2.5
2.5
2.2
..
35.6
11.1
17.9
85
20.2
Bosnia and Herzegovina
~
PRICES and GOVERNMENT FINANCE
1983
1993
Domestic prices
(%change)
Consumer prices
Implicit GDP deflator
Government finance
(%of GDP, includes current grants)
Current revenue
Current budget baiance
Overall suwlusideficit
2002
2003
0.3
1.0
02
09
50.7
6.5
-2.5
49 3
65
03
2002
2003
Inflation
I
(Oh)
I
/lo
5
0
sa
,
x
~
00
99
15'
~
-
02
01
GDPdeflator
03
=-+-.CPI
TRADE
1983
1993
(US$ millions)
Total exports (fob)
n.a
n.a.
Manufactures
Total imports (cif)
Food
Fuel and energy
Capital goods
1
Export and i m p o r t l e v e l s ( U S $ mill.)
I
952
3,233
1272
3 890
T
l5 Oo0
,4 000
f
'3 000
t
12 000
c
11 000
I
0 -b
97
E,~pottpnce index (1995=WO)
Import pnce index (?S95=WO)
Terms o f trade (995=100)
I
9a
99
00
oExports
01
02
03
mlmports
BALANCE o f PAYMENTS
1983
1993
(US$ millions)
Exports o f goods and services
Imports o f goods and services
Resource balance
2002
2003
1,374
3,428
-2,054
1759
4 121
-2 362
248
565
327
7 11
Current account balance
-1,241
1325
Financing items (net)
Changes in net reserves
1,282
-41
1806
-481
0
2.1
1785
17
Memo:
Reserves including goid (US$ millions)
Conversion rate (DEC, local/US$j
Total debt service
IERD
IDA
Composition o f net resource flows
Official grants
Official creditors
Pnvate creditors
Foreign direct investment
Portfolio equity
Worid Bank program
Commitments
Disbursements
Principal repayments
t o G D P (%)
1
Net income
Net current transfers
EXTERNAL DEBT a n d RESOURCE FLOWS
1983
(US$ millions)
Total debt outstanding and disbursed
IB RD
IDA
I C u r r e n t a c c o u n t balance
1993
2002
2003
C o m p o s i t i o n o f 2 0 0 3 debt (US$ mill.)
424
0
2,563
538
726
2 880
540
803
0
0
125
45
5
151
43
6
G 65
32
D 71
0
0
0
102
97
23
86
23
35
A - IBRD
B - IDA
23
C-IMF
C 92
D - Other multilateral
E - Bilateral
F - Private
G - Short-term
IBRD 33375R
B O S N I A A N D H E R Z E GO V I N A
SELECTED TOWNS
MAIN ROADS
NATIONAL CAPITAL
RAILROADS
MAIN RIVERS
DAYTON AGREEMENT LINES
MUNICIPAL BOUNDARIES
INTERNATIONAL BOUNDARIES
This map was produced by the Map Design Unit of The World Bank.
The boundaries, colors, denominations and any other information
shown on this map do not imply, on the part of The World Bank
Group, any judgment on the legal status of any territory, or any
endorsement or acceptance of such boundaries.
To Zagreb
16°E
17°E
18°E
To Bjelovar
19°E
To Osijek
CROATIA
Un a
To
Karlovac
Bosanski Brod
(Srp.Brod)
va
Dervent
De
rventa
a
Derventa
Bo
Cazin
Sa
Vbr
as
Bihac´
Bosanska
Krupa
a
an
na
Varoˇs
Kotor Varos
Bosanski
Petrovac
Kljucˇ
Vlasic´ Mts
Mts..
Kri
Jajce
Travnik
Travnik
D
To Obrovac
Zenica
Kladanj
Vareˇs
Vares
Vlasenica
ba
Vr
Srebrenica
a
Bugojno
r
REPUBLIKA
SRPSKA
Visoko
Visoko
FEDERATION OF
BOSNIA AND
HERZEGOVINA
i
c
Livno
To Valjevo
Bosna
s
n
To
Zadar
Spreca
va
ja
i
44°N
SERBIA
Tuzla
Tuzla
Maglaj
REPUBLIKA SRPSKA
Drvar
Drva
rvarr
To Belgrade
Teslic
Teslic´
ˆ
To Medak
Bijeljina
Gracanica
ˇ
S
U
CROATIA
45°N
Sava
ˇ
Brcko
Banja
Luka
Sanski Most
To
Sveti Rok
To Belgrade
sna
Drin
a
45°N
ˇ
Bosanska Gradiska
ˇ
(Srp. Gradiska)
Bosanska Novi
(Novi Grad)
Prijedor
Pale
Visegrad
Visegrad
ˆ
l
im
L
A
ˇ
Gorazde
Konjic
44°N
To Kraljevo
SARAJEVO
Jablanicko
jezero
Jablanica
D ri
na
a
retv
Ne
p
To Sjenica
s
Foca
ˇ
(Srbinje)
Mostar
Ta
ra
Gacko
a
Piv
Stolac
43°N
43°N
Bileca
´
MONTENEGRO
Trebinje
Trebinje
To Podgorica
BOSNIA and
HERZEGOVINA
Ad r iat i c
Sea
To Shkodër
0
10
20
30
40
50 Kilometers
ALBANIA
0
16°E
17°E
10
20
30 Miles
18°E
19°E
JULY 2006