Proposed ACDC Regional Investment Project Financing Pitch 2018-03-20

World Bank Support for Africa CDC ProposedRegional Investment ProjectFinancing Estimated at $ 50- 100 Million

Project Development Objectives (PDO)The expressed goal of the ACDC is to safeguardAfrica’s health. This is consistent with the AU’sAgenda 2063.The specific development objective (PDO) of theproposed project is to help operationalize the ACDCto effectively deliver on its mandate of preventing,detecting and responding to health threats for thebenefit of African Union Member States and itscitizens.

PROJECT COMPONENTSThe proposed project will include the following indicative components: Support for ACDC Headquarters in Addis Ababa: Provisions will be made to: (a) establish modern systems for financial management and procurement; (b) build a data warehouse for surveillance and early-warning system; (c) develop a robust communication strategy and platform; (d) connect all RCCs; (e) build the human resources; (f) compile and maintain a roster of deployable professionals from member states available to respond to public health threats across borders; (g) work with AU’s Peace and Security team to ensure expeditious response to emergencies; (h) harmonize disease control and prevention policies and the surveillance systems for all member states; (i) build strategic alliances and partnerships; and (j) develop a harmonized continental program for epidemiology training. Support to Regional Collaborating Centers in Nigeria: Under this component of the proposed project, provisions will be made to: (a) strengthen Lassa diagnostic capabilities in Nigeria to act as the referral center for regional Lassa control (lab infrastructure, equipment and reagents); (b) implement connectivity platform for rapid access to test and instrument data (connectivity software); (c) implement an integrated Sample management system for the West Africa Region (sample shipment, special vehicles, UAEs for hard to access places); and (d) training for lab and data management staff (Training of national staff). Support to the Regional Collaborating Center in Gabon Under this component of the proposed project, provisions will be made for: (a) Molecular diagnostic platform; (b) implementation of an integrated specimen transport and storage facility; (c) setting up of Connected Diagnostic facility to network diagnostics within the Central African Region (Specimen transport mechanism, special vehicles, training personnel, UAEs); (d) implementation of Laboratory information management system linking all reference labs within member states in the Central African region (Set up software for Lab data acquisition and transfer); (e) data platform for rapid acquisition of data within the region to enhance cross-border data transmission (Software and personnel); and (f) training of Lab and data staff (Training).

 Other RCCs: For other RCCs (Egypt, Kenya and Zambia), the need for support under the proposed project will be determined during Preparation Mission. Support for the Regional Integrated Surveillance and Lab network (RISLNET): The RISLNET will link laboratory networks with surveillance networks to create: (a) an electronic platform for real-time collaborative analysis of public health threats to be used by Africa CDC, Member States, and trusted partners; (b) event-based surveillance systems in Member States; (c) a strategy and technical requirements for real-time surveillance of the healthcare delivery system; and (d) an ACDC policy and standards for health information exchange within and between government agencies. The RISLNETs will be linked to an ECHO platform, which is an affiliated ACDC network of public health professionals working to strengthen national, regional and continental public health systems. The ECHO operating context promotes use of case-based learning and collaborative problem solving combined with the sharing of best- practices complemented by use of online workspaces as a means to share real- time information towards application to ongoing public health activities and programs. Support to Ethiopia’s National Reference Lab and Center of Excellence: A major epidemic in Ethiopia could put the health and economic gains being achieved by the country at risk. Given its geographic location Ethiopia is also at particular risk of transmission from other countries. Addis Ababa Airport is one of the largest aviation hubs in Africa. It links thousands of passengers and cargo to the rest of the continent and beyond. Ethiopia’s size and vast porous borders link the country to its neighbors, many of which are fragile (Sudan, South Sudan, Somalia, Djibouti and Eritrea) which do not all have the capacity to screen passengers, provide services, and contain the potential spread of infectious pathogens. This includes diseases such as MERS which has been found in camels in Ethiopia. The health system in many of the countries neighboring Ethiopia are far from ready to handle an outbreak of the magnitude seen in Guinea, Liberia and Sierra Leone during the 2014 Ebola crisis.

PROJECT FINANCINGThe indicative financing requirements are yet to bedetermined.



RISKSThe proposed project faces significant risks to development outcomes.These will be mitigated during the design phase: First, the ACDC’sautonomy vis-à-vis the AUC’s laborious bureaucracy, unused to theunique demands of public health engagement, particularly as it pertains toemergency response. The ACDC recognizes that this could impact itsability to make expeditious decisions.