Federal Democratic Republic of Ethiopia Environmental …

1 1 Federal Democratic Republic of Ethiopia Environmental and Social Management Framework (ESMF) For Africa CDC Regional Investment Financing Program (ACRIFP) (Revised ESMF Report) Addis Ababa, May 2019 2 List of Abbreviations ACRIFP Africa CDC Regional Investment Financing Program AMR Antimicrobial Resistance BSL Bio-safety Level CDC Centre for Diseases Prevention and Control EA Environmental Assessment EIA Environmental Impact Assessment EMP Environmental Management Plan EOC Emergency Operating Centre EPHI Ethiopian Public Health Institute EPLAUA Environmental Protection, Land Administration and Use Authority ESIA Environmental and Social Impact Assessment ESMP Environmental and Social Management Plan FDRE Federal Democratic Republic of Ethiopia FEPA Federal Environmental Protection Authority FEPA Federal Environmental Protection Authority FEPA Federal Environmental Protection Agency FECCC Forest Environmental and Climate Change Commission FMOH Federal Ministry of Health GF Global Fund GoE Government of Ethiopia GTP Growth and Transformation Plan HCF Health Care Facility HCW Health Care Waste HCWM Health Care Waste Management HCWMNG Healthcare Waste Management National Guideline HCWMP Health Care Waste Management Plan HIV Human

2 Immunodeficiency Virus HSDP Health Sector Development Plan HWMNG Healthcare Waste Management National Guideline HWMP Health Waste Management Plan IPPS Infection Prevention and Patient Safety MDG Millennium Development Goals 3 MOH Ministry of Health MPA Multiphase Programmatic Approach OP Operational Policy RG Risk group PHEM Public Health Emergency Management Unit (PHEM) PHID Public health infrastructure directorate PPSD Project Procurement Strategy for Development PVC Polyvinylchloride RHB Regional Health Bureau SNNPRS Southern Nations, Nationalities, and People's Regional State TB Tuberculosis WHO World Health Organization 4 I. Table of Contents List of Abbreviations.

3 2 I. Table of Contents .. 4 II. List of Table .. 7 III. List of Figures .. 7 Executive Summary .. 8 1. Introduction .. 18 Background .. 18 Objectives of the ESMF .. 19 Study Methodology .. 19 2. Project Description .. 21 Project Development Objective .. 21 Project Components .. 21 3. Social and Environmental Baseline Conditions .. 28 General Environmental Setting .. 28 Climate .. 29 Physical environment .. 29 Biological environment .. 29 Soil and Geology .. 30 Water Resources .. 30 Natural vegetation and Forests .. 30 Physical cultural resources .. 31 Health Services in Ethiopia .. 31 Environmental Setting Specific to the Regions .. 32 Tigray Regional State .. 32 Amhara Regional State .. 33 Afar Regional State .. 34 Somali Regional State .. 36 Oromia Regional 37 SNNP Regional State.

4 39 Gambella Regional State .. 40 Benshangul Gumuz Regional State .. 42 4. Legal and Institutional Framework .. 44 Background .. 44 National Regulatory Framework .. 44 Constitution .. 45 Environmental Policy of Ethiopia .. 45 Environmental Proclamations Regulation and Guidelines Relevant to this project .. 46 Environmental and Social Impact Assessment Guidelines and Directives .. 52 International Environmental Conventions .. 53 World Bank Safeguard Policies .. 54 Comparison of the World Bank Safeguard and National Polices .. 59 5. Environmental and Social Impacts and Mitigation Measures .. 61 Positive Impacts .. 61 Negative Impacts and Proposed Mitigation Measures .. 63 5 Impacts Specific to Proposed Project .. 63 Impacts during Construction Phase .. 66 Impacts during Laboratory Operation.

5 72 Laboratory Biosafety Level and Risk Groups .. 72 Risks on BSL 2 Laboratories .. 73 Occupational Health and Safety and Community Health Concerns .. 75 Occupational Health and Safety on BSL 2 Laboratories .. 75 Community Health and Safety on BSL 2 Laboratories .. 77 Potential impacts associated with BSL 2 laboratories operation .. 77 Strategies to mitigate the potential risks associated with BSL 2 Laboratories 78 Basic Principles and Practices for Effective Healthcare Waste Management in BSL 2 Laboratory .. 95 Occupational Health and Safety .. 102 Impact of None-routine Emergency Events .. 105 Risk due to Laboratory biosafety issues .. 106 Community Health and Safety .. 110 Impacts during decommissioning .. 111 Generic Environmental and Social Management Framework (ESMF) .. 111 6. ESMF Implementation and Monitoring Process.

6 118 Sub-project Screening and Approval Process .. 118 ESMF Implementation Arrangement .. 122 Institutional Arrangements .. 122 Public Health Infrastructure Directorate (PHID) .. 122 Environmental and Social Safeguards committee .. 122 ESMF Monitoring, Supervision and Reporting .. 124 Health Care Waste/ Laboratory Waste Management and Monitoring Plan .. 137 Chance Finds and GRM Procedures .. 138 Procedure for the management of Chance Finds .. 138 GRM Procedure .. 139 Grievance Mechanism .. 140 Capacity Building and Technical Assistance .. 142 Institutional Capacity Assessment .. 142 Training and Awareness Raising .. 143 Technical Assistances .. 143 7 Protocol for Conducting Environmental and Social Audits under Africa CDC Program for BSL2 labs to be financed by the Program in Ethiopia .. 145 Environmental auditing and Scope of audits for World Bank projects.

7 145 The Environmental Audit 147 Checklists for the audit protocol and methodology for auditing .. 147 8 Disclosure Policies and Procedures .. 149 Annexes 150 A. Annex 1: Environmental and Social Screening Form .. 150 B. Annex 2: Environmental and Social Guidelines for Contractors .. 155 C. Annex 3: Subproject Eligibility Screening Checklist .. 162 6 D. Annex 4: Checklist for Environmental and social impact identification and rating .. 164 E. Annex 5: Guideline for Monitoring and Evaluation of the implementation of ESMF .. 166 F. Annex 6: Summary of Field assessment and stakeholder consultation .. 168 G. Annex 7 . An indicative Terms of Reference for Environmental and Social Audit Consultant .. 169 H. Annex 8: Audit Checklist for BSL 2 laboratories to be financed by Africa CDC Program in 172 Instruction 172 I.

8 Annex 9 Protocol for transportation of infectious substances .. 176 J. Annex 10: Some Minutes of Community and Stakeholders Consultation .. 197 K. Annex 11: Guidelines for Management of Each Class of HCW .. 200 L. Annex 12: List of Contributor Experts .. 204 References 205 7 II. List of Table Table 1: World Bank Applicable Operational Policies, Bank Procedures .. 54 Table 2: Waste Expected from the Proposed BSL 2 Laboratories .. 89 Table 3: Summary of WHO recommended segregation and collection scheme .. 98 Table 4: Generic Environmental and Social Management 112 Table 5: Rating and classification of potential impacts of Sub-projects .. 119 Table 6: Implementation arrangement and Roles and Responsibilities institute of the ESMF .. 123 Table 7: Table Generic Environmental and Social Monitoring Plan of the proposed Project.

9 126 Table 8: Health Care Waste/ Laboratory Waste Management and Monitoring Plan .. 134 Table 9: Estimated budget for the implementation of the ESMF .. 144 III. List of Figures Figure 1: Map of Ethiopia showing location (Regional state) of the BSL 2 Reference Laboratories constructed by Global Fund to be equipped by the 24 Figure 2: Map of Ethiopia showing location (Regional state) of the BSL 2 Reference Laboratories to be constructed by World Bank Support .. 27 Figure 3: Grievance management mechanism .. 141 8 Executive Summary Project Background The Strategic Plan Management of Ethiopian Public Health Institute (EPHI) (2015/16 to 2019/20) together with the Ethiopian Action Plan for Health Security (2018-2022) is enthused and determined for the construction and furnishing of high-level Biosafety Level (BSL-2) laboratory complex in 15 BSL 2 regional laboratories and equipping of 8 BSL 2 regional laboratories constructed by Global Fund.

10 The Africa CDC Regional Investment Financing Program (ACRIFP) project is part of this initiative. World Bank is supporting the East Africa Public Health Laboratory Networking Project by providing finance for the implementation of the start-up phase of (ACRIFP) in Ethiopia . This will involve supporting the set-up of the institutional framework and delivery systems and launching the constructions of BSL 3 laboratory at EPHI ,15 Regional reference laboratories and equipping and furnishing 8 district laboratories constructed by Global fund in Tigray, Afar, Amhara, Oromia, Somali, SNNPRS, Benishangul Gumuz and Gambella regional states and Addis Ababa city administration. Project description The proposed project will support vital institutional capacity-building efforts by the Africa CDC headquarters in Addis Ababa, the SA-RCC in Lusaka, and the Ethiopian and Zambian health authorities.