The World Bank Group, one of the largest sources of funding and knowledge for developing countries, is taking broad, fast action to help developing countries strengthen their pandemic response. In Sri Lanka, the Bank is working with the Government to implement pandemic management and prevention measures, and to protect vulnerable communities from the impacts of the pandemic. The $128.6 million Sri Lanka COVID-19 Emergency Response and Health System Preparedness Project (ERHSP) which came into operation in May 2020 has supported the implementation of Sri Lanka’s ‘test, track, isolate and treat strategy’ by contributing to the provision of essential supplies and services. An additional financing of $88.97 million was approved to provide scaled-up social protection measures to vulnerable communities, and a second additional financing of $80.5 million was approved in April 2021 to support vaccine procurement and deployment.
In addition, in September 2020, funds worth $56 million were also reallocated to pandemic related assistance from existing projects, with $17 million from the Local Development Support Project (LDSP), $15 million from the General Education Modernization Project (GEMP), $9 million from the Sri Lanka Primary Healthcare System Strengthening Project (PHSSP) and $15 million from the Climate Smart Irrigated Agriculture Project (CSIAP).
The ERHSP with a total of $298.07 million has contributed to Sri Lanka’s pandemic management and prevention efforts by:
1. Supporting emergency response measures
In the first six months of implementation, project focus was on emergency response measures, and on supporting the Ministry of Health (MoH) with urgent healthcare priorities and pandemic management and prevention measures including quarantining and contact tracing. Project funds have contributed to the provision of essential works, goods, services and consultancies for emergency pandemic management and prevention activities, including the procurement of medical and surgical consumables and PPEs. Project funds have been used to:
- Procure 279,500 PCR test kits and necessary biomedical equipment for hospitals.
- Provide goods and services, and support essential work on 70 COVID-19 treatment centers around the country. Work has been completed in 15 centers, and is in progress in the remaining centers.
- Provide facilities, and medical and non-medical equipment to quarantine centers, and support necessary renovations.
- Procure 26 cabs and 805 motorbikes to be used by MoH/PHIs in carrying out public health activities. The project is also in the process of procuring ambulances and scooters.
- In the current emergency context, the project is supporting the strengthening of High Dependency Units (HDUs) with facilities for high flow oxygen therapy units and adequate oxygen concentrators/ facilities.
2. Providing social protection and support to vulnerable communities
The social protection component of the ERHSP supported vulnerable populations during the first and second waves of the pandemic. The cash transfer program supported 629,303 elderly persons, 52,940 people with special needs, and 18,972 CKD patients. In addition, 1,338,422 beneficiaries who lost their livelihoods due to the lockdown received a one-time cash transfer of Rs. 5,000, and 417,427 beneficiaries sent on home quarantine received an in-kind transfer of food packs worth Rs. 5,000 for two weeks from October to December 2020.
3. Establishing health sector preparedness and pandemic prevention measures
Since late 2020, the project has gradually begun to shift focus from emergency activities, and has initiated the implementation of several short-term health sector preparedness and long-term pandemic prevention measures. Work is underway to establish isolation units in secondary and tertiary care hospitals around the country. Two units have already been completed and several others are currently in the design stage. The project has also contributed to increasing the ICU/HDU bed capacity by 65 beds, and is supporting the strengthening of ICU/HDUs. Laboratory quality development activities have been initiated to increase and improve the testing and diagnostic capacity in the country. In addition to procuring laboratory equipment, the project is in the process of establishing a Laboratory Information Management System (LIMS) for PCR testing laboratories. Project funds will also be used to upgrade the Medical Research Institute (MRI) laboratory, which is the national reference laboratory to a Biosafety Level 3 laboratory.
4.Strengthening routine public healthcare services
An additional grant of US$ 1.7 million provided by the Pandemic Emergency Financing Facility (PEF) has supplemented ongoing efforts to strengthen national systems for pandemic response and public health preparedness. These funds were used to support the continuation of routine health services at community health centers. PEF funding has helped strengthen mental health support services provided through the public health sector. Funds were used to expand and adapt mental health services as required in the pandemic context, to conduct mental health promotion activities, develop IEC material, strengthen the toll free mental health helpline, and to support facility and capacity development at the National Institute for Mental Health. PEF resources were also used to strengthen programs for the prevention of gender-based violence (GBV), and to create awareness on the public services available to victims of GBV. The grant also supported the strengthening of the national and regional communicable disease surveillance system. PEF funds were used to introduce an online disease notification system linked to the existing e-surveillance system, and to provide the necessary IT hardware capacity to hospitals and MOH offices in all districts. This funding also contributed to the scale up of risk communication efforts, supporting the development of more nuanced communication strategies and public information on preventive measures.
5. Supporting the procurement and deployment of COVID-19 vaccines
A second additional financing to the ERHSP was approved in April 2021, to purchase and deploy safe and effective COVID-19 vaccines that meet the World Bank’s Vaccine Approval Criteria, to strengthen relevant health systems that are necessary for successful deployment, and to prepare for the future.
Since the detection of the first confirmed COVID-19 case in early 2020 Sri Lanka has been relatively successful in its pandemic management efforts. With many lessons learned along the way, the country now finds itself at a crucial juncture, struggling to contain the third wave that began in April 2021. The World Bank has remained responsive to the country’s healthcare priorities, and while continuing to support emergency needs, the ERHSP has now initiated several medium and long term preparedness measures to ensure that Sri Lanka’s public healthcare system is better placed to face the future.
Last Updated: Apr 30, 2021