Building Resilient Energy Solutions for Health Facilities during the COVID-19 Pandemic

Challenge

While the percentage of the global population with access to electricity has increased over the past decades, more than 730 million people worldwide still lack access to electricity. Moreover, in Sub-Saharan Africa, more than one million health care and education facilities lack reliable electricity supply, limiting their ability to deliver essential services and optimize human development outcomes. The COVID-19 pandemic highlighted an urgent need to improve access to electricity through resilient solutions. Mini-grid and off-grid solar industry plays a key role in the electrification of health facilities, especially in low-access countries. Reliable cold chains are integral to improving health sector infrastructure in Sub-Saharan Africa and beyond. Limited access to cooling in health facilities has resulted in low rates of vaccination in Africa as compared to the rest of the world.

Approach

The Electricity Access and Efficient and Clean Cooling Programs support countries create an enabling environment for inclusive, impactful, and accelerated electrification and deployment of climate-friendly cooling in the health sector through technical guidance, technical assistance, and recipient-executed grants. The programs have accelerated progress towards achieving universal access to electricity for health facilities (SDG 7) and deployment of climate-friendly cold chains to deliver COVID-19 vaccines through technical leadership, convening power and resource mobilization for Covid-19 response. The response consisted of existing World Bank funded projects being restructured to support Covid-19 interventions (e.g. Nigeria mini-grids), additional financing to existing projects in Haiti, Liberia, Mali, South Sudan, Zimbabwe, Niger and Comoros, and support to inform project pipeline development and technical expertise. Several technical pieces and tools have been developed to support energy solutions for the sustainable electrification of health facilities.

The programs collaborated with Governments, external partners, and private sector to enable climate-resilient energy solutions to serve critical health needs. The programs also helped set up the Energy Access Relief Fund (EARF), a unique effort involving over a dozen public and private partners to provide energy access companies – which supply energy to millions of households and businesses - with emergency capital to alleviate financial distress caused by the COVID-19 crisis.

Results

• Accelerate electrification of health facilities to respond to Covid 19 pandemic supporting clients served by 20 existing World Bank-funded operations. In Nigeria, 14 health facility electrification projects have been completed and are operational as of September 2022; and further 486 facilities will be completed and operational over the coming months. This result was achieved through the Nigeria National Electrification Project (NEP, $350 m), which provided $77 m to the electrification of health facilities through mini-grid solutions. In Liberia, the program facilitated grants processed under the Electricity Sector Strengthening and Access Project (LESSAP $64.2 m) targeting the electrification of 190 priority health care facilities by mainstreaming li-lion battery systems, enabling modular and scalable systems which can meet future load growth and conduct remote monitoring performance of all systems. In Haiti, the Electricity Access Program provided a $2.9 m grant in September 2020 alongside $2.5 m re-allocation under the Renewable Energy for All Project ($26.52 m) and $2 m from the Haitian Ministry of Health to provide solar PV and battery systems at 5 large hospitals, 5 water pumping sites, and 10 primary health facilities. Site preparation and final system design are underway for the 5 large hospitals and 5 water pumping sites, and negotiations are ongoing with two leading mini-grid companies to electrify up to 10 health facilities across their mini grid sites.
• Support vaccine cold chain development. 15+ countries were provided technical assistance to accelerate the deployment of climate-friendly cold chains for COVID-19 vaccines. For example, in South Sudan 62 solar direct drive refrigerators (climate-friendly cold chain equipment) have been procured, deployed, and installed and are operational in field locations in Upper Nile and Jonglei States. These investments delivered services to approximately 1.26 m people and provided climate-friendly energy solutions in the health sector. In Mongolia the program provided technical assistance to design and construct a new, reliable, energy-efficient, solar-ready, state-of-the-art central vaccine storage facility, with four times the original capacity.  The facility ensured reliable storage for life-saving vaccines-while limiting greenhouse gases and lowering operating costs. Mongolia has vaccinated over two million people with two doses. 
• Support off-grid industry respond to Covid 19. The program provided emergency capital to energy access companies thereby ensuring they can continue to serve their existing client base of more than 20 million low-income households and micro-businesses in sub-Saharan Africa and Asia.  By December 2021, EARF supported the off-grid sector through 41 approved loans amounting to a total of USD $27.2 m for small energy access companies located in more than 15 countries. Energy access companies that are receiving low-interest debt to address their liquidity constraints include distributors of Solar Home Systems and mini-grid developers that serve customers in rural areas where the grid does not reach, as well as companies distributing clean cooking solutions. As of December 2021, borrowing companies provide energy access to an additional 1.4 million people and support the livelihood of more than 1,900 employees and 4,400 sales agents.
• Knowledge development. The program developed knowledge products including Homer Powering Healthcare Tool to simplify the process of sizing distributed generation systems to meet a facility’s needs (June 2020); Energy Requirements for COVID 19 Testing which provided technical guidance for sustaining cold chains that are essential for COVID testing and vaccine delivery (July 2020); Powering Health Care Catalogue with Sustainable Energy for All documenting diverse private sector solutions (August 2020 and updated regularly); Requirements and Guidelines for Installation of Off-Grid Solar Systems for Public Facilities (May 2021)

Bank Group Contribution

The Electricity Access and Efficient and Clean Cooling Programs mobilized $20.6 m in grants to support more than $850 m IDA financing and $100 m of non-IDA financing across 25+ countries. Additionally, the Efficient and Clean Cooling program helped mobilize $11 m of concessional financing from the Green Climate Fund (GCF). 

Partners

The World Bank has built strong partnerships with World Health Organization (WHO), United Nations Children’s Fund (UNICEF), Sustainable Energy for All (SEforALL), GAVI, Vaccine Alliance Green Climate Fund (GCF) for global advocacy, knowledge sharing, coordination of ongoing activities, market intelligence and country support. For EARF, an additional $66 m was catalyzed from other partners including the United States International Development Finance Corporation (DFC), Dutch Entrepreneurial Development Bank (FMO), British International Investment (BIS), Acumen Investment Fund, Rockefeller Foundation, IKEA Foundation, Shell Foundation, the United Kingdom Foreign, Commonwealth & Development Office (FCDO), the United States Agency for International Development (USAID), and The Swedish International Development Cooperation Agency (SIDA). 

Looking Ahead

The work on electrification of health facilities and cold chains will have far reaching impact beyond the COVID-19 pandemic. On the operational side, the programs will continue to promote an increased focus on sustainable business models for electrification of health facilities and cold chain development integrating energy efficiency considerations and renewable energy solutions. The Programs will continue to advance the knowledge agenda through capacity building. Lessons learned from project design and implementation will continue to be embedded in energy access and health portfolios. The programs will continue to foster global partnerships to promote advocacy and action for reaching SDG3 and SDG7 along with SDG 13, critical for human capital development.  

EARF will continue to help off-grid electrification companies recover from the COVID-19 crisis and build and strengthen their internal capacity. This will put them in a stronger position to secure future funding from other sources. The Lighting Global and Global Mini-Grid Facility workstreams continue to support market-building activities and identify strategies to fully leverage private sector participation to improve energy access to millions of households that are still living without access to electricity.