One WASH Fund November 2019 - International Federation of Red Cross and ...

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One WASH Fund November 2019 - International Federation of Red Cross and ...
One WASH Fund
      November 2019

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One WASH Fund November 2019 - International Federation of Red Cross and ...
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I.       Background
The Humanitarian and Development Sector provide a shared founda-
tion for social and economic justice that can contribute to shared pros-
perity through the principles of inclusive participation and risk sharing,
and achievement of the Sustainable Development Goals (SDGs).

The Islamic Development Bank (IsDB) and the International Federation
of Red Cross and Red Crescent National Societies (IFRC) together
developed an innovative approach involving development finance,
humanitarian aid and private capital investment to support One WASH
programs and contribute towards achieving the SDGs.

As a priority the IsDB and the IFRC have set themselves the ambitious
objective of contributing to the reduction of Cholera related deaths by
90% in the most affected Organization of Islamic Cooperation (OIC)
States, over the next 10 years. This objective contributes not only to
SDG 6 (Clean Water and Sanitation) but also SDG 3 (Good Health and
Wellbeing), SDG 5 (Gender Equality), SDG 13 (Climate Action) and SDG
17 (Partnership for the Goals) and aligns with the Global Task Force for
Cholera Control (GTFCC) ‘Cholera Roadmap’. The funds required for
delivering on SDGs and the Cholera Roadmap will require innovative
and transformative forms of financing beyond traditional humanitarian
aid or development finance responses.

To achieve this vision, IsDB and IFRC are creating a multi-million-dollar
fund (the One WASH Fund) to combat cholera and other diarrheal
diseases as part of the Global One WASH Initiative targeting 40 cholera
hotspots globally.

Specifically, the One WASH Fund will finance One WASH Programs in
29 OIC member states where it aims to impact the lives of 5 million
people by strengthening and integrate the delivery of water, sanitation,
and hygiene (WASH) with health services building upon well proven
methodologies being practiced by the IFRC at the grass roots level.

The One WASH Fund uses an innovative financing mechanism de-
signed to attract new philanthropic and private investor capital in
addition to traditional humanitarian donor financing.

Primarily, the model seeks to blend outcome-based financing with
grant financing in a structure that will position participating funders
and stakeholders ahead of the innovative financing curve and suggests
a new approach to humanitarian development organizations resource
mobilization.

                                                                        3
II.         THE PROBLEM
The 2017 mapping of the “Progress on drinking water, sanitation and                          SNAPSHOT
hygiene” from the Joint Monitoring Program (WHO/UNICEF) states
that 844 million people still lack access to an improved water supply, 2.3
billion lack basic sanitation and 159 million people still collect drinking                   2.3 billion
water from unprotected sources.                                                               People still lack
In addition, 47 per cent of people in less developed countries have no
                                                                                               even a basic
hand-washing facilities1. The resulting and continuing negative health                       sanitation service
impact of unsafe water, poor sanitation and hygiene practices place a
heavy burden on individuals, families, communities and governments
due to the added cost of health care and loss of productivity. Lack of                       844 million
sanitation, contaminated water and poor hygiene contribute to almost                          People still lack
90 per cent of child deaths from diarrheal diseases (289,000 children
every year)2 and these factors are major causes of the spread of other
                                                                                              a basic drinking
acute diseases, particularly cholera. Further, lack of adequate sanitation                      water service
and water supply costs $260 billion every year in economic losses (World
Bank estimate) and poses greater risks of epidemics and political crises
exacerbated by climate change.                                                                159 million
                                                                                             People still c†ollect
Why Cholera?                                                                                   drinking water
Cholera continues to disproportionately affect the poorest and most                          from unprotected
vulnerable communities in high-risk countries. Cholera spread, inci-                              sources
dence and severity are exacerbated by rapid and often unplanned
urbanization and population growth, by climate change, food insecu-
rity, extreme weather events or trends and complex settings, especially
where conflict and unrest are present, and health and WASH services
                                                                                             One WASH
are weak.                                                                                     objective
    • There are an estimated 2.9 million cholera cases and 95,000                             #ENDCHOLERA
      deaths per year globally3.                                                               related deaths
    • 89 million people live in cholera “high-risk” areas in Africa                             by 90% in the
      alone.                                                                                    most affected
                                                                                                OIC member
    • Providing access to basic WASH services requires between                               countries, by 2030
      USD 40 and USD 80 per person4.

1     https://www.globalwaters.org/resources/assets/handwashing-soap-where-are-we

2     https://www.wateraid.org/uk/media/world-health-assembly-cholera-resolution-a-vi-
      tal-next-step-towards-prevention-but-promises

3     Global Task Force on Cholera Control – GTFCC

4     https://sustainabledevelopment.un.org/content/documents/hlpwater/13-UniversalAccess.
      pdf                                                                                                            4
III.         THE SOLUTION – ONE
             WASH PROGRAMME                                                                         WASH and
It is estimated that every 10 seconds someone is infected with Cholera.
And every case and death from cholera is preventable with the tools                                  Cholera
we have today: effective cholera prevention and control interventions
are well established. However, current efforts focus more on emer-
                                                                                                     Every 10 seconds,
gency response that have less of an impact on long-term control or                                  someone is infected
elimination of cholera. A proven solution exists in linking public health,                             with cholera
vaccination and long-term WASH. All these components are needed to
eventually eliminate cholera.                                                                        There are 95,000
                                                                                                       preventable
The roadmap to end cholera is based on a multi-sectoral approach that
has been defined by the Global Task Force for Cholera Control (GTFCC)                                  deaths from
who with other partners and stakeholders, including the International                               cholera every year
Federation of Red Cross and Red Crescent Societies (IFRC), has adopted.
                                                                                                      Bringing WASH
Over the past 12 years, the IFRC and its membership have significantly                               and public health
scaled up delivery of longer-term water and sanitation programs
                                                                                                        together to
through the Global Water and Sanitation Initiative (GWSI). The GWSI
promotes a common but adaptable approach amongst National Red                                          fight cholera
Cross Red Crescent Societies to establish large-scale, long-term sustain-
able water and sanitation Programs. The Initiative provides equitable,
affordable and sustainable solutions to help improve the health and
quality of life of vulnerable communities. Additionally, it is estimated
that every $1 spent gives a return of $4.305 in developmental impact.
                                                                                                    IFRC Global
                                                                                                     Water and
The IFRC have reached more than 20 million people between 2005 and
2017 through the GWSI and a further 16 million through emergency                                     Sanitation
WASH services by delivering over 750 projects and operations in over
80 countries and is committed to use this capacity to contribute to                                  Footprint
cholera elimination.
                                                                                                    36 million
The One WASH Objective:
                                                                                                      People reached
Align the expected outcomes and impact of the ‘One WASH’ Initiative
with the GTFCC ‘Cholera Roadmap’ and by doing so contribute to ‘reduc-
                                                                                                        with WASH
ing cholera related deaths by 90% by 2030’. Concurrently, ‘One WASH’                                infrastructure and
programming will reduce vulnerability to and incidence of cholera and                               services since 2005
Acute Watery Diarrhoea (AWD) outbreaks, their severity and resultant
morbidity in recognised ‘hot spots’ while further contributing, by deliv-
ering integrated WASH and public health interventions, to SDG’s 3, 5, 6
and 17 while indirectly contributing to other cross cutting goals related
                                                                                                     Sustainable
to climate action, WASH related diseases and malnutrition and overall                               Development
poverty reduction. This global initiative intends to reach a minimum of
7 million ‘high risk’ people within the first five years expanding to over                              Goals
12 million people by 2030.
                                                                                                    contribution
The One WASH Fund, to be managed by IsDB and IFRC for target coun-
tries in the OIC that are affected or at risk from cholera and AWD, a
minimum of over 25 countries are targeted within which over 5 million
people are targeted in the first five years to be expanded to over 10
million by 2030.

5      https://www.who.int/water_sanitation_health/publications/glaas_report_2014/en/ and
       https://news.un.org/en/story/2014/11/484032-every-dollar-invested-water-sanitation-brings-
       four-fold-return-costs-un                                                                                          5
(In addition to OIC member countries, the Global One WASH initiative
 targets as well non OIC cholera endemic countries which will reach an
 additional minimum of 2 million ‘high risk’ people.)

 IV.          WHY INNOVATIVE FINANCE
 Globally, there has been remarkable economic and social progress in
 the past two decades. This prosperity, however, is unevenly distributed
 and the next tranche of gains are threatened by persistent develop-
 ment challenges exacerbated by prolonged crisis, climate change and
 rising inequality. The relative importance of drivers of economic growth
 and prosperity has evolved over time, and, for a growing number of
 countries, innovation in its many dimensions is emerging as a leading
 factor.

 SDGs Require Unlocking New Funding Sources

                    SDGS FINANCING GAP ($ TRILLION)
             4.5
DEMAND

                            X3                                      $3T
                                     1.4

                                                                     =        ~1.5% OF PRIVATE
                                                                              CAPITAL CAN FILL
                                                    0.1

         ANNUAL CAPITAL          CURRENT ANNUAL     ODA                         THE SDG GAP
         NEEDS FOR SDGS            INVESTMENT
                                                                  ~1.5%
                                                                               HARNESSING
                   PRIVATE CAPITAL SOURCES ($ TRILLION                         THIS CAPITAL
                                                                                REQUIRES A
                                                                     ×
           121

                                                                              NEW RESOURCE
                                                                              MOBILISATION
SUPPLY

                                                                                  MODEL
                                                                 $210T
                       34

                                     26

                                              25

                                                    6.3

          BANK       PENSION INSURANCE       TNCS    SWFS
          ASSETS      FUNDS

 Governments’ ability to strategically mobilize various sources of financ-
 ing for social purposes remains constrained and many traditional donors
 around the world are dealing with fiscal pressure that exacerbates the
 reality of limited Official Development Assistance (ODA). UN estimates
 suggest that developing countries will need more than $2.5 trillion a
 year to fill the SDG financing gap while the total ODA does not exceed
 $150 billion. Compare this to private capital sources alone amounting to
 more than $200 Trillion and it is clear that an increasing contribution of
 funds to achieve the SDGs must come from non-government sources.

 Much has been written about the urgent need for new sources and
 forms of finance for development as a complement to ongoing public
 financing efforts. True enough, of recent times, we are finding the                             6
emergence of several new financing models, growing both in terms
of their market size, their operations and the way they serve those in
need, as a new alternative.

Development Impact Bonds (DIBs) are perceived as an innovative
model that seeks to unlock private capital and help further leverage
public funding while at the same time realigning interests of various
partners around an objective: focus on defined and measurable out-
comes. We believe the model is promising especially to achieve impact
by focusing on outcome delivery for a multi country programme like
One WASH. However, DIBs in its current form carries several limitations
and falls woefully short of meeting expectations of donors:

1.     Yet to prove their scalability – of the 166 impact bonds in 30
       countries, only an average of 13,231 beneficiaries have been
       served while half of impact bonds have so far served fewer
       than 480 people.

2.     Do not serve countries most in need i.e. low and middle-in-
       come countries (LIC and MIC), of the total issued more than
       70% are in the US – UK and the total issuance amount of
       the few instruments for developing countries so far does
       not exceed $50 million, and fails to meet the critical financ-
       ing gap of development and humanitarian needs globally.

3.     Costs are high and therefore does not truly unlock private
       capital as claimed since returns are paid to the investors
       who take on the implementation risk.

Based on our analysis, we identified that the critical obstacle in the
modality of outcome focused instruments is the shift of risk from the
commissioner to the investors in DIBs that prevents their flourishing,
with the following assumptions:

1.     The financial markets are not familiar with the outcome
       achievement risk of a humanitarian or development assis-
       tance project in low and middle-income countries,

2.     Because they are not familiar with this risk, they tend to
       price it very high or refuse to engage with it,

3.     The lack of investors willing to engage limits the potential
       of scaling the use of DIBs that are exclusively subscribed
       by a small group of social investors, in many cases they are
       initially donors themselves, ready to subsidize the structure
       for the development impact to be achieved,

4.     The mix of investment for return and subsidy (grant) in a
       single instrument creates confusion about the role of the
       social investors and how much grant they are contributing.

5.     It also challenges the popular affirmation that the DIBs
       in their current form mobilize private sector contribution
       for humanitarian and development as the subsidy portion
       remains undefined.

It was therefore clear that the current construct of DIBs considered
innovative required further innovation to truly achieve impact at scale.
                                                                           7
The challenge: a small market focused on developed countries

                                                                33

           30                                           67

                                                                                                  3

                                                                                         4
                                                                 9
               5
               25
                                 4
               50
               75                                                                            11

      A TOTAL OF 161 BONDS FOR 400M US$
     Source: The New Humanitarian - Brookings Institution Global Impact Bond Database,
     August 1, 2019

V.         The One WASH Fund
The One WASH Fund is the product of a strong partnership between
IsDB, a multilateral development bank with 44 years of experience in
providing support to its 57 member countries to achieve social and eco-
nomic development in the framework of the SDGs, with a strong exper-
tise in financial engineering; and IFRC, an international organization
that federates the efforts of the Red Cross and Red Crescent Societies
with over a 100 years of activity with a strong track record in WASH and
cholera control project implementation all around the world including
high risk areas.

The joint vision for the One WASH Fund is triggered by the basic ques-
tion of: how can DIBs work at scale for LICs MICs and bring additionality
in terms of grant financing?

The One WASH Fund proposes an innovative grant capital blending
approach that ambitions to address some of the main criticisms of the
DIBs model by defining an adapted role for each partner involved in
the structure. The structure is based on the understanding that tra-
ditional donors are more familiar with the outcome non-delivery risk
of a humanitarian or development project in a low- or middle-income
country and therefore are more relevant to take this risk versus inves-
tors. The grant capital – not conditional to outcome delivery and paid
upfront – and the guarantees – covering the outcome non-delivery
risk – are blended with the outcome funding to absorb the outcome
non-delivery risk externalized by outcome funders that is usually, in
traditional impact bond structures, shifted to investors.
                                                                                                      8
The One WASH Fund internalizes the outcome non-delivery risk and
shifts only credit risk of outcome funders and guarantors to investors
that are by nature more familiar with credit risk and willing to take it
when it matches their available allocations. This mechanism allows to
expect for a broader investor base versus the limited social investor
base usually targeted by traditional impact bonds.

With these innovations on existing DIB models, the financial model
of this outcome fund proposes to allocate to each stakeholder in the
structure a role that better fits its natural role and experience, as follows:

   • Donors Leverage: The grant donors and guarantors are absorb-
     ing the outcome non-delivery risk shifted by outcome funders
     to enable the structure and are leveraging on their grant contri-
     bution for a minimum of 1 to 5 ratio.

   • Outcomes Driven Structure: The outcome funders commit only
     for defined KPIs and drive the Fund strategy towards an out-
     come-based implementation that generates better monitored
     and quantifiable impact while being involved in a structure
     that ultimately allocates more of their contribution to project
     activities versus payment to investors.

   • Investors Credit Risk Allocation: The investors are only exposed
     to the credit risk of outcome funders and guarantors, a risk they
     are familiar with and can easily price and engage in.

In summary, compared to existing DIB occurrences of 3 LIC / 6 MIC for
a volume of $37million, the One WASH Fund and Sukuk instead pro-
poses 29 countries (22 LIC / 7 MIC), with a total programming volume
of $160million.

The One WASH Fund

                                                             Financial Markets

                                                             Sukuk
     Donors                    Grants
  Guarantors                   Guarantees                ONE WASH FUND                            Trustee

                                                                     A          L
                                                                Grants          Projects
    Outcome                                                 Guarantees          Sukuk
                               Commitments                                                        Implementation
     Funders                                              Commitments

    *This is not an accounting approach but just an illustration where assets are understood
    as assets backing the Sukuk (or inputs to the fund) and liabilities as outputs of the fund.
                                                                                                                   9
VI.            The One WASH Sukuk
The Fund will seek to mobilize resources, principally on commercial
basis from the international capital markets.

                                                   One WASH SUKUK term sheet
Obligor                 ONE WASH FUND

Obligor Type            Trust Fund under IsDB Article of Agreement Art. 11, 13, 14 and 23

Credit Risk             Philanthropic Capital (Donors, Outcome Funders and Guarantors)

Credit Risk Type        Bilateral Development Agencies, Institutional Donors, International Foundations, Multinational Corporate Donors

Underlying Contract     Mudaraba

Shariah Pronouncement   IsDB Shariah Board

Expected Issue date     First quarter 2020

Expected Sukuk Issue    US$ 80.000.000,00

Final Maturity Date     8 years after issue date

Sukuk Type              Bullet Payment

Mark-up Payment         Fixed at X per cent. per annum, payable semi-annually

Notional Payment        Callable at 5 years / 7 years / 8 years

VII.           Value Proposition

Exposing Investors to Credit Risk
By blending traditional donor financing and guarantees with outcomes
funding, the fund absorbs the implementation risk amongst donor
partners familiar with WASH implementation therefore exposing
investors only to credit risk. This allows for the model to be accessible to
capital investors and provides them a more familiar risk return match.

Ensuring additionality of capital
As investors are only exposed to credit risk, it not only optimizes the cost
of the bond but also ensures that any upside paid for overperformance
stays within the fund unlocking additional capital for continued WASH
programming.

Scalability of impact
With the convergence of the above, the model is uniquely placed to
ensure channeling of resources to communities most in need and
enable scalability of impact For endemic diseases like Cholera, an inte-
grated multi country programmatic approach that targets well defined
disease ‘hotspots’ to scale provides a realistic opportunity to improve
not only the expected overall impact of One WASH but also the efforts
of other local national and international stakeholders.

Incentivize over-performance
In case the implementing agency over-perform, the upside for over-per-
formance is paid to the Fund instead of being paid to the investors (in
a traditional impact bond set-up) and all amounts paid to the Fund
are ultimately used to finance additional WASH projects. This way, the                                                                    10
implementing agency has additional funds for projects as a way to
incentivize it to overperform.

Enhanced Data and Monitoring
Providing more time and resources during pre-inception and planning
phases of projects goes beyond standard developmental good practice
and ensures investments at a systems level are put to their best use in
the whole planning cycle. This investment in better planning helps to
better define the processes required for better project delivery, setting
of targets and creating a more positive internal and external enabling
environment tailored to any specific context. It also ensures that the
systems required for more robust verification of outcomes and a more
easily measurable evidence base is clear from the beginning and roles
and responsibilities of all stakeholders are adequately defined.

Reduced aversion to high risk areas
A criticism often documented is that outcomes or results-based mod-
els are known to create to some extent a ‘risk averse’ response. This is
not favorable to mandates of reaching the most vulnerable or ‘high risk’
communities in fragile and complex settings. In response, by introduc-
ing a ‘weighting’ when setting both expected outcomes and outputs
ensures instead that impact is maximized without setting unachieva-
ble targets especially in such scenarios. The intended value therefore
is to reduce the likely consequences of recognized implementation
risks rather than avoid risks or enable low setting of targets that do not
encourage over performance.

Economies of Scale
In addition to strengthening impact at scale, a portfolio of projects
approach especially on WASH infrastructure is crucial if economies
of scale are to be realized and impact and sustainability achieved.
Hardware procurement and contracting alone done at scale reduce
costs significantly without creating increased transaction, administra-
tion or overheads costs.

VIII. OPERATIONS
The Program will combine investments in WASH and public health
interventions especially in recognized cholera and AWD ‘hotspots’
and will target prevention, resilience building and outbreak-response
preparedness activities.

Health and hygiene behaviour change communication and marketing
programs will also be implemented in target communities, including
advocacy and support to cholera vaccination campaigns when planned
or implemented.

In terms of budget allocation, in most cases a significant portion of the
investment will be in increasing sustainable WASH infrastructure or
‘hardware’ access typically representing as much as 50% of the budget
allocation per project, the remainder directed to the to the public
health, behavioural change “software” and project support activities.

Following established best practice in Developmental and Sustainable
WASH Programming, the Program will follow the Operational Norms as
                                                                             11
follows, however with some country specific considerations according
to context:

      Program Phase                 Description                                               Timeline
A     Initial Consultation          Consultation with Government, stakeholders and other      2-3 months
                                    actor in agreement with them identify target areas for
                                    One WASH Programming in any given country. Target
                                    areas identified are considered ‘at high risk’ from
                                    cholera/AWD or are recognized cholera/AWD ‘hot spots’.
                                    Secondary data will provide data on incidence severity
                                    and occurrence of cholera/AWD but also on WASH
                                    coverage and access to Primary Health Care which will
                                    aid specific project design and components according
                                    to context.
B     Project & Budget Approval     Final detailed base line, proposal and budget approved    2-3 months
                                    by Governments and One WASH Steering Group and
                                    project inception date agreed upon.
C     Project inceptions            Project inceptions/set-up varying according to context.   6 months
                                    During this period staff, volunteers and project team
                                    established and first ‘software’ teams mobilized and
                                    become active. Local office, logistics and procurement
                                    established.
D     Primary Implementation        Primary Project Implementation Period (during which       3-5 years
                                    regular finance and narrative reporting undertaken
                                    (every 6 months); Mid-term review; end-line review.
                                    Regular steering group and stakeholder meetings under-
                                    taken. Combined ‘software’ and ‘hardware – infrastruc-
                                    ture works’ delivered and the Operation, Maintenance
                                    and management structures and capacities. Quality
                                    assurance mechanisms.
E     Wind-up                       Project wind-up and final handover and plans for          2-3 years
                                    post-implementation M & E framework agreed upon.
F     Lookback                      Lookback study and measurement of project outcomes.       3 years

IX.          EXPECTED OUTCOMES
The Program has four cholera reduction Outcomes that are linked to
SDG 3 and 6 and the GTFCC Cholera Roadmap.

Each ‘One WASH’ Project will be designed specifically to meet the
contextual requirements in each target area and country though all
projects will have a similar generic approach, time frame and set of
outputs and outcomes. It should be recognized at the outset that the
target areas have at present in most cases exceptionally poor access to
WASH services and this combined with poor knowledge of key public
health awareness and practices relative to cholera and AWD identifies
these target areas as cholera ‘hotspots’ or populations at ‘high risk’
from cholera. Most target areas will already have a history of recurring
cholera or AWD outbreaks.

As reflected in KPI 1

Outputs will be measured as an increase in access to WASH services for
the target population. That is increasing access to a safe or improved
water supply and basic sanitation to those presently unserved in the
target area to reach an overall minimum of 80% of the total population.
                                                                                                           12
This will be investment in WASH infrastructure typically construction of
water supplies and sanitation systems (borehole drilling; surface water
intakes; water treatment; water storage and distribution systems – con-
struction of latrines and toilets; sewerage systems; sewerage treatment;
training of WASH operations and maintenance staff). This will target
the general population but also schools and health structures, such as
clinics, in the target area.

Outcomes will be measured by proxy accepting the fact that the overall
health, incidence of disease, well-being and productivity of a targeted
population will improve significantly if WASH coverage is increased to
reach a minimum of 80% of the target population and preferably above
that threshold if practical.

As reflected in KPI 2
Outputs will be measured as an increase in the knowledge of WASH
diseases especially cholera; increase in the knowledge, preparation
and use of Oral Rehydration Solution; increase in the knowledge
and acceptance of the use of Oral Cholera Vaccine when applicable;
improvement in hygiene practices especially hand-washing, safe water
and food storage and other personal and household hygiene habits;
establishing community based cholera surveillance; establishing com-
munity based cholera preparedness and response capacities (together
with Government and other actors). The whole target population in
the target area will be reached by public health campaigns (at house-
hold. community level and in schools) primarily through the local Red
Crescent or Red Cross Volunteer and Branch network including media
campaigns and interaction with local Government, traditional and
religious leaders and other actors.

Outcomes will be measured by proxy accepting the fact that if the
entire target population including schools is reached by this intensive
public health campaign and over a five-year period their awareness of
and participation in cholera prevention control and reduction will be
achieved.

                                                                           13
One WASH Generic KPI’s Outputs and Outcomes.

                        Output Base line         Output                   Means of               Outcome                 Means of              Outcome
                        data at Project          measured at              Verification.          Base line data          Verification and      measured at
                        inception                End-Line                                        at Project              data collection       End-Line and
                                                                                                 Inception               at Base line an       3 years beyond
                                                                                                                         End-Line.             End-Line at
                                                                                                                                               ‘Look Back’
KPI 1: Increase         1.1 – % of Target Pop-   1.1 – % increase in      Scientific Sampling    # of recorded cholera   Secondary data from   % reduction in
access to sustaina-     ulation with access      Target Population        Methodology (field     or AWD outbreaks in     Government, UNICEF,   cholera and AWD
ble WASH services       to safely managed        with access to safely    survey).               the Target Population   WHO and other         outbreak inci-
(Water Supply) to the   drinking water ser-      managed drinking                                in the previous         WASH and Health       dence in the Target
target population by    vices or an improved     water services or an     Mid-Term, End-line     10 years or more        actors/sources.       Population
WASH infrastructure     drinking water           improved drinking        Reviews, ‘Look Back’   (Incidence of
development.            source (according to     water source (ac-        Studies.               outbreaks)             Clinical data from     % reduction Cholera
                        context)                 cording to context)                                                    the target area if     and AWD related
                                                                          Scientific Sampling    # of recorded cholera available.              deaths in the
                        1.2 – % water sources    1.2 – % increase in      Methodology (field     or AWD deaths in the                          Target Population.
                        meeting national wa-     water sources meet-      survey).               Target Population      Red Cross and Red
                        ter quality standards    ing national water                              in the previous ten    Crescent cholera and   % reduction in
                        in the target area       quality standards in     Mid-Term, End-line     years or more reflect- AWD Emergency Re-      scale of suspected
                                                 the target area          Reviews, ‘Look Back’   ed in Case Fatality    sponse Operational     Cholera and AWD
                                                                          Studies.               Rate CFR. (Severity Reporting.                cases in the Target
                                                                                                 of outbreaks)                                 Population.
                                                                                                                        Mid-Term, End-line
                                                                                                 # of recorded          Reviews, ‘Look Back’
                                                                                                 suspected cholera      Studies.
                                                                                                 or AWD cases in the
                                                                                                 Target Population
                                                                                                 in the previous
                                                                                                 ten years or more
                                                                                                 (Scale of out-
                                                                                                 breaks)
KPI 1: Increase         1.3 – % of Target Pop-   1.3 – % increase in      Scientific Sampling            Ditto                  Ditto                 Ditto
access to sustaina-     ulation with access      Target Population        Methodology (field
ble WASH services       safely managed san-      with access to safely    survey).
(Sanitation) to the     itation services or to   managed sanita-
target population by    improved sanitation      tion services or to      Mid-Term, End-line
WASH infrastructure     facilities (according    improved sanitation      Reviews, ‘Look Back’
development.            to context)              facilities (according    Studies.
                                                 to context)
                        1.4 – % Target                                    Scientific Sampling
                        Population with a        1.4 – % increase in      Methodology (field
                        handwashing facility     Target Population        survey).
                        with soap and water      with a handwashing
                        on premises              facility with soap and
                                                 water on premises

                                                                                                                                                                 14
Output Base line         Output                   Means of               Outcome          Means of           Outcome
                        data at Project          measured at              Verification.          Base line data   Verification and   measured at
                        inception                End-Line                                        at Project       data collection    End-Line and
                                                                                                 Inception        at Base line an    3 years beyond
                                                                                                                  End-Line.          End-Line at
                                                                                                                                     ‘Look Back’
KPI 2: Target popula-   2.1 – % of Target        2.1 – % increase of      Scientific Sampling          Ditto            Ditto              Ditto
tion benefitting from   Population with          Target Population        Methodology (field
public health and       knowledge and            with knowledge and       surveys)
community- based        awareness of cholera     awareness of cholera
interventions and       and AWD symptoms         and AWD symptoms         Knowledge Attitude
campaigns in cholera    and common means         and common means         and Practices Survey
and AWD awareness       of transmission          of transmission
and mitigation.                                                           Secondary Data from
                        2.2 – % of Target        2.2 – % increase of      Government, UNICEF,
                        Population familiar      Target Population        WHO and GTFCC.
                        with the importance      familiar with the
                        of using safe drinking   importance of using      Mobile Phone based
                        water and storage,       safe drinking water      data collection
                        using latrines or        and storage, using       system
                        toilets and hand         latrines or toilets
                                                                          Household Surveys
                        washing at crucial       and hand washing at
                                                                          and Focus Group
                        times                    crucial times
                                                                          Discussions.
                        2.3 – % of Target        2.3 – % increase of
                                                                          Mid-Term, End-line
                        Population with          Target Population
                                                                          Reviews, ‘Look Back’
                        knowledge on the         with knowledge on
                                                                          Studies.
                        preparation and use      the preparation and
                        of Oral Rehydration      use of Oral Rehydra-
                                                                          Red Cross/Red
                        Solution or Salts        tion Solution or Salts
                                                                          Crescent Volunteer
                        (ORS)                    (ORS)
                                                                          Data Base.
                        2.4 – % of Target        2.4 – % increase of
                        Population with          Target Population
                        knowledge of Oral        with knowledge of
                        Cholera Vaccine          Oral Cholera Vaccine
                        (OCV)                    (OCV)

                        2.5 – % of Population    2.5 – % increase of
                        willing to accept OCV    Population willing to
                        if offered               accept OCV if offered

                        2.6 – % of Target        2.6 – % increase of
                        Population having        Target Population
                        received OCV in the      having received OCV
                        last three years         in the last five years
                                                 if they have been
                        2.7 – % of Target        offered OCV
                        Population registered
                        and trained as Red       2.7 – % increase in
                        Cross or Red Cres-       Target Population
                        cent health and/or       registered and
                        WASH Volunteers          trained as Red Cross
                                                 or Red Crescent
                                                 health and/or WASH
                                                 Volunteers

     * WASH coverage target will be increasing the coverage at baseline (typically between 30
        and 60% for water and sanitation access) to a minimum of 80% coverage for the whole
        population at end line (year 5). Reaching that minimum 80% overall WASH coverage is
        represented here by achieving 100% of the target in the table. Every effort will be made
        to exceed that minimum target.

                                                                                                                                                      15
X.          GEOGRAPHICAL FOCUS
The Program is focused on the communities with the highest risks of
cholera and other diarrheal outbreaks. Off the 29 OIC countries recog-
nised as Cholera or AWD endemic that are targeted, a prioritisation
analysis, based on available data on magnitude and urgency of needs,
project readiness and country contexts, yielded a start up for 26 OIC
countries within the next 2 to 3 years.

     * The list below is indicative and subject to final revisions upon field level appraisal of
        initial project concepts.
                                                                                                    16
One WASH Projects for OIC Countries, Summary of Project
Concept Notes (PCN’s):

 Region             Country                  Project       Contribution     Proposed con-    Total Proposed   Proposed      Number
                                             Number        from IFRC and    tribution from   Project Budget   Inception     of people
                                                           partners (20%)   the One WASH     USD              Year (2020,   targeted
                                                           in USD           Fund (80%) in                     2021 or
                                                                            USD                               2022)
 Africa             Benin                    001           290,400          1,161,600        1,452,000        2020          48,400
                    Burkina Faso             002           1,200,000        4,800,000        6,000,000        2020          150,000
                    Cameroon                 003           2,300,000        9,200,000        11,500,000       2020          300,000
                    Comoros                  004           600,000          2,400,000        3,000,000        2020          85,700
                    Cote d’Ivoire            005           660,000          2,640,000        3,300,000        2021          83,000
                    Guinea (Conakry)         006           1,000,000        4,000,000        5,000,000        2021          120,000
                    Mali                     007           2,128,000        8,512,000        10,640,000       2020          250,000
                    Mauritania               008           400,000          1,600,000        2,000,000        2021          65,000
                    Mozambique               009           3,000,000        12,000,000       15,000,000       2020          250,000
                    Niger                    010           4,620,000        18,480,000       23,100,000       2020          1,500,000
                    Nigeria                  011           (900,000)*       3,600,000        4,500,000        2021          120,000
                    Sierra Leone             012           1,600,000        6,400,000        8,000,000        2020          200,000
                    Somalia                  013           1,500,000        6,000,000        7,500,000        2020          200,000
                    Sudan                    014           1,090,000        4,360,000        5,450,000        2021          120,000
                    Tchad                    015           1,217,600        4,870,400        6,088,000        2020          173,000
                    Togo                     016           600,000          2,400,000        3,000,000        2020          75,000
                    Uganda                   017           1,200,000        4,800,000        6,000,000        2020          150,000
 Asia/Pacific       Afghanistan              018           1,000,000        4,000,000        5,000,000        2021          149,000
                    Bangladesh               019           1,026,375        4,105,500        5,131,875        2020          125,000
                    Pakistan                 020           800,000          3,200,000        4,000,000        2021          120,000
                    Tajikistan               021           490,000          1,960,000        2,450,000        2020          70,000
 MENA               Algeria                  022           1,000,000*       4,000,000        5,000,000        2021          80,000
                    Iraq                     023           3,246,096        12,984,384       16,230,48        2020          350,000
                    Libya                    024           2,000,000*       8,000,000        10,000,000       2022          120,000
                    Syria                    025           9,936,590        39,746,360       49,682,950       2020          1,500,000
                    Yemen                    026           2,000,000        8,000,000        10,000,000       2021          350,000
 Total                                                     45,805,061       183,220,244      229,025,305      —             6,754,100
                                                           USD              USD              USD                            Persons

* All figures remain provisional at present subject to further review.

                                                                                                                                        17
#ENDCHOLERA
CONTACTS
Mohamed Habib Ansari, Lead Strategist, IsDB – MAnsari@isdb.org
Mohamed Amine Hillal, Lead Alternative Development Finance, IsDB – MHillal@isdb.org
Ramya Gopalan, Global Innovation & Innovative Finance Coordinator, IFRC – ramya.gopalan@ifrc.org
Simon Meldrum, Investment Specialist, IFRC and British Red Cross – smeldrum@redcross.org.uk

Partners:

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