Turkey COVID-19 Equipment Emergency Response

Location:

Turkey

Project number:

52199

Business sector:

Municipal and environmental infrastructure

Notice type:

State

Environmental category:

B

Approval date:

22 Jul 2020

Status:

Signed

PSD disclosed:

22 May 2020

Project Description

Up to EUR 130 million sovereign loan to the Republic of Turkey, for the benefit of the Ministry of Health (MoH), to finance the purchase of ventilators and ICU monitors, and other emergency medical equipment urgently needed in public hospitals to fight the Covid-19 pandemic. 

Project Objectives

The project aims to support the Government of Turkey in uplifting its healthcare emergency response in public hospitals across the country and to help the emergency response efforts against the Covid-19 crisis. The loan proceeds will be used to equip Turkey's existing and new public hospitals built to provide adequate and timely healthcare services to the pandemic patients.

The project supplements the ICU bed capacity in the country, including in Istanbul pandemic hospital in Yesilkoy. This pandemic hospital along with other Covid-19 hospitals will remain in service for possible future waves of Covid-19 cases, as well as other emergencies related to earthquakes, risk of which is particularly high in the country and requires ample sector capacity.

The project reduces the funding gap of the government's emergency health programme and is complementary to other loans provided by IFIs in the country to fight the pandemic.

Transition Impact

ETI score: 65

The project contributes to the "resilient" quality by providing financing to strengthen the resilience of the health system amid the Covid-19 pandemic. This investment will allow the health sector to respond more effectively to the crisis and build capacity to respond to other health emergencies in the future.

The project also contributes to the "inclusive" quality by aiming to improve and upgrade training provision for healthcare workers in Turkey and strengthen gender equality in the sector, building on a close mutual coordination with MoH.

Client Information

TURKEY SOVEREIGN

The Ministry of Health will be the beneficiary of the loan and is responsible for proposing and executing government policy on health, planning and providing healthcare and protecting patients. The Ministry of Treasury and Finance will be the borrower and represents the Republic of Turkey.

EBRD Finance Summary

EUR 130,000,000.00

A sovereign loan with a grace period of 3years and a tenor of up to 10 years.

Total Project Cost

EUR 200,115,008.00

The the loan will be provided in parallel with a World Bank crisis response - a sovereign loan to the health sector which helps reduce the funding gap for the government's response programme. The EBRD's collaboration with the World Bank ensures complementarity and efficient project implementation.

Additionality

The Bank is additional thanks to: 

-Financing structure

-Policy, sector, institutional, or regulatory change

-Standard-setting: helping projects and clients achieve higher standards

Environmental and Social Summary

Categorised B under 2019 ESP.  Environmental & Social Due Diligence (ESDD) has been carried out internally in accordance with ESD COVID-19 approach. ESDD included review of the World Bank documentation on their preceding similar project with the MoH (Turkey Emergency COVID-19 Health Project), discussions with the World Bank on their approach and findings from their ESDD; information received from the MoH for the completion of the ESDD Questionnaire; review of on-line information on the MoH website and the Turkish Medical Association website; and discussions with MoH's Project Management & Support Unit (PMSU).

The ESDD showed that the Bank's financing of the MoH's procurement of ventilators, ICU monitors and other emergency equipment have limited environmental and social impacts.  It also showed that the MoH's comprehensive COVID-19 response strategy & Pandemic Action Plan by testing, contact tracing and isolating the cases have been effectively in line with the WHO guidance. The Bank's project will support the WHO policy recommendation to strengthen ICU capacities to treat seriously ill COVID-19 patients. The ICU equipment and others to be procured under this project will be derived from priority needs of the MoH's Pandemic Hospitals, WHO priority medical devices in the context of COVID-19 and the World Bank advisory.  The project will comply with international standards including relevant WHO guidelines and EU standards as well as EBRD PR including Antibiotics Stewardship defined by EBRD Performance (PR) 4.  

As the project does not involve any new construction but only procurement of medical equipment for already constructed hospitals, it is not associated with resettlement and economic displacement, bio-diversity and cultural heritage issues and it is not required to go through Turkish EIA procedures. Key environmental issues associated with the project is medical waste management and wastewater treatment. Medical waste in Turkey is treated at off-site medical incinerators and autocracy facilities with official recording & tracking systems. 

Wastewater is discharged into municipal wastewater collection systems to be treated in a wastewater treatment plant in compliance with Turkish law. The MoH has asserted that the country's medical waste treatment capacities are still sufficient under the COVID-19 situation. The project does not define location and facility-specific workforce in relation to labour and Occupational Health & Safety (OHS) issues.  Therefore, the ESDD has considered the health and safety issues concerning the healthcare workers handing ICU equipment and diagnostic equipment to be procured under the project in public hospitals.   

The existing Environmental and Social Commitment Plan (ESCP) and Stakeholder Engagement Plan (SEP) developed for WB's Turkey Emergency COVID-19 Health Project and to be implemented by PMSU are comprehensive. The development of an E&S Management Framework (ESMF) by the World Bank is at its final stage to be implemented by the concerned healthcare facilities under their loan.  EBRD will require the same robust E&S management requirements to apply for the hospitals covered under this project. 

Given the wider workforce and numeral healthcare facilities subject to the project impacts, the ESMF in the ESCP provides an overarching management structure to adequately cover the issues. The ESMF includes (i) an Infection Control and Waste Management Plan (ICWMP); (ii) Labour management procedures (LMP) addressing labour risks associated with the project including specific occupational health and safety (OHS) for healthcare workers (including facility management workers) to protect themselves and prevent infection while providing treatment in line with the World Health Organization (WHO) guidelines; (iii) mitigation measures during collection of samples and laboratory testing for COVID-19 or during the transport of potentially affected samples or persons in line with WHO guidance (iv) mitigation measures for water, sanitation, hygiene and waste management for COVID-19 in line with WHO guidance; (v) measures to prevent the wider community to be exposed to the virus, with a particular focus on high-risk individuals.  

Under the ESMF, each concerned healthcare facility will apply infection control and waste management planning following the requirements in accordance with Good  International Practices including relevant WHO guidelines and EU standards as well as Antimicrobial Stewardship. The SEP has identified key stakeholders as well as has set itself as a key instrument for outreach to the community at large on issues related to social distancing, higher risk demographics, self-quarantine, and quarantine, and citizen participation. It is critical that these messages be widely disseminated, repeated often, and clearly understood. The MoH has a free hotline through a call center which is 7/24 available and accessible from everywhere in the country. The MoH has also been using this as a Grievance redress mechanism for people to raise concerns, requests related. It serves both the health workers as well as the wider public on questions, health emergency situation, grievances and other requests related with health services.   An email address has also been set specially to receive concerns from MoH employees.  The ESCP & SEP have been disclosed to the public on the MoH's website. 

EBRD will monitor the project through reviews of annual environmental & social reports and periodic lender supervisor reports as well as site visits, as necessary. 

Technical Cooperation and Grant Financing

A comprehensive Technical Cooperation (TC) package includes a Gender and Economic Inclusion TC, which aims at fostering an inclusive environment for healthcare workers in close collaboration with MoH, as well as a project implementation support TC, aiming to leverage MoH's implementation capacity for an efficient delivery of the project.

Company Contact Information

Izzet Yerdes (Ministry of Treasury and Finance General Directorate of Foreign Economic Relations)
dei_pfd@hmb.gov.tr
+90 312 204 73 62
www.hmb.gov.tr
Inönü Bulvari No:36 06510 Emek/Ankara

PSD last updated

12 Nov 2020

Understanding Transition

Further information regarding the EBRD’s approach to measuring transition impact is available here.

Business opportunities

For business opportunities or procurement, contact the client company.

For business opportunities with EBRD (not related to procurement) contact:

Tel: +44 20 7338 7168
Email: projectenquiries@ebrd.com

For state-sector projects, visit EBRD Procurement:

Tel: +44 20 7338 6794
Email: procurement@ebrd.com

General enquiries

Specific enquiries can be made using the EBRD Enquiries form.

Environmental and Social Policy (ESP)

The ESP and the associated Performance Requirements (PRs) set out the ways in which the EBRD implements its commitment to promoting “environmentally sound and sustainable development”.  The ESP and the PRs include specific provisions for clients to comply with the applicable requirements of national laws on public information and consultation as well as to establish a grievance mechanism to receive and facilitate resolution of stakeholders’ concerns and grievances, in particular, about environmental and social performance of the client and the project. Proportionate to the nature and scale of a project’s environmental and social risks and impacts, the EBRD additionally requires its clients to disclose information, as appropriate, about the risks and impacts arising from projects or to undertake meaningful consultation with stakeholders and consider and respond to their feedback.

More information on the EBRD’s practices in this regard is set out in the ESP.

Integrity and Compliance

The EBRD's Office of the Chief Compliance Officer (OCCO) promotes good governance and ensures that the highest standards of integrity are applied to all activities of the Bank in accordance with international best practice. Integrity due diligence is conducted on all Bank clients to ensure that projects do not present unacceptable integrity or reputational risks to the Bank. The Bank believes that identifying and resolving issues at the project assessment approval stages is the most effective means of ensuring the integrity of Bank transactions. OCCO plays a key role in these protective efforts, and also helps to monitor integrity risks in projects post-investment.

OCCO is also responsible for investigating allegations of fraud, corruption and misconduct in EBRD-financed projects. Anyone, both within or outside the Bank, who suspects fraud or corruption should submit a written report to the Chief Compliance Officer by email to compliance@ebrd.com. All matters reported will be handled by OCCO for follow-up. All reports, including anonymous ones, will be reviewed. Reports can be made in any language of the Bank or of the Bank's countries of operation. The information provided must be made in good faith.

Access to Information Policy (AIP)

The AIP sets out how the EBRD discloses information and consults with its stakeholders so as to promote better awareness and understanding of its strategies, policies and operations following its entry into force on 1 January 2020. Please visit the Access to Information Policy page to find out what information is available from the EBRD website.

Specific requests for information can be made using the EBRD Enquiries form.

Independent Project Accountability Mechanism (IPAM)

If efforts to address environmental, social or public disclosure concerns with the Client or the Bank are unsuccessful (e.g. through the Client’s Project-level grievance mechanism or through direct engagement with Bank management), individuals and organisations may seek to address their concerns through the EBRD’s Independent Project Accountability Mechanism (IPAM).

IPAM independently reviews Project issues that are believed to have caused (or to be likely to cause) harm. The purpose of the Mechanism is: to support dialogue between Project stakeholders to resolve environmental, social and public disclosure issues; to determine whether the Bank has complied with its Environmental and Social Policy or Project-specific provisions of its Access to Information Policy; and where applicable, to address any existing non-compliance with these policies, while preventing future non-compliance by the Bank.

Please visit the Independent Project Accountability Mechanism webpage to find out more about IPAM and its mandate; how to submit a Request for review; or contact IPAM  via email ipam@ebrd.com to get guidance and more information on IPAM and how to submit a request.

 

Share this page: