World Bank Helps Bhutan’s COVID-19 Response with $5 Million Emergency Aid Package

Challenge

The Bank responded promptly to the COVID-19 pandemic, which spread across the world and quickly reached the small landlocked country of Bhutan in the eastern Himalayas. Given the uncertainty of health supplies amid the global crisis and the risk that the Buddhist kingdom’s healthcare facilities could be overstretched, the Bank worked quickly with government counterparts to prepare a $5 million assistance project. The aim was to ensure there were sufficient properly trained medical personnel and enough medical supplies and equipment and testing kits to protect the 770,000 population and a robust awareness campaign to make sure officials and the public understood the dangers and knew how to respond.  

Approach

The project, which adhered to international best practice, was designed to provide goods, equipment, drugs and consumables to support testing, contact tracing, reporting and recording of COVID-19 infections; strengthen health systems at central and district levels to enable the necessary quarantining and treatment; and set up rigorous community engagement to maximize the use of public health measures and minimize risks of infection. As part of the emergency response component of the project, surveillance programs were put in place in all 20 districts through Case Investigation and Contact Tracing (CICT) teams overseen by the Ministry of Health. Key personnel were trained in infection prevention, control and disease management. 

The Bank developed an innovative financing model by establishing a Pandemic Emergency Financing Facility which was activated during the COVID-19 pandemic. It allocated $1 million in grant resources to the government as part of the Bhutan Development Policy operation with a catastrophe drawdown option (Cat-DDO) that focuses on health. Funds were immediately transferred to support the government's rapid response and relief efforts, following triggering of the Cat-DDO. One of the policy reform areas under the Cat-DDO is to strengthen Bhutan’s institutional and technical capacity for emergency preparedness and response. 

Results

As of April 18, 2021, 664,713 people in Bhutan were tested for COVID-19. There were 957 confirmed cases (male-658, female-299), 878 recovered cases (male-594, female-284) and only one death (male) was reported. All Bhutan’s hospitals and 78 primary health centers were provided with test kits and all 20 district health authorities were provided with personal protective equipment (PPE) and other supplies. 

Isolation facilities were created in four national COVID-19 centers and all hospitals prepared small units for the isolation of suspected cases awaiting laboratory test reports. Hospitals were also upgrading their isolation wards in preparation for mass community outbreaks and plans were in place for ICUs in the four COVID centers with a total of 54 of beds.

To expand community engagement and risk communication, press briefings, video-screenings and other information campaigns were organized, and a dedicated call center was opened. 

With the support of the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), the Global Alliance for Vaccines and Immunizations (Gavi) and the World Bank, Bhutan established one of the world’s most effective vaccination campaigns. As of April 18, 2021, 87% of the eligible population (male-53%, female-47%) had been vaccinated with the first of the two necessary doses. 

Bank Group Contribution

Of the $5 million provided by the International Development Association (IDA) for Bhutan to combat COVID-19, $1.7 million was to support case detection, confirmation, contact tracing, recording, and reporting; $2.65 million was for health systems strengthening; $400,000 for community engagement and risk communication; and $250,000 for implementation management and monitoring and evaluation. Grant funding from the Pandemic Emergency Financing Facility in the amount of $1 million (inclusive of cost recovery) was provided as budget support to mitigate the impact of the pandemic. Under the Cat-DDO, $15.04 million was disbursed on June 8, 2020 to support COVID-19 response and relief operations.

Partners

The WHO and UNICEF are the technical agencies providing guidance to the Bhutan Ministry of Health and Population with its response to the pandemic.

Moving Forward

The Bank-financed COVID-19 relief project is continuing to support Bhutan’s fight against the pandemic. In the near future the country is expected have vaccinated its eligible population with a second dose of vaccine that was anticipated to arrive soon.  

Beneficiaries

The Bhutanese people have been able to make use of COVID-19 testing facilities in specially upgraded laboratories. Those afflicted by the virus were able to safely quarantine themselves and had access to fully equipped Intensive Care Units and ventilators. Frontline health care workers were trained and equipped with personal protective gear. Officials were enabled to spread information about the public health measures through rigorous community engagement.