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Lebanon Health Resilience Project in Collaboration with the World Bank

 
Background
Achieving Universal Health Coverage is a main goal of the Ministry of Public Health (MoPH) National Health Strategy, and is based on the principles of justice, equity, poverty reduction and the rational use of resources. It requires providing quality health care for all, satisfying individual needs while alleviating the financial burden, on households, especially the poor.
 
Since the development of the national primary healthcare network, scaling up the primary healthcare system and reducing out of pocket payments have been a major goal for the MoPH.  However, the Syrian crisis has placed a large and additional burden on the healthcare system in Lebanon with the primary care system at the frontline.
 
Realizing the urgent need to address the emerging health crisis especially in underserved host communities, the MoPH developed an emergency program aimed at expanding Primary Health Care (PHC) coverage to the uninsured poor in Lebanon.  Accordingly, the MOPH developed a basic benefit package of essential preventive healthcare services (vaccination, screening visits...) and pilot tested this model through the World Bank supported project:

Emergency Primary Healthcare Restoration project (EPHRP) (2016-2019). The US$ 15 Million project targeted 150,000 poor Lebanese identified through the National Poverty Targeting Program (NPTP) developed by the Ministry of Social Affairs. Based on the successful implementation of the EPHRP, the MoPH is scaling up the program through a new Lebanon Health Resilience (LHR) Project.  LHR aims to ‎ increase access to quality health care services to poor Lebanese and displaced Syrians in Lebanon.‎ The main project beneficiaries are as follows:
 
  1. Poor Lebanese and displaced Syrians: These vulnerable populations will benefit from improved health services and a more comprehensive package of PHC services that addresses their health needs.
  2. Primary Health Care Centers. The project will benefit MoPH network by upgrading the capacity of the PHCCs and the skills of health workers and managers to effectively manage the increased demand for health care while delivering quality care during and after the crisis.
  3. Public hospitals. The project will benefit public hospitals by upgrading and refurbishing their equipment, training their staff, and improving the cash flow to enhance the quality and efficiency of their operation.
  4. The MoPH. The project will contribute to maintaining the MoPH’s commitment to deliver services to vulnerable populations and will build central-level capacity for planning and project management.
 
Project Objectives
  1. Scaling up the scope and capacity of the PHC Universal Health Coverage program:
 
  1. Increasing the number of beneficiaries from 150000 to 340,000 poor Lebanese provided with essential health services at primary healthcare centers
  2. Strengthening the capacities of all the 204 PHCCs in the National PHC Network for the provision of the basic benefit packages
 
  1. Provision of outpatient healthcare services in public hospitals
 
  1. Provide coverage for outpatient services to vulnerable Lebanese in public hospitals
  2. Strengthen of the technical and organizational capacities of participating public hospitals for provision of quality healthcare services
 
Environmental and Social Safeguards Management Framework
This section analyses the environmental and social impacts associated with activities undertaken by Lebanon Health Resilient Project (LHRP) and provides a framework for social and environmental management.
 
Restructuring of Lebanese Health Resilience Project
 
Lebanon Health Resilience Project (LHRP) was initiated by the Ministry of Public Health (MoPH) in 2017 with the support of the World Bank (WB). LHRP will undergo a restructuring to support the Government Of Lebanon (GOL) to mitigate the impact of the COVID-19 outbreak. The restructuring responds to a request from the GOL dated March 27, 2020 to add a new component to the Project on COVID-19 preparedness and response (Component 4) that will allow for immediate support to assess country preparedness, multi-sectoral response capabilities, and to finance the procurement of medical goods and equipment, and capacity-building and training of health workers and front-line responders. An Environmental and Social Management Framework (ESMF) was prepared for the Project, consulted on, disclosed and cleared by the World Bank (WB) in May 2019 [1]. The WB team requested an update of the ESMF in the form of an addendum that tackles the additional environmental, health and safety measures that need to be considered to cover the environmental and social risks under Component 4.

[1] The ESMF was disclosed as Environmental and Social Safeguard Framework (ESSF). In this document both terms ESMF and ESSF refer to the same report disclosed on May 2019 on the WB website....

Updated Addendum ESMF-LHRP - February 2021
Addendum ESMF-LHRP - July 2020
LEBANON HEALTH RESILIENCE
PROJECT
Original ESMF- May 2019
 
 Reports
 
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ATC Name B/G Ingredients Dosage Form Price
A10BJ05 TRULICITY BioTech Dulaglutide - 4.5mg 4.5mg/0.5ml Injectable solution 10,165,201 L.L
L01FD01 HERCEPTIN BioTech Trastuzumab - 440mg 21mg/ml Injectable concentrated powder for solution+diluent 166,423,476 L.L
L04AC05 STELARA BioTech Ustekinumab - 130mg 130mg Injectable concentrate for solution 214,532,009 L.L
M03AX01 BOTOX BioTech Clostridium botulinum type A neurotoxin complex - 100U 100U Injectable powder for solution 18,625,995 L.L
L01FD01 ARYOTRUST BioTech Trastuzumab - 440mg 440mg Injectable powder for concentrate for solution + solvent 34,948,930 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 80mg/4ml 80mg/4ml Injectable concentrated solution 11,127,864 L.L
M03AX01 XEOMIN BioTech Clostridium botulinum type A neurotoxin complex - 100 units LD50 100 units LD50 Injectable powder for solution 20,517,541 L.L
L01FD01 OGIVRI BioTech Trastuzumab - 440mg 440mg Injectable lyophilised powder 80,027,615 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 162mg/0.9ml 162mg/0.9ml Injectable solution 79,959,812 L.L
M03AX01 BOTOX BioTech Clostridium botulinum type A neurotoxin complex - 100U 100U Injectable powder for solution 18,625,995 L.L
L01FD01 MABTIN 440 BioTech Trastuzumab (r-DNA origin) - 440mg 440mg Injectable powder for solution 70,042,700 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 200mg/10ml 200mg/10ml Injectable concentrated solution 25,485,937 L.L
M03AX01 NEURONOX BioTech Clostridium botulinum type A neurotoxin complex - 100units 100units Injectable lyophilised powder for solution 13,011,437 L.L
L01FD01 TRAZIMERA BioTech Trastuzumab - 440mg 440mg Injectable powder for solution+solvent 75,295,202 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 400mg/20ml 400mg/20ml Injectable concentrated solution 47,925,322 L.L
M03AX01 DYSPORT BioTech Clostridium botulinum type A neurotoxin complex - 300units 300units Injectable powder for solution 14,625,182 L.L
L01FD01 HERZUMA BioTech Trastuzumab - 440mg 440mg Injectable powder for concentrate for solution 89,046,707 L.L
L04AC10 COSENTYX BioTech Secukinumab - 150mg/ml 150mg/ml Injectable solution 70,463,329 L.L
M03AX01 DYSPORT BioTech Clostridium botulinum type A neurotoxin complex - 500units 500units Injectable powder for solution 42,726,155 L.L
L01FD01 TRASTUREL BioTech Trastuzumab - 440mg 440mg Injectable lyophilised powder 52,047,114 L.L
L04AC13 TALTZ BioTech Ixekizumab - 80mg/ml 80mg/ml Injectable solution 85,080,792 L.L
M03AX01 NEURONOX BioTech Clostridium botulinum type A neurotoxin complex - 200units 200units Injectable lyophilised powder for solution 25,175,058 L.L
L01FD01 ARYOTRUST BioTech Trastuzumab - 150mg 150mg Injectable powder for concentrate for solution 21,176,745 L.L
L04AC16 TREMFYA BioTech Guselkumab - 100mg/ml 100mg/ml Injectable solution 190,195,151 L.L
M03AX01 XEOMIN BioTech Clostridium botulinum type A neurotoxin complex - 50 units LD50 50 units LD50 Injectable powder for solution 11,920,109 L.L
R03DX05 XOLAIR BioTech Omalizumab - 150mg 150mg Injectable lyophilised powder for solution+diluent 47,926,534 L.L
B02BD02 NOVOEIGHT BioTech Turoctocog Alfa - 500IU 500IU Injectable powder for solution+diluent 29,783,973 L.L
L01FD01 TRAZIMERA BioTech Trastuzumab - 150mg 150mg Injectable powder for solution 28,550,630 L.L
L04AC16 TREMFYA BioTech Guselkumab - 100mg/ml 100mg/ml Injectable solution 190,195,151 L.L
M03AX01 NEURONOX BioTech Clostridium botulinum type A neurotoxin complex - 50units 50units Injectable lyophilised powder for solution 8,904,323 L.L
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