UNITED NATIONS
NATIONS UNIES
Central Fund for Influenza Action (CFIA)
Small Project Funding Facility for UN Resident Coordinators
To Support Host Government Pandemic Preparedness and Response
Project Proposal Form
Project Summary
Country / Territory
Republic of Indonesia
Project Title
Advancing multi-sectoral pandemic, whole-of-society preparedness and
response capacities in the context of decentralization
Brief Project Description The CFIA project will advance multi-sectoral, whole of society pandemic planning
and preparedness in six Indonesian districts by assessing and strengthening the
capacity of local officials, leaders and key service providers to identify and manage
risks and hazards; as well as to develop appropriate business continuity plans that
will assure the continuity of essential services. The project is designed to
complement and balance the previous CFIA proposal that was oriented at
strengthening the capacity of GoI coordination and disaster management
structures at a national level. It will be implemented by the UN Resident
Coordinator’s Office in partnership with ILO and IOM, which bring applied expertise
in business continuity planning and working with vulnerable populations.
While the amount requested exceeds the recommended CFIA cap, Indonesia is a
large country of 230 million people in 490 districts on over 6,000 inhabited islands.
Indonesia accounts for approximately 40% of both the total population and the
total land mass of the 10 ASEAN nations. The distances involve require substantial
domestic travel costs to support decentralized projects. Simultaneously, Indonesia
is one of the globe’s most deeply affected countries by entrenched H5N1. The
culmination of these factors place Indonesian citizens at elevated humanitarian risk
for influenza and other emerging infectious diseases. Despite six years of
experience with H5N1, most districts are unprepared. The project design pilots
approaches for wider replication and uptake in this decentralized archipelago. For
these reasons, a higher budgetary allocation is justified.
CFIA Funds Requested
$ 198,271
Project Sponsorship & Accountability
Project Sponsor
CFIA Small Project Funding Facility
Mr. El-Mostafa Benlamlih
UN Resident Coordinator, Indonesia
Menara Thamrin,Jalan MH Thamrin, Kav 3
Jakarta 10250
Telephone: (62-21) 314-1308 Ext 101
Email: el-mostafa.benlamlih@undp.org
Project Proposal Form
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United Nations Central Fund for Influenza Action (CFIA)
Implementing Agency
Office of the UN Resident Coordinator in Indonesia,
(funding via UNDP)
Focal Point
Ms. Brenda Langdon, Planning Specialist, Pandemic Influenza
Office of the UN Resident Coordinator, Indonesia
Menara Thamrin,Jalan MH Thamrin, Kav 3
Jakarta 10250
Telephone: (62-21) 314-1308 Ext 840
Email: brenda.langdon@un.or.id
CFIA Small Project Funding Facility
Project Proposal Form
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United Nations Central Fund for Influenza Action (CFIA)
Project Details
Whole-of-Society
Assistance Requested
Full Project Description
The following assistance was requested in the UNIP related to Whole-ofSociety assistance. Both were clearly larger efforts which exceed the
current availability of CFIA funds, but are consistent with the overall
concept of the proposed activities.
1. Provincial and Local Preparedness/Contingency Planning. Efforts should
be expanded to expand preparedness and contingency planning efforts to
the 70% of provinces and 95% of districts which still haven’t received
them, likely incorporating a simulation model developed by
UNICEF/KOMNAS, and factoring in the results of the vulnerability
assessment, discussed below. 23 provinces and over 400 districts have not
yet been trained. The model would be reviewed and adapted if necessary
to ensure that it results in a contingency planning process which includes
the articulation of standard operating procedures, coordination and
information flow; the prioritization of preparedness activities, and the
identification of resources. The unit cost per preparedness workshop is
approximately $25,000, depending upon venue, travel and number of
participants, although alternative arrangements might be possible where
there is existing programming. $2,500,000 would enable the
preparedness of an additional 100 entities.
2. High Risk, Vulnerable Populations. The needs of vulnerable populations
in Indonesia for pandemic influenza must be rapidly assessed and an
action plan developed to develop measures to meet their needs through
the adaption and expansion of current interventions, including
communications. In addition to the government, this work should harness
the inputs of the international humanitarian community, including IOM,
UNICEF, UNHCR, WFP and IFRC as well as the broad networks of
Indonesian faith-based organizations and the local Red Cross. The work of
the various actors should be inventoried, and include the identification of
risk communication channels. Specific activities include: (1) rapid
assessment of high risk, vulnerable populations; (2) mapping of vulnerable
populations and current interventions; (3) mapping of current facilities,
stockpiles and equipment; (4) development/expansion of strategies. BNPB
could take responsibility for the mapping, with a moderate level of
incremental investment. The one year budget, including project
implementation funds, is estimated at $375,000.
Background. Indonesia is often considered “ground zero” for avian influenza
(H5N1) as 134 of the world’s 282 fatalities (47.5%) have occurred on Indonesian soil
since 2003 to the present. The disease is considered “entrenched,” particularly in a
highly populated corridor in West Java, where 70% of the reported cases have
occurred. The H5N1 virus has one of the world’s highest case fatality rates in
Indonesia at 83.2%, partially due to limited public health infrastructure in some
parts of the archipelago and delays in the presentation or referral of suspected
cases. The virus is still quite active with 20 of the world’s 72 reported cases in 2009,
and 19 of its 32 fatalities. While Egypt reported a larger number of cases in 2009,
its case fatality rate is dramatically lower.
By contrast, H1N1 in Indonesia has been less remarkable to date. An initial wave in
August/September 2009 resulted in 1,097 laboratory-confirmed cases, and 10
related confirmed fatalities. While there was concern a second wave would occur
CFIA Small Project Funding Facility
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United Nations Central Fund for Influenza Action (CFIA)
during the rainy season (December – March), to date there has been little reported
activity. Nevertheless, with the two viruses in circulation, it is necessary to remain
vigilant and prepared for any eventuality, including genetic modification and the
introduction of a new influenza strain.
Continuing Evolution of National Coordination Structures. Following national
elections in mid-2009, and the appointment of a new cabinet in October, a 100-day
planning period ensued in which all government structures were appraised. A
decision was made to dissolve the National Commission for Bird Flu Control and
Influenza Pandemic Preparedness (KOMNAS) at the end of its tenure on March 13,
2010. On February 19, national media reported that the President had ordered the
creation of a National Zoonosis Commission to replace the KOMNAS structure. The
media and the Ministry of Agriculture subsequently stated that Zoonosis
Commission will operate under the control of the Deputy Minister of Agriculture,
Bayu Krishnamurti, who was also the Operational Chief of the National Commission
for Bird Flu Control and Influenza Pandemic Preparedness. The Zoonosis
Commission would answer to the Ministry of Agriculture, but its funding would be
handled by the Coordinating People’s Welfare Ministry (Menko Kesra). Both the
Ministry of Health and Ministry of Finance will also likely hold seats on the
Executive Board.
However, even as of this writing, there is conflicting information as to the variety of
proposals presented to the President regarding the constitution of this commission,
and the potential involvement of the National Disaster Management Agency
(BNPB) or alternatively, a structure led by the Ministry of Health. Approvals from
the relevant ministers are pending. A budget has not been identified. House of
Representatives members have apparently provisionally agreed to the principle of
this proposal provided that the duties and responsibilities of the new entity and are
clear and do not overlap with the responsibilities of the Directorate General
Disease Control and Environmental Health.
Beyond the organizational issues, little has yet been disclosed about the
Commission’s specific mandate. Some definitive structure is expected to be rolled
out in a “One World, One Health” seminar on March 9, prior to the KOMNAS
closure workshop, however this may be contingent upon intervening events.
Decentralization. Indonesia’s rapid “big bang” decentralization process in 2001 led
to a proliferation of new provinces, districts, municipalities, and sub-districts,
prompted by related financial incentives. However, the division and coordination
of responsibilities and functions among national, provincial and district
governments remain unclear in several key respects, despite attempts at reform,
nor are policies always aligned. Indonesia’s population of 230 million is spread
over approximately 6,000 islands, 33 provinces and 490 districts, many of them
isolated. Significant gaps in sub-national governance, as well as the delivery and
quality of basic social services, has resulted especially in poorer and more remote
regions, with tremendous disparities in human development indicators.
Given this highly decentralized government structure, it is unlikely that central
pandemic preparedness plans would be of direct relevance to many provinces and
districts. The recent experience with the West Sumatra and West Java earthquake
responses in September and October 2009 underline the paramount importance of
district capacity in responding to emergencies, including inter-line ministry
structures.
In many areas, central government links to the sub-national government entities
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United Nations Central Fund for Influenza Action (CFIA)
may not help mitigate a pandemic. Some provinces and districts in which H5N1 and
related donor assistance were concentrated may have related preparedness plans
and have undertaken an array of training and socialization activities, but a majority
does not. Moreover, even within “active” communities, preparations to date have
focused on animal and human health in an avian influenza pandemic scenario, and
still need to be adjusted to effectively address non-health essential service
continuity and whole of society approaches for a spectrum of pandemic events.
Goal: Indonesian society is prepared to confront the threats caused by pandemic
influenza and other emerging diseases, and has increased, equitable access to
timely information and essential, coordinated, multi-sectoral services which help
mitigate the risks and impact of any severe outbreaks.
While it is clear that CFIA funding alone will not be sufficient to achieve this goal
and its related strategic priorities, it is hoped that it will help establish a foundation
at this critical juncture and help leverage larger, long term contributions from the
donor and humanitarian community, thereby advancing multi-sectoral, whole of
society pandemic planning and preparedness in Indonesia. CFIA funds are therefore
needed for seed purposes, with the hope of subsequent uptake by the donor
community as the coordination structures attain credibility.
Strategic Priorities:
Strategic Priority 1. Strengthen capacity of decentralized coordination and disaster
management structures in six pilot districts in three Indonesian provinces to
expand pandemic preparedness and contingency planning efforts utilizing a wholeof-society, multi-sectoral approach which builds on existing capacities, resources
and structures, and addresses the needs of vulnerable groups.
Outputs:
1.
2.
3.
4.
CFIA Small Project Funding Facility
Site selection criteria are developed by UNRC/HC, ILO and IOM in
consultation with the National Zoonosis Commission and the Ministry of
Health, as well as the Disaster Risk Reduction working group (UNDP and
UNOCHA) to identify three provinces, and six related districts. In
preliminary conversations, locations on Sumatra, Java and West
Kalimantan have been identified on such preliminary criteria as hazards
and disease burden; existing presence of a UN agency and key
counterparts; vulnerable populations; collaborative governmental
structures and representative qualities. This list will be further expanded
and systematized, if funding is confirmed.
Site visits are conducted and districts selected in consultation with local
UN agency staff, their key counterparts and local stakeholders, including
district commissioners and/or mayors of major municipalities as
appropriate. (bupatis/walikota).
District level multi-sector vulnerability and capacity assessments are
conducted, and a preliminary mapping of resources is initiated. In those
districts with small and medium enterprises, the assessment shall include
an analysis of resources and actions to reduce the risk of infection and to
minimize the impact of a pandemic on the workforce.
Advocacy is conducted and start-up workshops are held to socialize
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United Nations Central Fund for Influenza Action (CFIA)
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
CFIA Small Project Funding Facility
pandemic influenza and whole of society concepts and lay the groundwork
for district-level working groups. Desk top simulations could be
incorporated to raise participants’ familiarity with potential pandemic
conditions.
Multi-sectoral pandemic working groups are formed, including emergency
health services, food, water and sanitation, public information, public
security, energy, transportation and communications infrastructure, and
finance. In those areas where disaster management, risk reduction or
emergency preparedness groups exist, efforts will be made to mainstream
pandemic influenza into their scope of activities, rather than creating
duplicate structures. Efforts will also be made to incorporate civil society
and faith based organizations which are extremely influential in Indonesia,
and are of particular relevance to vulnerable populations.
Workshops are held to establish a foundation for leadership, teamwork
and the understanding of roles and responsibilities in each local
environment. IOM’s existing guide on community preparedness and
involvement will serve as a key reference document.
A list of priorities/ plan of action is delineated reflecting the realities
within each area, and a designation of those services and sectors which
should be assigned the highest priority for rapid interventions;
Business continuity planning models for essential services continuity and
enterprises are developed or adapted for use at the district level, drawing
on multiple inputs, such as ILO’s existing guidance, and experience from
countries such as Laos. Separate tools may be needed for governmental
institutions/offices, NGOs/CSOs and enterprises.
A “training of trainers” workshop is conducted for selected working group
members in the business continuity models from each pilot district on a
central or regional level.
Subsequent “cascade training” is implemented in each district to include
all working group members
District level operational continuity plans are developed which use
pandemic influenza illustratively as an entry point for the continuity of
essential public services during major sudden disruptions in a community
and enhance emergency planning skills, within a whole-of-society
framework.
If airports are included in the selected areas, preparedness planning issues
will also address needs to be covered by airlines, airports and the
authorities responsible for air space security in order to assure safe air
space and aviation operations during a pandemic, possibly with technical
assistance from ICAO.
Table top simulation and functional exercises are held to practice and
refine the plans in each pilot district.
A national forum is held at the end of the project to share and extrapolate
lessons learned and identify best practices from the pilot districts in
decentralized multi-sector preparedness for provinces and other districts
in Indonesia. During this event, changes in capacity are identified by
participants.
As appropriate, district members may be invited to utilize active learning
approaches and share experience related to pandemic planning and
contingency planning approaches among areas and partner networks
working on similar problems and challenges, based on the identification of
appropriate opportunities for active learning and exchange in sub-regional
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United Nations Central Fund for Influenza Action (CFIA)
areas or in events sponsored by other partners and networks such as the
ASEAN TWG for pandemic preparedness, or to participate in regional
workshops and/or exchanges. These opportunities may arise at different
times during the project cycle.
Expected Timespan
Key Partners Involved
May 1, 2010 – April 30, 2011
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Deliverables
Strategic Priority 1:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Success Indicators
National Zoonosis Committee
National Disaster Planning Board (BNBP)
Ministry of Health (MoH)
Ministry of Agriculture (MoA)
District and Provincial Line Ministries for Planning, Health, Agriculture,
Finance, Industry/Trade, Transportation, Communication and Information
Technology, Public Works
Technology
Indonesian National Army
Indonesian National Police
Indonesian Red Cross and IFRC
UNRC/HC, ILO, IOM, UN-OCHA, UNDP UNICEF, FAO, WHO, WFP
Civil society and faith based organizations
Finalized district/municipality site selection criteria
Site selection report
District level multi-sector vulnerability and capacity assessments
Advocacy and startup workshop agenda and key materials; lists of
participants; evaluation
List of multi-sectoral working group members by district
Leadership/teamwork workshop agenda and key materials; lists of
participants; evaluations
District plans of action/priorities for rapid interventions
Adapted planning models for BCP at district level in Indonesia
Training of trainers workshop agenda and key materials; lists of
participants; evaluation
Cascade training workshop agenda and key materials; lists of participants;
evaluation
District level Operational/Business Continuity Plans
Table top and functional simulation agenda and key materials; lists of
participants; evaluation
National forum workshop agenda and key materials; lists of participants;
evaluation
Agenda and reports from participant exchanges and participation
opportunities
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CFIA Small Project Funding Facility
Participating districts demonstrate improved knowledge and skills
for pandemic preparedness
Participating districts have operational/business continuity plans
to use as contingency measures for a pandemic event
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United Nations Central Fund for Influenza Action (CFIA)
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District plans utilize a whole of society, multi-sectoral approach
Best practices from the pilot districts in decentralized multisector preparedness inform future efforts in other districts in
Indonesia
Budget Details
Total Project Budget
$198,271
Project Budget
Breakdown
(listed in U.S. Dollars , against standard categories below)
Category
1. Supplies, commodities, equipment and transport
Sub-total
2. Personnel (staff, consultants and travel)
Staff/Consultants
Pandemic Influenza Advisor (50%)
Vulnerability/Capacity Assessment Consultant
Master Trainer/Facilitator Consultant
Business Continuity Plan Consultant
Administrative Assistant, Pandemic Influenza (50%)
Sub-total
Travel
Site Selection Visits
Vulnerability/Capacity Assessments
Advocacy/startup workshops
Training of trainers
Simulation/functional exercises
Sub-total
3. Training of counterparts
Advocacy/startup workshops
Leadership/teamwork workshops
Training of trainers
Cascade training/BCP
Simulation/functional exercises
National forum
Participant exchange/active learning
Sub-total
US$
4. Contracts
5. Other direct costs
Total direct costs
6. Indirect support costs
Total project budget
CFIA Small Project Funding Facility
Project Proposal Form
%
500
500
.3%
54,000
11,500
11,000
15,000
4,800
102,800
51.8%
9,000
7,500
7,500
7,500
7,500
39,000
19.7%
3,000
2,400
7,200
4,800
3,600
11,000
9,500
41,500
21.7%
0
0
185,300
12,971
198,271
93%
7%
100%
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