How should World Bank-funded COVID-19 Additional Financing projects address equitable vaccine distribution?

To support inclusive vaccine distribution through Additional Financing COVID-19 projects, the World Bank must implement meaningful stakeholder engagement allowing all to raise concerns and must hold governments accountable to an equitable vaccine distribution plan.

Vaccine distribution components of the World Bank’s Additional Financing COVID-19 projects (hereinafter “Additional Financing projects”) pose significant risks of excluding marginalized groups if the Bank does not work with governments to design inclusive projects or sufficiently supervise their implementation. The projects must prioritize meaningful stakeholder engagement, disclose potential vaccine costs for the recipient, and design an equitable vaccine distribution plan to advance an inclusive COVID-19 response. 

According to the Bank’s Environmental and Social Framework, projects must empower all people “to participate in, and benefit from, the development process.” Meaningful stakeholder engagement during project design and throughout implementation plays an instrumental role in creating space for marginalized groups to be included as beneficiaries of the project. World Bank project teams need to engage marginalized groups throughout the process and identify and mitigate barriers to accessing project information and project benefits. They must design projects in an inclusive and accessible manner, considering the needs of both urban and rural communities. 

In the COVID-19 health response projects we monitored in partnership with civil society organizations in Malawi, El Salvador, and Liberia, we saw problems related to information disclosure, stakeholder engagement, provision of service to rural areas, and inadequate assessment of barriers to project benefits for marginalized groups. The Additional Financing projects have the opportunity to improve upon the gaps and shortcomings of the original COVID-19 health response projects, but this requires more supervision by the Bank. Bank management has raised concerns about the Additional Financing projects surrounding ID requirements for vaccine access and its effect on non-citizens, as well as vaccine distribution plans which fail to address the exclusion of marginalized groups. Considering the Bank’s critical role in the global COVID-19 response, they must redress this lack of inclusion and disclose vaccine costs for the recipient and distribution plans to promote an equitable vaccine distribution. 

Drawing upon observations from our review of a small sample of Additional Financing project documents, the Bank should take the following actions to promote an equitable and inclusive COVID-19 response.  

  1. Prioritize meaningful stakeholder engagement. Project documents indicate a tendency for engagement to focus heavily on vaccine hesitancy and sensitization rather than meaningfully engaging stakeholders around project design and implementation. Community outreach and education on prevention strategies and where and how to get the vaccine, though vital, are not equivalent to engagement that allows stakeholders to voice project concerns and provide input. Governments should meaningfully engage stakeholders beginning with project design throughout project implementation, in accordance with ESS 10. To do so, project documents need to be disclosed early in the design and implementation processes and prior to consultations. Likewise, consultations must include civil society organizations, especially those representing marginalized groups, so they can help raise the concerns of affected communities. Ultimately, if proper stakeholder engagement is not prioritized, the Bank will continue to leave marginalized segments of the population susceptible to the negative impacts of COVID-19 and undermine the success of vaccination efforts.
  2. Hold governments accountable to an equitable vaccine distribution plan. In some countries, vaccine distribution plans are still under development, which means that projects could be approved by the World Bank Board of Directors without a plan for how to allocate and distribute the vaccine equitably. In other cases, the Bank is funding the development of the plan, but it is not a key piece of the Environmental and Social Commitment Plan (ESCP)— a critical document included in the legal agreement between the Bank and the Borrower. Vaccine distribution plans must be included in the ESCP so that the Bank can hold the government accountable for an equitable distribution. The distribution plans need to define which groups of people will be prioritized and why these selections have been made. Furthermore, while vaccines should be provided to the recipient free of charge, the price people may have to pay to get vaccinated needs to be explicitly stated within distribution plans to promote transparency and enable people to hold their governments accountable as well. These steps will help prevent vaccine distributions from becoming a weapon of political power, as has been seen in Brazil, and abate the continued exclusion of marginalized groups like LGBTQI+ people from COVID-19 relief efforts.  

The success and effectiveness of these COVID-19 Additional Financing projects are a matter of life and death for many communities. The Bank has a responsibility to fulfill stakeholder engagement requirements and extend project benefits to marginalized groups. Robust oversight of vaccine distribution is essential for an inclusive and equitable COVID-19 response. 

For more information on BIC’s COVID-19 Response project monitoring, visit our COVID-19 Campaign page.