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Fri, 27 Aug 2021 08:52:49 +0000 From: Hadia Samaha <hsamaha@worldbank.org> To: AHO Afghanistan <aho.afghanistan@gmail.com> CC: Pmo MoPH <Pmo.moph@gmail.com>, Ahmad Wali Rasekh <Rasekh.pmo@gmail.com>, hassan2 gcmu <Hassan2.gcmu@gmail.com>, "Dr. Yasamin Yousofzai" <yyousofzai@aada.org.af>, "Dr. Muhammad Najeeb Baleegh" <nbaleegh@aada.org.af>, "qmnoori@aada.org.af" <qmnoori@aada.org.af>, naseem <naseem@healthnettpoaf.org>, Dr.NajeebUllah <najeeb@healthnettpoaf.org>, "farhadpaiman@gmail.com" <farhadpaiman@gmail.com>, "drshekibfalah@gmail.com" <drshekibfalah@gmail.com>, Masoud Sarwari <masoudsarwari@gmail.com>, Raz Mohammad Dalili <dalili.kabul@gmail.com>, Ebadullah Hedayat <ebadhedayat@gmail.com>, Ahmad Abid Humayun <sdo.programs@gmail.com>, Aziz Naderi <sdokabul@gmail.com>, "Dr. Ebadullah Hedayat" <health.deputydirector@sanayee.org.af>, "caf.director.general@gmail.com" <caf.director.general@gmail.com>, "Dr. Nasir Hamid" <caf.operation.director@gmail.com>, "Dr. Qawi Qadiri" <q.qadiri@bdn.org.af>, "Mdr. Saboor" <mdrsaboor@baran.org.af>, Hashimi <hashimi@baran.org.af>, Dr.Mohammad Asef Tajzad <dr.tajzad@baran.org.af>, Ahmad Shah Pardis <ahmadshah.pardis@sca.org.af>, "khalid.fahim@sca.org.af" <khalid.fahim@sca.org.af>, Samiullah Hasanzoi <samiullahhasanzoi@gmail.com>, "arwahab@gmail.com" <arwahab@gmail.com>, "abdul.rashid@mmrca.org.af" <abdul.rashid@mmrca.org.af>, Abdul Majeed Siddiqi <majeed.hntpo@gmail.com>, Asmand <fareed@ahds.org>, "zarjan@cha-net.org" <zarjan@cha-net.org>, Taj Mohammad Bassiry <bassiry@cha-net.org>, Zabiullah <hmis@cha-net.org>, Said Iftekhar Sadaat <iftekhar.sadaat@sca.org.af>, "movewelfare@yahoo.com" <movewelfare@yahoo.com>, "shdpkbl@gmail.com" <shdpkbl@gmail.com>, "shdp.hc@gmail.com" <shdp.hc@gmail.com>, ORCD Afghanistan <info@orcd.org.af>, Ezatullah Roshan <finance@orcd.org.af>, Mirwais Sidiqi <m.sidiqi@orcd.org>, "shdpkbl.tm@gmail.com" <shdpkbl.tm@gmail.com>, "laily_temor@yahoo.com" <laily_temor@yahoo.com>, Dr.Jumakhan Nasir Khairzada <general_director@saf.org.af>, "Program_director@saf.org.af" <Program_director@saf.org.af>, Mohammad Hussain Hasseen <mh.hasseen@bdn.org.af>, Maroof Abdul <pdd.kbl@gmail.com>, Nooromari <nooromari@jack.ngo>, "ahmad@jack.ngo" <ahmad@jack.ngo>, "finance.manager@jack.ngo" <finance.manager@jack.ngo>, "quraishi@jack.ngo" <quraishi@jack.ngo>, "drhumayoon2010@gmail.com" <drhumayoon2010@gmail.com>, Dr.Mohammad Jan <mjan@hewad.org.af>, "Dr. Aziz ur Rahman Rahman" <aziz.ur@brac.net>, "anwar.hassanzai@sca.org.af" <anwar.hassanzai@sca.org.af>, Mohammad Tahir Qarizada <t.qarizada@orcd.org>, "Nasrullah.org@akdn.org" <Nasrullah.org@akdn.org>, Humayoon Helal <humayoon.helal@akdn.org>, Habibullah Ahmadzai <hahmadzai@worldbank.org>, Bashir Ahmad Hamid <bhamid@worldbank.org>, Mohammad Mahdi Frough <mfrough@worldbank.org>, Husnia Sadat <hsadat@worldbank.org>, "ekraban@worldbank.org" <ekraban@worldbank.org>, Gyorgy Bela Fritsche <gfritsche@worldbank.org>, Mickey Chopra <mchopra@worldbank.org>, "Trina S. Haque" <thaque@worldbank.org>, Sybille Crystal <scrystal@worldbank.org>, "Lynne D. Sherburne-Benz" <lsherburnebenz@worldbank.org> Subject: RE: Alliance of Health Organizations (AHO) Members / BPHS and EPHS Implementing NGOs Concerns Thread-Topic: Alliance of Health Organizations (AHO) Members / BPHS and EPHS Implementing NGOs Concerns Thread-Index: AQHXlQ3VxjfO/mrbjkqR+fpexvN6NKuEefuAgAKcHzA= Date: Fri, 27 Aug 2021 08:52:49 +0000 Message-ID: <SJ0PR01MB6336404669D1013D273FF370B5C89@SJ0PR01MB6336.prod.exchangelabs.com> References: <CABckiUJ4UwUhVFh8t+Jo2r1f2R5+H+V+1xx=UQmGmVQkK6-vTQ@mail.gmail.com> <CABckiULbT8z1ghAvvA=tJJ9xZ7R9HRZ6Nhsp6WLuoZR6yOr5Wg@mail.gmail.com> In-Reply-To: <CABckiULbT8z1ghAvvA=tJJ9xZ7R9HRZ6Nhsp6WLuoZR6yOr5Wg@mail.gmail.com> Accept-Language: en-US Content-Language: en-US X-MS-Has-Attach: yes X-MS-TNEF-Correlator: authentication-results: gmail.com; dkim=none (message not signed) header.d=none;gmail.com; dmarc=none action=none header.from=worldbank.org; x-ms-publictraffictype: Email x-ms-office365-filtering-correlation-id: d5333e36-09b9-40e7-46fb-08d969380c91 x-ms-traffictypediagnostic: BY3PR01MB6691: x-ld-processed: 31a2fec0-266b-4c67-b56e-2796d8f59c36,ExtAddr x-ms-exchange-transport-forked: True x-microsoft-antispam-prvs: <BY3PR01MB66915A3DFD5908BA7F0CB070B5C89@BY3PR01MB6691.prod.exchangelabs.com> x-ms-oob-tlc-oobclassifiers: OLM:7691; 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charset="us-ascii" Content-Transfer-Encoding: quoted-printable Dear Dr. Sharifi and Sehatmandi SPs, We are deeply concerned about the situation in Afghanistan and the impact o= n the country's development prospects, especially women. We have paused disbursements in our operations in Afghanistan and we are cl= osely monitoring and assessing the situation in line with our internal poli= cies and procedures. As we do so, we will continue to consult closely with = the international community and development partners. As you know, the Bank does not have a contractual relationship with impleme= nting partners contracted by the government to deliver goods, works, and se= rvices. The World Bank only provides financing to the governments for proje= ct implementation as per its policies and procedures. However, the World Ba= nk's internal policies and procedures do lay out a process in these situati= ons that we are following carefully. These policies and procedure will gui= de us in determining further steps in relation to our Health/COVID-19 opera= tions. A final decision may take some time, depending on the security and = political situation, and would be communicated to all concerned parties. Regards, Hadia Hadia Nazem Samaha Human Development Practice Leader Afghanistan Country Office T +1 (202) 299-7860 E hsamaha@worldbank.org<mailto:hsamaha@worldbank.org> W www.worldbank.org<http://www.worldbank.org/> [cid:image003.jpg@01D79AFF.5FEE26E0] From: AHO Afghanistan <aho.afghanistan@gmail.com> Sent: Wednesday, August 25, 2021 12:56 PM To: Habibullah Ahmadzai <hahmadzai@worldbank.org>; Hadia Samaha <hsamaha@wo= rldbank.org>; Bashir Ahmad Hamid <bhamid@worldbank.org>; Mohammad Mahdi Fro= ugh <mfrough@worldbank.org>; Husnia Sadat <hsadat@worldbank.org>; ekraban@w= orldbank.org; EDS01 Office <eds01@worldbank.org>; Sayed Ghulam <gsayed@worl= dbank.org> Cc: Pmo MoPH <Pmo.moph@gmail.com>; Ahmad Wali Rasekh <Rasekh.pmo@gmail.com>= ; hassan2 gcmu <Hassan2.gcmu@gmail.com>; Dr. Yasamin Yousofzai <yyousofzai@= aada.org.af>; Dr. Muhammad Najeeb Baleegh <nbaleegh@aada.org.af>; qmnoori@a= ada.org.af; naseem <naseem@healthnettpoaf.org>; Dr.NajeebUllah <najeeb@heal= thnettpoaf.org>; farhadpaiman@gmail.com; drshekibfalah@gmail.com; Masoud Sa= rwari <masoudsarwari@gmail.com>; Raz Mohammad Dalili <dalili.kabul@gmail.co= m>; Ebadullah Hedayat <ebadhedayat@gmail.com>; Ahmad Abid Humayun <sdo.prog= rams@gmail.com>; Aziz Naderi <sdokabul@gmail.com>; Dr. Ebadullah Hedayat <h= ealth.deputydirector@sanayee.org.af>; caf.director.general@gmail.com; Dr. N= asir Hamid <caf.operation.director@gmail.com>; Dr. Qawi Qadiri <q.qadiri@bd= n.org.af>; Mdr. Saboor <mdrsaboor@baran.org.af>; Hashimi <hashimi@baran.org= .af>; Dr.Mohammad Asef Tajzad <dr.tajzad@baran.org.af>; Ahmad Shah Pardis <= ahmadshah.pardis@sca.org.af>; khalid.fahim@sca.org.af; Samiullah Hasanzoi <= samiullahhasanzoi@gmail.com>; arwahab@gmail.com; abdul.rashid@mmrca.org.af;= Abdul Majeed Siddiqi <majeed.hntpo@gmail.com>; Asmand <fareed@ahds.org>; z= arjan@cha-net.org; Taj Mohammad Bassiry <bassiry@cha-net.org>; Zabiullah <h= mis@cha-net.org>; Said Iftekhar Sadaat <iftekhar.sadaat@sca.org.af>; movewe= lfare@yahoo.com; shdpkbl@gmail.com; shdp.hc@gmail.com; ORCD Afghanistan <in= fo@orcd.org.af>; Ezatullah Roshan <finance@orcd.org.af>; Mirwais Sidiqi <m.= sidiqi@orcd.org>; shdpkbl.tm@gmail.com; laily_temor@yahoo.com; Dr.Jumakhan = Nasir Khairzada <general_director@saf.org.af>; Program_director@saf.org.af;= Mohammad Hussain Hasseen <mh.hasseen@bdn.org.af>; Maroof Abdul <pdd.kbl@gm= ail.com>; Nooromari <nooromari@jack.ngo>; ahmad@jack.ngo; finance.manager@j= ack.ngo; quraishi@jack.ngo; drhumayoon2010@gmail.com; Dr.Mohammad Jan <mjan= @hewad.org.af>; Dr. Aziz ur Rahman Rahman <aziz.ur@brac.net>; anwar.hassanz= ai@sca.org.af; Mohammad Tahir Qarizada <t.qarizada@orcd.org>; Nasrullah.org= @akdn.org; Humayoon Helal <humayoon.helal@akdn.org> Subject: Re: Alliance of Health Organizations (AHO) Members / BPHS and EPHS= Implementing NGOs Concerns [External] Dear World Bank Colleagues, Based on the Sehatmandi implementing NGOs discussion about the new developm= ent from the World Bank side. The attached link indicates that the World Ba= nk decided that there is no commitment from the World Bank to continue serv= ice delivery to the health facilities in Afghanistan. https://www.bbc.com/n= ews/business-58325545<https://nam11.safelinks.protection.outlook.com/?url= =3Dhttps%3A%2F%2Fwww.bbc.com%2Fnews%2Fbusiness-58325545&data=3D04%7C01%7Chs= amaha%40worldbank.org%7C8736a078c8a64c6cf73708d967e9a9f8%7C31a2fec0266b4c67= b56e2796d8f59c36%7C0%7C0%7C637655075552297028%7CUnknown%7CTWFpbGZsb3d8eyJWI= joiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata= =3DU9fve2Ehrn%2BV%2FqacHiyf0flTZog7tsrGYK%2FdEH%2BJRO8%3D&reserved=3D0> . https://www.nytimes.com/2021/08/24/world%20/asia/world-bank-afghanistan.htm= l<https://nam11.safelinks.protection.outlook.com/?url=3Dhttps%3A%2F%2Fwww.n= ytimes.com%2F2021%2F08%2F24%2Fworld%2520%2Fasia%2Fworld-bank-afghanistan.ht= ml&data=3D04%7C01%7Chsamaha%40worldbank.org%7C8736a078c8a64c6cf73708d967e9a= 9f8%7C31a2fec0266b4c67b56e2796d8f59c36%7C0%7C0%7C637655075552297028%7CUnkno= wn%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVC= I6Mn0%3D%7C1000&sdata=3DHp4lZdC79Dgc2ioAtH4OaUt7M2iGubucbLkROt4CWM8%3D&rese= rved=3D0> . The Alliance of Health Organizations (AHO) members/ BPHS and EPHS implement= ing NGOs kindly request you to inform us about the stand of the World Bank = regarding the such issue. We, the Health NGOs, would like to receive the right and optimistic respons= e related to such concerns. You're Sincerely On behalf of SEHATMANDI Implementers Dr. Mohammad Sharaf 'Sharifi' AHO Coordinator On Thu, Aug 19, 2021 at 7:47 PM AHO Afghanistan <aho.afghanistan@gmail.com<= mailto:aho.afghanistan@gmail.com>> wrote: Dear World Bank Colleagues, We, the Health NGOs, appreciate that you are aware of the recent political = change that has been taking place very quickly. This has led to uncertainty= about the future of the SEHATMANDI project implementation in Afghanistan. = Hereby, we would kindly like to request the World Bank to provide us with c= larification on its position on the future modalities of funding and implem= entation of the SEHATMANDI program. This would enable us to convey clear me= ssages to our staff at the provincial level and avoid any interruption in s= ervice delivery during this critical time. Further, we would like to request the World Bank to address the remaining o= perational concerns which have been encountered over the current and last p= eriod: 1. Contract provision: Although the contracting process has been= completed including the contract negotiations, the NGOs have not yet recei= ved the signed copy of the contract from the MoPH. The NGOs continue the s= ervices provision as usual from 1st July 2021 to date and all the Health Fa= cilities (HFs) across the country are functional and expenses are made. Whe= n and how the contract will be signed, as it is a high financial risk towar= ds organizations. 2. Force majeure: Force majeure is a contractual requirement, which ou= ght to be respected. MoPH request to redirect resources towards Covid-19 wh= ich resulted in stopping the services effected performance and it never com= pensated. . The Covid-19 pandemic and lock down had an impact on client num= bers. Clients numbers in quarter 2 and quarter 3 of 2020 down which resulte= d in a significant reduction of service delivery and meeting the targets. T= hus, the income for the project is reduced and in addition to that hike in = prices and instructions of MoPH for prioritizing the services, aggravating = the situation. NGOs did ask MoPH to not consider P4P for quarter 2 and quar= ter 3 of 2020, but so far, no response. The issue of force majeure and reco= mmendation was part of mid-term review last year, and so far, no action, be= sides repeated requests from NGOs, has been taken. NGOs recently received a= letter from MoPH to stop elective surgeries, where it is linked with payme= nt, if this is stopped, from where the fund for salary of staff and cost of= services will come, this is not considered. The Covid- 19 pandemic and its= impact on health service delivery should be seen as a force majeure. Howev= er, this was ignored and thus should be considered as a breach of contract. 3. Payment delay: The payment of instalments to NGO's have been d= elayed despite the fact that NGOs carry the burden of the financial liabili= ties by having to pay for the staff salaries, medicines, oxygen supplies an= d other medical and non-medical needs of the HFs. Payments are linked to third party verification which is delayed. In additi= on, the instalment schedule is not in line with the expenses, and due to de= lays, it is not possible for many NGOs to pay salaries and other expenses o= n time. Therefore, a revised instalment schedule and more assurance for an = on time verification and payment, is needed. However, this is not considere= d for the extension period and there is a great need to do so in order to p= revent financial bottlenecks and secure smooth program implementation 4. Budget implications: The extension budget is kept the same as it was= during the last 30 months of SEHATMANDI. It does, therefore, not accommoda= te the inflation rate, hike in prices and the additional conditions to incr= ease salaries during the extension period. It is simply not possible to run= the services with the same budget, due to reasons given above in addition = to security issues and an increased demand. Although this has been previous= ly discussed during face to face and online meetings there has been no resp= onse from the MoPH and/or the World Bank. Some national and international N= GOs are thus forced to withdraw and others are considering the withdrawal i= f the environment and conditions are not feasible to implement the SEHATMAN= DI during the extension. Withdrawal of NGOs will result in unnecessary and = unwanted delay in service delivery and anyone who will implement, will be f= acing serious challenges resulting in dissatisfaction of the community. In = addition, the collateral and direct damage to health facilities due to war,= did require and will require a major rehabilitation work. This was not sup= ported through SEHATMANDI but we urge that it should be foreseen in the ext= ension period. A budget revision for the extension period is therefore urge= ntly needed and we, hereby, request the World Bank to address this issue. 5. Quality and quantity of pharmaceuticals: NGOs are blamed for inade= quate quality of pharmaceutical. However, pharmaceutical quality is the res= ponsibility of MoPH as it provides the quality certificate. There is a grea= t need to ensure improved quality control and licenses to import pharmaceut= icals into the country. In addition, NGOs have set targets, where payme= nt is based on the targets defined, and thus the supply. NGOs request for p= roper target setting for extension period based on actual needs, to be able= to supply enough pharmaceuticals. The issue of over-caps (ceiling for P4P)= is important and besides many promises by MoPH we do not see any action so= far. Without resolving the cap issues for indicators, it is not possible t= o resolve the quantity of pharmaceutical supplies. 6. Standard Operating Procedures: NGOs raised issues on third party mo= nitoring reports, deductions issue, and SoP problems. NGOs do request that = these issues will be considered and properly addressed during the extension= period NGOs, both national and international, have made significant contributions = to improve the performance of the health sector over the last two decades b= y mobilizing resources and developing trust of donors and the international= community. Therefore, considering their professional experiences in healt= h service delivery is of utmost importance to ensure the functioning of the= health system in future. On behalf of NGOs, I hereby request the World Bank to consider the concerns= mentioned above and engage with NGOs to discuss the future challenges and = implementation modalities. We want to improve the health system and healthcare in the country and I am= looking forward to receiving your response Yours sincerely Dr. Sharaf Sharifi AHO Coordinator --_000_SJ0PR01MB6336404669D1013D273FF370B5C89SJ0PR01MB6336prod_ Content-Type: text/html; charset="us-ascii" Content-Transfer-Encoding: quoted-printable <html xmlns:v=3D"urn:schemas-microsoft-com:vml" xmlns:o=3D"urn:schemas-micr= osoft-com:office:office" xmlns:w=3D"urn:schemas-microsoft-com:office:word" = xmlns:m=3D"http://schemas.microsoft.com/office/2004/12/omml" xmlns=3D"http:= //www.w3.org/TR/REC-html40"> <head> <meta http-equiv=3D"Content-Type" content=3D"text/html; charset=3Dus-ascii"= > <meta name=3D"Generator" content=3D"Microsoft Word 15 (filtered medium)"> <!--[if !mso]><style>v\:* {behavior:url(#default#VML);} o\:* {behavior:url(#default#VML);} w\:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} </style><![endif]--><style><!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; font-size:11.0pt; font-family:"Calibri",sans-serif;} a:link, span.MsoHyperlink {mso-style-priority:99; color:blue; text-decoration:underline;} p.xxmsonormal, li.xxmsonormal, div.xxmsonormal {mso-style-name:x_xmsonormal; margin:0in; font-size:11.0pt; font-family:"Calibri",sans-serif;} span.EmailStyle21 {mso-style-type:personal-compose; font-family:"Calibri",sans-serif; color:windowtext;} .MsoChpDefault {mso-style-type:export-only; font-size:10.0pt;} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --></style><!--[if gte mso 9]><xml> <o:shapedefaults v:ext=3D"edit" spidmax=3D"1026" /> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext=3D"edit"> <o:idmap v:ext=3D"edit" data=3D"1" /> </o:shapelayout></xml><![endif]--> </head> <body lang=3D"EN-US" link=3D"blue" vlink=3D"purple" style=3D"word-wrap:brea= k-word"> <div class=3D"WordSection1"> <p class=3D"MsoNormal">Dear Dr. Sharifi and Sehatmandi SPs,<o:p></o:p></p> <p class=3D"MsoNormal"><o:p> </o:p></p> <p class=3D"xxmsonormal" style=3D"text-align:justify"><span style=3D"color:= black">We are deeply concerned about the situation in Afghanistan and the i= mpact on the country’s development prospects, especially women. <o:p></o:p></span></p> <p class=3D"xxmsonormal" style=3D"text-align:justify"><o:p> </o:p></p> <p class=3D"xxmsonormal" style=3D"text-align:justify"><span style=3D"color:= black">We have paused disbursements in our operations in Afghanistan and we= are closely monitoring and assessing the situation in line with our intern= al policies and procedures. As we do so, we will continue to consult closely with the international community and d= evelopment partners.<o:p></o:p></span></p> <p class=3D"MsoNormal"><o:p> </o:p></p> <p class=3D"MsoNormal">As you know, the Bank does not have a contractual re= lationship with implementing partners contracted by the government to deliv= er goods, works, and services. The World Bank only provides financing to th= e governments for project implementation as per its policies and procedures. However, the World Bank’s intern= al policies and procedures do lay out a process in these situations that we= are following carefully. These policies and procedure will guid= e us in determining further steps in relation to our Health/COVID-19 operations. A final decision may take some time,= depending on the security and political situation, and would be communicat= ed to all concerned parties.<o:p></o:p></p> <p class=3D"MsoNormal"><o:p> </o:p></p> <div> <p class=3D"MsoNormal">Regards,<o:p></o:p></p> <p class=3D"MsoNormal">Hadia<o:p></o:p></p> <p class=3D"MsoNormal"><o:p> </o:p></p> <p class=3D"MsoNormal"><o:p> </o:p></p> <p class=3D"MsoNormal"><b><span style=3D"color:#1F3864">Hadia Nazem Samaha<= /span></b><span style=3D"color:#201F1E"><o:p></o:p></span></p> <p class=3D"MsoNormal"><b><span style=3D"color:#1F3864">Human Development P= ractice Leader <o:p></o:p></span></b></p> <p class=3D"MsoNormal"><b><span style=3D"color:#1F3864">Afghanistan Country= Office</span></b><span style=3D"color:#201F1E"><o:p></o:p></span></p> <p class=3D"MsoNormal"><span lang=3D"FR" style=3D"color:#00AEEF">T </s= pan><span lang=3D"FR" style=3D"color:#032A45">+1 (202) 299-7860</span><span= lang=3D"FR" style=3D"color:#201F1E"><o:p></o:p></span></p> <p class=3D"MsoNormal"><span lang=3D"FR" style=3D"color:#00AEEF">E </span><= u><span style=3D"color:#00AEEF"><a href=3D"mailto:hsamaha@worldbank.org"><s= pan lang=3D"FR">hsamaha@worldbank.org</span></a></span></u><span lang=3D"FR= " style=3D"color:#201F1E"><o:p></o:p></span></p> <p class=3D"MsoNormal"><span lang=3D"FR" style=3D"color:#00AEEF">W </s= pan><span style=3D"color:#201F1E"><a href=3D"http://www.worldbank.org/" tar= get=3D"_blank"><span lang=3D"FR" style=3D"color:#032A45">www.worldbank.org<= /span></a></span><span lang=3D"FR" style=3D"color:#201F1E"><o:p></o:p></spa= n></p> <p class=3D"MsoNormal"><span style=3D"font-size:10.0pt;color:#002060"><img = border=3D"0" width=3D"232" height=3D"43" style=3D"width:2.4166in;height:.44= 44in" id=3D"Picture_x0020_1" src=3D"cid:image003.jpg@01D79AFF.5FEE26E0"></s= pan><span style=3D"color:#201F1E"><o:p></o:p></span></p> <p class=3D"MsoNormal"><o:p> </o:p></p> </div> <p class=3D"MsoNormal"><o:p> </o:p></p> <div> <div style=3D"border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in = 0in 0in"> <p class=3D"MsoNormal"><b>From:</b> AHO Afghanistan <aho.afghanistan@gma= il.com> <br> <b>Sent:</b> Wednesday, August 25, 2021 12:56 PM<br> <b>To:</b> Habibullah Ahmadzai <hahmadzai@worldbank.org>; Hadia Samah= a <hsamaha@worldbank.org>; Bashir Ahmad Hamid <bhamid@worldbank.or= g>; Mohammad Mahdi Frough <mfrough@worldbank.org>; Husnia Sadat &l= t;hsadat@worldbank.org>; ekraban@worldbank.org; EDS01 Office <eds01@worldbank.org>; Sayed Ghulam <gsayed@worldbank.org><br> <b>Cc:</b> Pmo MoPH <Pmo.moph@gmail.com>; Ahmad Wali Rasekh <Rasek= h.pmo@gmail.com>; hassan2 gcmu <Hassan2.gcmu@gmail.com>; Dr. Yasam= in Yousofzai <yyousofzai@aada.org.af>; Dr. Muhammad Najeeb Baleegh &l= t;nbaleegh@aada.org.af>; qmnoori@aada.org.af; naseem <naseem@healthne= ttpoaf.org>; Dr.NajeebUllah <najeeb@healthnettpoaf.org>; farhadpaiman@gmail.com; = drshekibfalah@gmail.com; Masoud Sarwari <masoudsarwari@gmail.com>; Ra= z Mohammad Dalili <dalili.kabul@gmail.com>; Ebadullah Hedayat <eba= dhedayat@gmail.com>; Ahmad Abid Humayun <sdo.programs@gmail.com>; Aziz Naderi <sdokabul@gmail.com>; Dr. Ebadullah Hedayat <health.d= eputydirector@sanayee.org.af>; caf.director.general@gmail.com; Dr. Nasir= Hamid <caf.operation.director@gmail.com>; Dr. Qawi Qadiri <q.qadi= ri@bdn.org.af>; Mdr. Saboor <mdrsaboor@baran.org.af>; Hashimi <hashimi@baran.org.af>; Dr.Mohammad Asef Tajzad <dr.tajza= d@baran.org.af>; Ahmad Shah Pardis <ahmadshah.pardis@sca.org.af>; = khalid.fahim@sca.org.af; Samiullah Hasanzoi <samiullahhasanzoi@gmail.com= >; arwahab@gmail.com; abdul.rashid@mmrca.org.af; Abdul Majeed Siddiqi <majeed.hntpo@gmail.com>; Asmand <fareed@ahds.org&= gt;; zarjan@cha-net.org; Taj Mohammad Bassiry <bassiry@cha-net.org>; = Zabiullah <hmis@cha-net.org>; Said Iftekhar Sadaat <iftekhar.sadaa= t@sca.org.af>; movewelfare@yahoo.com; shdpkbl@gmail.com; shdp.hc@gmail.c= om; ORCD Afghanistan <info@orcd.org.af>; Ezatullah Roshan <finance@or= cd.org.af>; Mirwais Sidiqi <m.sidiqi@orcd.org>; shdpkbl.tm@gmail.c= om; laily_temor@yahoo.com; Dr.Jumakhan Nasir Khairzada <general_director= @saf.org.af>; Program_director@saf.org.af; Mohammad Hussain Hasseen <mh.hasseen@bdn.org.af>; Maroof Abdul <pdd.kbl@gmail.com&= gt;; Nooromari <nooromari@jack.ngo>; ahmad@jack.ngo; finance.manager@= jack.ngo; quraishi@jack.ngo; drhumayoon2010@gmail.com; Dr.Mohammad Jan <= mjan@hewad.org.af>; Dr. Aziz ur Rahman Rahman <aziz.ur@brac.net>; anwar.hassanzai@sca.org.af; Mohammad Tahir Qarizada <t.qarizada@orcd.or= g>; Nasrullah.org@akdn.org; Humayoon Helal <humayoon.helal@akdn.org&g= t;<br> <b>Subject:</b> Re: Alliance of Health Organizations (AHO) Members / BPHS a= nd EPHS Implementing NGOs Concerns<o:p></o:p></p> </div> </div> <p class=3D"MsoNormal"><o:p> </o:p></p> <p class=3D"MsoNormal">[External]<o:p></o:p></p> <div> <div> <p class=3D"MsoNormal"><b><span style=3D"font-size:12.0pt">Dear World Bank = Colleagues,</span></b><o:p></o:p></p> <p class=3D"MsoNormal"><span style=3D"font-size:12.0pt"> </span><o:p><= /o:p></p> <p class=3D"MsoNormal"><span style=3D"font-size:12.0pt">Based on the Sehatm= andi implementing NGOs discussion about the new development from the World = Bank side. The attached link indicates that the World Bank decided that the= re is no commitment from the World Bank to continue service delivery to the health facilities in Afghanistan. <a h= ref=3D"https://nam11.safelinks.protection.outlook.com/?url=3Dhttps%3A%2F%2F= www.bbc.com%2Fnews%2Fbusiness-58325545&data=3D04%7C01%7Chsamaha%40world= bank.org%7C8736a078c8a64c6cf73708d967e9a9f8%7C31a2fec0266b4c67b56e2796d8f59= c36%7C0%7C0%7C637655075552297028%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMD= AiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=3DU9fve2E= hrn%2BV%2FqacHiyf0flTZog7tsrGYK%2FdEH%2BJRO8%3D&reserved=3D0"> https://www.bbc.com/news/business-58325545</a> .</span><o:p></o:p></p= > <p class=3D"MsoNormal"><span style=3D"font-size:12.0pt"><a href=3D"https://= nam11.safelinks.protection.outlook.com/?url=3Dhttps%3A%2F%2Fwww.nytimes.com= %2F2021%2F08%2F24%2Fworld%2520%2Fasia%2Fworld-bank-afghanistan.html&dat= a=3D04%7C01%7Chsamaha%40worldbank.org%7C8736a078c8a64c6cf73708d967e9a9f8%7C= 31a2fec0266b4c67b56e2796d8f59c36%7C0%7C0%7C637655075552297028%7CUnknown%7CT= WFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%= 3D%7C1000&sdata=3DHp4lZdC79Dgc2ioAtH4OaUt7M2iGubucbLkROt4CWM8%3D&re= served=3D0">https://www.nytimes.com/2021/08/24/world%20/asia/world-bank-afg= hanistan.html</a> .</span><o:p></o:p></p> <p class=3D"MsoNormal"><span style=3D"font-size:12.0pt"> </span><o:p><= /o:p></p> <p class=3D"MsoNormal"><span style=3D"font-size:12.0pt">The Alliance of Hea= lth Organizations (AHO) members/ BPHS and EPHS implementing NGOs kindly req= uest you to inform us about the stand of the World Bank regarding the such = issue. </span><o:p></o:p></p> <p class=3D"MsoNormal"><span style=3D"font-size:12.0pt"> </span><o:p><= /o:p></p> <p class=3D"MsoNormal"><span style=3D"font-size:12.0pt">We, the Health NGOs= , would like to receive the right and optimistic response related to such c= oncerns.</span><span style=3D"font-size:12.0pt;font-family:"Times New = Roman",serif"> </span><o:p></o:p></p> <p class=3D"MsoNormal"> <o:p></o:p></p> <p class=3D"MsoNormal"> <o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-bottom:8.0pt;line-height:106%"><span= style=3D"font-size:12.0pt;line-height:106%">You’re Sincerely</span><= o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-bottom:8.0pt;line-height:106%"><span= style=3D"font-size:12.0pt;line-height:106%">On behalf of SEHATMANDI Implem= enters</span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-bottom:8.0pt;line-height:106%"><span= style=3D"font-size:12.0pt;line-height:106%"> Dr. Mohammad Sharaf R= 16;Sharifi’</span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-bottom:8.0pt;line-height:106%"><span= style=3D"font-size:12.0pt;line-height:106%"> AHO Coordinator &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp; = &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; &n= bsp;  = ; </span><o:p></o:p></p> </div> <p class=3D"MsoNormal"><o:p> </o:p></p> <div> <div> <p class=3D"MsoNormal">On Thu, Aug 19, 2021 at 7:47 PM AHO Afghanistan <= <a href=3D"mailto:aho.afghanistan@gmail.com">aho.afghanistan@gmail.com</a>&= gt; wrote:<o:p></o:p></p> </div> <blockquote style=3D"border:none;border-left:solid #CCCCCC 1.0pt;padding:0i= n 0in 0in 6.0pt;margin-left:4.8pt;margin-right:0in"> <div> <div> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <b><span lang=3D"EN-GB" style=3D"font-size:12.0pt">Dear World Bank Colleagu= es,</span></b><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">We, the Health NGOs, apprec= iate that you are aware of the recent political change that has been taking= place very quickly. This has led to uncertainty about the future of the SE= HATMANDI project implementation in Afghanistan. Hereby, we would kindly like to request the World Bank to provide us with = clarification on its position on the future modalities of funding and imple= mentation of the SEHATMANDI program. This would enable us to convey clear m= essages to our staff at the provincial level and avoid any interruption in service delivery during this critical = time. </span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt;font-family:"Times New = Roman",serif"> </span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">Further, we would like to r= equest the World Bank to address the remaining operational concerns which h= ave been encountered over the current and last period: </span><o:p></= o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p style=3D"mso-margin-top-alt:0in;margin-right:0in;margin-bottom:0in;margi= n-left:.25in;background-image:initial;background-position:initial;backgroun= d-size:initial;background-repeat:initial;background-origin:initial;backgrou= nd-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">1.</span><span lang=3D"EN-G= B" style=3D"font-size:7.0pt;font-family:"Times New Roman",serif">= <b> </b></span><b><span lang=3D"EN-GB" style=3D"font-size:12.0pt= ">Contract provision:</span></b><span lang=3D"EN-GB" style=3D"font-size:12.= 0pt"> </span><span lang=3D"EN-GB" style=3D"font-size:7.0pt;font-family:"Time= s New Roman",serif"> </span><span lang=3D"EN-GB" styl= e=3D"font-size:12.0pt"> Although the contracting process has been completed= including the contract negotiations, the NGOs have not yet received the signed copy of the contract from the MoPH. The NGOs continue the= services provision as usual from 1<sup>st</sup> July 2021 to date and all = the Health Facilities (HFs) across the country are functional and expenses = are made. When and how the contract will be signed, as it is a high financial risk towards organizations.</span><o:= p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:7.0pt;font-family:"Times New R= oman",serif"> </span><o:p></o:p></p> <p style=3D"mso-margin-top-alt:0in;margin-right:0in;margin-bottom:0in;margi= n-left:.25in;background-image:initial;background-position:initial;backgroun= d-size:initial;background-repeat:initial;background-origin:initial;backgrou= nd-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">2.</span><span lang=3D"EN-G= B" style=3D"font-size:7.0pt;font-family:"Times New Roman",serif">= </span><b><span lang=3D"EN-GB" style=3D"font-size:12.0pt">Force majeure:</s= pan></b><span lang=3D"EN-GB" style=3D"font-size:12.0pt"> Force majeure is a= contractual requirement, which ought to be respected. MoPH request to redi= rect resources towards Covid-19 which resulted in stopping the services effected performance and it never compensated. . = The Covid-19 pandemic and lock down had an impact on client numbers. Client= s numbers in quarter 2 and quarter 3 of 2020 down which resulted in a signi= ficant reduction of service delivery and meeting the targets. Thus, the income for the project is reduced and i= n addition to that hike in prices and instructions of MoPH for prioritizing= the services, aggravating the situation. NGOs did ask MoPH to not consider= P4P for quarter 2 and quarter 3 of 2020, but so far, no response. The issue of force majeure and recommend= ation was part of mid-term review last year, and so far, no action, besides= repeated requests from NGOs, has been taken. NGOs recently received a lett= er from MoPH to stop elective surgeries, where it is linked with payment, if this is stopped, from where the fund f= or salary of staff and cost of services will come, this is not considered. = The Covid- 19 pandemic and its impact on health service delivery should be = seen as a force majeure. However, this was ignored and thus should be considered as a breach of contract.</s= pan><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-left:.25in;background-image:initial;= background-position:initial;background-size:initial;background-repeat:initi= al;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p style=3D"mso-margin-top-alt:0in;margin-right:0in;margin-bottom:0in;margi= n-left:.25in;background-image:initial;background-position:initial;backgroun= d-size:initial;background-repeat:initial;background-origin:initial;backgrou= nd-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">3.</span><span lang=3D"EN-G= B" style=3D"font-size:7.0pt;font-family:"Times New Roman",serif">= </span><b><span lang=3D"EN-GB" style=3D"font-size:12.0pt">Payment delay:</s= pan></b><span lang=3D"EN-GB" style=3D"font-size:7.0pt;font-family:"Tim= es New Roman",serif"> </span><span = lang=3D"EN-GB" style=3D"font-size:12.0pt">The payment of instalments to NGO= ’s have been delayed despite the fact that NGOs carry the burden of the financial liabi= lities by having to pay for the staff salaries, medicines, oxygen supplies = and other medical and non-medical needs of the HFs. </span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-left:.25in;background-image:initial;= background-position:initial;background-size:initial;background-repeat:initi= al;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"margin-left:.25in;background-image:initial;= background-position:initial;background-size:initial;background-repeat:initi= al;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">Payments are linked to thir= d party verification which is delayed. In addition, the instalment schedule= is not in line with the expenses, and due to delays, it is not possible fo= r many NGOs to pay salaries and other expenses on time. Therefore, a revised instalment schedule and more assura= nce for an on time verification and payment, is needed. However, this is no= t considered for the extension period and there is a great need to do so in= order to prevent financial bottlenecks and secure smooth program implementation</span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-left:.5in;background-image:initial;b= ackground-position:initial;background-size:initial;background-repeat:initia= l;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"margin-left:.25in;background-image:initial;= background-position:initial;background-size:initial;background-repeat:initi= al;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">4.</span><span lang=3D"EN-G= B" style=3D"font-size:7.0pt;font-family:"Times New Roman",serif">= </span><b><span lang=3D"EN-GB" style=3D"font-= size:12.0pt">Budget implications: The</span></b><span lang=3D"EN-GB" style= =3D"font-size:12.0pt"> extension budget is kept the same as it was during the last 30 months of S= EHATMANDI. It does, therefore, not accommodate the inflation rate, hike in = prices and the additional conditions to increase salaries during the extens= ion period. It is simply not possible to run the services with the same budget, due to reasons given above in ad= dition to security issues and an increased demand. Although this has been p= reviously discussed during face to face and online meetings there has been = no response from the MoPH and/or the World Bank. Some national and international NGOs are thus forced to wi= thdraw and others are considering the withdrawal if the environment and con= ditions are not feasible to implement the SEHATMANDI during the extension. = Withdrawal of NGOs will result in unnecessary and unwanted delay in service delivery and anyone who will imp= lement, will be facing serious challenges resulting in dissatisfaction of t= he community. In addition, the collateral and direct damage to health facil= ities due to war, did require and will require a major rehabilitation work. This was not supported through S= EHATMANDI but we urge that it should be foreseen in the extension period. A= budget revision for the extension period is therefore urgently needed and = we, hereby, request the World Bank to address this issue.</span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-left:.5in;background-image:initial;b= ackground-position:initial;background-size:initial;background-repeat:initia= l;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"margin-left:.25in;background-image:initial;= background-position:initial;background-size:initial;background-repeat:initi= al;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">5.</span><span lang=3D"EN-G= B" style=3D"font-size:7.0pt;font-family:"Times New Roman",serif">= </span><b><span lang=3D"EN-GB" style=3D"font-size:12.0pt">Quality and quant= ity of pharmaceuticals:</span></b><b><span lang=3D"EN-GB" style=3D"font-siz= e:7.0pt;font-family:"Times New Roman",serif"> </span></b><sp= an lang=3D"EN-GB" style=3D"font-size:7.0pt;font-family:"Times New Roma= n",serif"> </span><span lang=3D"EN-GB" style=3D"font-= size:12.0pt"> NGOs are blamed for inadequate quality of pharmaceutical. However, pharmac= eutical quality is the responsibility of MoPH as it provides the quality ce= rtificate. There is a great need to ensure improved quality control and lic= enses to import pharmaceuticals into the country. In addition, NGOs have set targe= ts, where payment is based on the targets defined, and thus the supply. NGO= s request for proper target setting for extension period based on actual ne= eds, to be able to supply enough pharmaceuticals. The issue of over-caps (ceiling for P4P) is important and besides many promise= s by MoPH we do not see any action so far. Without resolving the cap issues= for indicators, it is not possible to resolve the quantity of pharmaceutic= al supplies.</span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-left:.5in;background-image:initial;b= ackground-position:initial;background-size:initial;background-repeat:initia= l;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"margin-left:.25in;background-image:initial;= background-position:initial;background-size:initial;background-repeat:initi= al;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">6<b>.</b></span><b><span la= ng=3D"EN-GB" style=3D"font-size:7.0pt;font-family:"Times New Roman&quo= t;,serif"> </span></b><b><span lang=3D"E= N-GB" style=3D"font-size:12.0pt">Standard Operating Procedures:</span></b><= span lang=3D"EN-GB" style=3D"font-size:12.0pt"> NGOs raised issues on third party monitoring reports, deductions issue, an= d SoP problems. NGOs do request that these issues will be considered and pr= operly addressed during the extension period</span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"margin-left:.5in;background-image:initial;b= ackground-position:initial;background-size:initial;background-repeat:initia= l;background-origin:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">NGOs, both national and int= ernational, have made significant contributions to improve the performance = of the health sector over the last two decades by mobilizing resources and = developing trust of donors and the international community. Therefore, considering their professional experiences in = health service delivery is of utmost importance to ensure the functioning o= f the health system in future. </span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">On behalf of NGOs, I hereby= request the World Bank to consider the concerns mentioned above and engage= with NGOs to discuss the future challenges and implementation modalities. </span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">We want to improve the heal= th system and healthcare in the country and I am looking forward to receivi= ng your response</span><o:p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">Yours sincerely</span><o:p>= </o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt"> </span><o:p></o:p></p= > <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">Dr. Sharaf Sharifi</span><o= :p></o:p></p> <p class=3D"MsoNormal" style=3D"background-image:initial;background-positio= n:initial;background-size:initial;background-repeat:initial;background-orig= in:initial;background-clip:initial"> <span lang=3D"EN-GB" style=3D"font-size:12.0pt">AHO Coordinator</span><o:p>= </o:p></p> </div> </div> </blockquote> </div> </div> </div> </body> </html> --_000_SJ0PR01MB6336404669D1013D273FF370B5C89SJ0PR01MB6336prod_-- --_004_SJ0PR01MB6336404669D1013D273FF370B5C89SJ0PR01MB6336prod_ Content-Type: image/jpeg; name="image003.jpg" Content-Description: image003.jpg Content-Disposition: inline; filename="image003.jpg"; size=5509; creation-date="Fri, 27 Aug 2021 08:52:47 GMT"; modification-date="Fri, 27 Aug 2021 08:52:47 GMT" Content-ID: <image003.jpg@01D79AFF.5FEE26E0> Content-Transfer-Encoding: base64 /9j/4AAQSkZJRgABAQEAkACQAAD/2wBDAAoHBwkHBgoJCAkLCwoMDxkQDw4ODx4WFxIZJCAmJSMg IyIoLTkwKCo2KyIjMkQyNjs9QEBAJjBGS0U+Sjk/QD3/2wBDAQsLCw8NDx0QEB09KSMpPT09PT09 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