TBC-Bekämpfung Phase VI

Das Ziel der FZ-Maßnahme ist die Verbesserung von Diagnose und Behandlung der unterschiedlichen Formen der Tuberkulose sowie Erhöhung der Nutzung von qualitativ hochwertigen Gesundheitsdienstleistungen durch die an Tuberkulose erkrankten Menschen in der Region Kathlon in Tadschikistan. Dies soll im Wesentlichen durch den Neubau und Ausstattung eines TB-Krankenhauses auf dem Gelände des bestehenden regionalen TB-Krankenhauses in Kulyob sowie durch die Durchführung von Aus- und Fortbildungsmaßnahmen des Personals erreicht werden. Zusätzlich soll ein kleiner Anteil an Patienten (8 %) für andere Lungenerkrankungen bereitgestellt werden. Auch wird das TB-Krankenhaus über eine Isolationsstation für MDR/XDR-Patienten verfügen, die im Falle einer Pandemie mit Lungenerkrankungen genutzt werden kann. Die aktuelle Zielgruppe umfasst rund 1,4 Mio. Menschen Tadschikistans. Die Gesamtkosten werden auf 11,55 Mio. Euro geschätzt, davon sollen 11 Mio. Euro durch FZ-Mittel (10,5 Mio. Euro - Investition und 0,5 Mio. Euro - Begleitmaßnahme) und 0,55 Mio. Euro durch den tadschikischen Eigenbeitrag finanziert werden.

Umwelt- und Sozialverträglichkeit

The project for the construction and rehabilitation of hospitals has been classified as a moderate risk category B in accordance with the requirements of the KfW Sustainability Directive (2023). It is anticipated that the project will have a small to moderate, locally limited environmental and social impact, which can be mitigated by standard measures. These measures will be incorporated into an environmental and social management plan, and their implementation by the construction companies will be monitored by the consultant within the normal monitoring requirements for the project. Typical potential environmental and social impacts expected during the construction phase of the project are, for example, noise and air quality deterioration, pollution and waste generation, water resources, etc. In addition, potential impacts on workers, communities and the environment are expected due to the presence of hazardous building materials, including materials containing asbestos. During the operational phase, the production and treatment of medical waste could pose environmental and health risks if not managed effectively. Social impacts typically include the health and safety of residents, impacts related to occupational safety and health, and working conditions. No land acquisition is expected, with the risk of physical or economic relocation and loss of livelihoods. Although these effects are localised and in most cases reversible, they require mitigation based on standard approaches and best practices. These are implemented and monitored with the help of a project-specific Environmental and Social Management Plan (ESMP). This includes, in addition to mitigation measures during construction, the involvement of stakeholders and the introduction of a complaints mechanism for workers and other people affected or interested by the project, as well as measures for the proper management of asbestos-containing and other hazardous materials.This is ensured by the developer with the help of the implementation consultant. Furthermore, the project will continue to be subject to a comprehensive stakeholder engagement process and a complaints mechanism. By proactively identifying and addressing these potential risks, the project aims to minimize its environmental and social impact and contribute to the sustainable development of the local community.