CDC in Georgia

In today’s globally connected world, disease threats can spread faster and more unpredictably than ever before. CDC’s global health security efforts in Georgia help improve the country’s ability to prevent, detect, and respond to infectious disease outbreaks before they become epidemics that could affect global populations. These efforts help Georgia reach the targets outlined in the Global Health Security Agenda (GHSA), a global partnership launched in 2014 to help make the world safer and more secure from infectious disease threats. Under GHSA, Georgia is committed to strengthening real-time surveillance and the national laboratory system, as well as detection and prevention of zoonotic diseases, with the Georgia National Center for Disease Control and Public Health (NCDC) as a key leading institution.

CDC supports the country of Georgia in strengthening the capacity of its workforce to investigate and respond to disease outbreaks through the South Caucasus Field Epidemiology and Laboratory Training Program (SC/FELTP). SC/FELTP trains a workforce of field epidemiologists—or disease detectives—to identify and contain outbreaks before they become epidemics. This 2-year competency-based program builds self-sustaining workforce capacity in the countries of Georgia, Azerbaijan, Armenia, and Ukraine by training local epidemiologists, veterinarians, and laboratory managers in field epidemiology, veterinary epidemiology, and laboratory quality management systems. Graduates often assume leadership positions within their country and over 90% remain employed within their respective public health agency. CDC is working with NCDC on the transition of the SC/FELTP to be housed as part of a Masters of Public Health Program at a local university.

Since 2008, CDC has been training managers in the Georgia NCDC on laboratory quality management systems and project management. This unified approach to laboratory management capacity building includes:

• Strengthening management capacity through needs-assessments and
  skill-building workshops.
• Establishing reference laboratory capacity and functions in line with the International Health Regulations and GHSA requirements.
• Providing technical assistance in preparation for and receiving ISO 15189 accreditation.
• Developing a comprehensive laboratory quality assurance program and national testing strategy.

CDC works with Georgia and other partners to approach disease from a One Health perspective, recognizing that the health of people is connected to the health of animals and the environment. A coalition of partners designed and implemented research and surveillance in Georgia using a One Health approach, focusing on a previously unknown orthopoxvirus, Akhmeta virus, discovered in 2013. CDC continues to collaborate with partners at CDC and the National Food Agency to collect data on the epidemiology and characteristics of the virus while building laboratory capacity to detect infections in humans and animals. Over 700 animal samples have been taken and studies are being conducted to establish the burden of disease and identify possible risk factors for human and livestock infections.

Antimicrobial resistance (AMR) and healthcare associated infections (HAI) have significantly affected healthcare quality worldwide, leading to higher morbidity and mortality, and longer hospitalizations. The Government of Georgia has committed to establishing the nationwide HAI/AMR Surveillance Systems by adopting the 2017-2020 National Strategy for Combating Antimicrobial Resistance. CDC AMR/HAI project activities to support the implementation of the strategy include:

• HAI surveillance at selected Georgian hospitals introducing HAI protocol and database management skills.
• Training a cohort of healthcare workers on infection and prevention control (IPC) best practices, creating a cadre of highly qualified national trainers.
• Developing the new National IPC Guidelines along with 15 Georgian experts.
• Establishing the Richard Lugar Public Health Research Center in Tbilisi as a proficiency test provider.
• Determining levels of AMR in healthcare facilities and guiding empiric therapy.

In 2015, Georgia embarked on the world’s first national viral hepatitis elimination program. CDC supported population-based hepatitis C virus (HCV) serosurvey to determine disease burden; at the time, over 7% of adults had evidence of HCV infection, and over 5% were living with HCV—about 150,000 persons. CDC continues to support hepatitis C elimination efforts in Georgia by providing technical assistance to the program.

CDC has been working with the World Health Organization (WHO) and Georgian institutions on immunization since the 1990s, when help was provided to investigate the large-scale diphtheria outbreak in Georgia and an effective immunization campaign was implemented to control the outbreak. CDC continues to help Georgia achieve measles and rubella elimination by providing technical assistance with the analysis of epidemiologic data, surveillance reviews, immunization program reviews, and supplementary immunization activities. CDC also continues to work on ensuring Georgia remains polio-free.