Highlighting World TB day in Georgia

UNCLAS SECTION 01 OF 02 TBILISI 000645 SENSITIVE SIPDIS DEPT FOR EUR/CARC, EEB E.O. 12958: N/A TAGS: ECON PGOV GG SUBJECT: Highlighting World TB day in Georgia REF: STATE 17303 ¶1. Summary: The Ambassador and Embassy officials joined the National Tuberculosis Program (NTP) of Georgia to acknowledge World TB day at the recently opened National Center of Tuberculosis and Lung Diseases in Tbilisi on March 24. At the event, the Ambassador congratulated those working in the fight against TB and underlined the U.S. commitment to worldwide collaboration against the disease. End Summary. ¶2. Comment: Georgia has one of the highest TB prevalence rates in Europe. The GoG has shown a commitment to tackle this issue effectively and has increased budgetary funding to TB treatment programs. Nevertheless, critical international support will come to an end in 2009-10 and while much progress has been achieved, TB continues to be a major health care issue in Georgia. End Comment. World TB Day Events ¶3. At a World TB Day event, NTP Director Dr. Archil Salakaia described recent achievements and challenges in the fight against TB in Georgia. While increased diagnostic and treatment capabilities have not yet reached to WHO goal of 85% treatment success they have reduced the gap by 8% in the last year(from 68 to 74%. It is too soon to evaluate the work against drug resistant forms of TB (the first cohort will not complete treatment until late 2010). The government has supported this work vigorously and government funding has increased, despite overall budget decreases. However, critical international support is scheduled to come to an end in 2009-10 and the goals of all the good work to date will not have yet been achieved. ¶4. At the event, the Ambassador congratulated those working hard in the fight against TB and underlined the U.S. commitment to a worldwide collaboration against the disease. He mentioned that the USG has acted on the frontlines of the fight against TB including last year's signature of the United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act, which authorized up to $48 billion over the next five years to combat global HIV/AIDS, tuberculosis, and malaria. The Ambassador also noted that the Congress recently approved a bill authorizing an additional $900 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) in 2009. The U.S. pledge to continue support for TB control in Georgia contributed to a festive tree planting ceremony in the Center's garden to celebrate the day. ¶5. Also in Tbilisi, students of the Tbilisi State Medical University presented a seminar including a two-hour program for fellow students focused on pediatric TB. Twelve children currently under treatment for TB, ranging from about 6 - 14 years of age, were the guests of honor underlining the importance of their treatment and their place in society without stigma. A puppet play based on the story of Little Red Riding Hood was shown, featuring the characters' TB symptoms, drug treatments and the importance of follow-through. Outside of Tbilisi ¶6. The Georgian Ministry of Health and Social Affairs (MoLHSA), local authorities of Shida Kartli, TB health care providers and the USAID funded Tuberculosis treatment and Control Program (TTCP) in Georgia celebrated the kick off of new activities March 19 in the Shida Kartli region. Approximately 300 new TB cases are registered annually in Shida Kartli, or about 7 percent of the total number of patients in Georgia. While there have been TB activities in the area since 2003, this renewed support for new DOTS Spots (treatment centers) and technical training is critically needed by a region badly damaged by the August 2008 conflict. Regional health care Qbadly damaged by the August 2008 conflict. Regional health care professionals tracking TB patients reported that the only resource they currently have is their own enthusiasm, and they continue to serve their communities without adequate facilities and working equipment. Renovation of local TB facilities is still envisioned, but the previously planned renovations may face further delays because of the widespread destruction due to the August conflict. ¶7. On March 26 the Ajara Ministry of Health in Georgia and the USAID funded TTCP Project conducted a conference on TB Prevention with information on the current progress and challenges of TB in the autonomous republic of Ajara and beyond. Georgian Government Engaged with USG Assistance ¶8. The Georgian government has made a serious commitment to control tuberculosis (TB) in Georgia against a growing prevalence of multi-drug resistant TB (MDR-TB) cases. An HIV epidemic which has been driven more by intravenous drug use is a growing danger to the general community where TB, as a coinfection, will grow. Georgia, located between the high prevalence countries of Russia, Armenia, and Azerbaijan, all with reported cases of extensively-drug resistant TB (XDR-TB) in 2008, will face challenges. TBILISI 00000645 002 OF 002 ¶9. Georgia has one of the highest TB prevalence rates in Europe. In 2006 WHO reported TB prevalence rates in West Europe averaged 17/100,000 compared to 142/100,000 for Georgia in the same time period. In the 12 East European countries the average prevalence was 110/100,000 where Georgia's rate was above average (142) and only surpassed by Kazakhstan (282) and Moldova (160). In the WHO report 2007 Global TB Control, 4501 cases (new and relapses) were identified in 2005, which account for a total WHO rate of 101 per 100,000 population. The case detection rate for all new cases is 116%; for new sputum smear positive cases it is 91%. ¶10. With support from USAID, the Tuberculosis Treatment and Control Project (TTCP) in Georgia is improving the quality of diagnosis and treatment of TB in Georgia. The TTCP project is implemented by Medical Services Corporation International (MSCI),and its pilot sites include Tbilisi, Poti, Adjara, and Shida Kartli. Nearly five years of assisting the Georgian Government's National TB Program (NTP) through this project has resulted in better treatment-success rates, lower patient defaulting, and a higher quality of disease diagnosis. More than 1200 health professionals in both the civilian and penitentiary systems in TB-related issues were trained since the start of the project in 2003. ¶11. The USG funded TTCP project established DOTS Spots; specialized TB nursing rooms in outpatient clinics that are easily accessible for patients, where treatment of TB is provided under a directly observed treatment short course (DOTS) strategy. These DOTS Spots have proven to be very successful in increasing TB treatment success rate from 60% to 71% and the case detection rate from 44% to 91%. These significant accomplishments of the project to date have been recognized by the Ministry of Labor, Health and Social Affairs (MoLHSA) and the Global Fund to Fight TB, AIDS and Malaria (GFTAM) projects.