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DE RUEHSI #0645/01 0910612
ZNR UUUUU ZZH
R 010612Z APR 09
FM AMEMBASSY TBILISI
TO RUEHC/SECSTATE WASHDC 1295
INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE

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.