This presentation on Georgia was made by Tamar Gabunia, Lithuania, at the 3rd Health Systems Joint Network meeting for Central, Eastern and South-eastern European Countries held in Vilnius, Lithuania, on 25-26 April 2019

1. Georgia Experience and the
perspective on TB, HIV and Hep C
Elimination in the context of
anticipated transition
Tamar Gabunia
Deputy Minister of Internally Displaced Persons from
Occupied
Territories, Labor, Health, and Social Affairs
Vilnius, April 26, 2019

2. Demographic and Socio-Economic Situation
Government expenditure on health per capita – 104 $US
Government expenditure on health as % of GDP – 2.8%
Government expenditure on health as % of State Budget – 8%
Maternal Mortality (per 100000 live birth) – 13.1
Infant mortality (per 1000 live birth) – 9.6
Under 5 mortality rate (per 1000 live birth) – 11.1
GDP per capita (at current prices), (2017) – 4067 $US
GDP growth – 5%
Government expenditure on health as % of GDP – 3.1%
General Government expenditure on health per capita (USD) – 117
Population – 3 728 300 (2017)
Birth rate (per thousand population) – 14.3
Mortality rate (per thousand population) – 12.8
Life expectancy at birth – 73.5

3. Access to Health Services: Universal Health Care Program
• Substantial increase of State Health Care Budget:
2012 365 million Gel  2018 1.111 million Gel
• Key Outcomes since 2013 (HUES 2017)
– Reduced out of pocket payments among most poor
– Increased utilization of hospital services
– Relatively slow increase in utilization of outpatient services
– Reduced financial payments on drugs
• 23 vertical programs including HIV/AIDs, Tuberculosis and Hepatitis C
• Global Fund support to HIV/AIDs and TB since 2004

4. The way towards Sustainable Development Goals
Better access to care
Better user experience
Better financial protection
WHO Barcelona Office for Health Systems Strengthening
Decentralization & Integration in Primary care
and Community Base Services (e.g. Georgia
Harm Reduction Network)
Focus on Quality and Performance
Measurement
Improved efficiency, Strategic Purchasing of
Health Services, payment mechanisms

5. Some examples of ongoing efforts for improving quality and access to
essential health services currently supported by the Global Fund and
other partners
• International partnership with Gilead to ensure access to free Hep C drugs for Hep C
elimination by 2020
– 90% of the population tested-95% of confirmed enrolled on treatment-95% of enrolled
cured
– Substantial progress made since the project launch
– In 2019 the International Liver Foundation recognized Georgia as the Center for Excellence
in Hep C elimination
• Integration of TB, HIV and Hepatitis C Services and greater decentralization at Primary care
level and within harm reduction services
– One window principle
– Shared use of GeneXpert capacity for TB and Hep C testing
• Results –based financing for TB care : Multidisciplinary approach to better case management
at outpatient level

6. Interventions to address Challenges of the Transitional Period
Service Standards approved
by the Ministry
Services delivered by Civil
Society Actors costed and
mechanisms for output
based financing introduced
Budget impact analysis
undertaken for harm
reduction and other
interventions supported by
the GF
Build capacity of Social
Service Agency and create
enabling environment for
CSO contracting for health
service delivery
Mechanisms to verify
outputs and outcomes
Key performance indicators
for quality monitoring and
Results Based Financing

7. Thanks for your attention!