At a glance
Since 1995, CDC has collaborated with Georgia's National Center for Disease Control and Public Health (NCDC) to enhance public health in key areas. The focus includes strengthening surveillance and laboratory systems, workforce development, coordinating outbreak response, and supporting the development of NCDC as a true National Public Health Institute. Achievements range from training public health workers to Georgia's success in maintaining polio-free status for more than 20 years and achieving hepatitis B control.
Overview
CDC first collaborated with Georgia in 1995 to assist with the investigation of a large-scale diphtheria outbreak. CDC has also partnered with Georgia's NCDC on multiple scientific and disease control initiatives. This work has included the discovery of a new poxvirus (Akhmetapox) and a groundbreaking hepatitis C elimination program.
Since 2009, CDC has supported the training of epidemiologists from the region as part of the Field Epidemiology Training Program (FETP). CDC continues to partner with Georgia's NCDC, government ministries, and partner organizations to support global health security. CDC works to build upon the following capacities:
- Data and surveillance.
- Laboratory system strengthening.
- Workforce development and public health systems.
- Disease prevention and response.
- Health policy and communications.
Global health security
In 2023, Georgia was designated as a U.S. Intensive Support Partner Country for Health Security by the U.S. National Security Council. CDC's global health security work in Georgia focuses on providing support to strengthen the country's public health systems. It also focuses on addressing leading public health threats facing the country.
CDC's focus areas in Georgia include:
- Antimicrobial resistance
- Healthcare associated infections
- Pandemic respiratory threats
- Viral hepatitis
- Zoonotic diseases (including Crimean-Congo hemorrhagic fever, poxviruses, and rabies)
- Enteric diseases
- Mycotic diseases
Workforce development
After gaining independence from Russia in 1991, Georgia's public health workforce experienced little change. In 2022, the Georgia Ministry of Labor, Health, and Social Affairs requested CDC assistance. CDC supports work to develop a public health workforce strategy and improve recruitment and retention. Implementation of the strategy is expected to occur over the next five years with support from CDC.
CDC supports the training of public health professionals through the Field Epidemiology Training Program (FETP). The program consists of three levels of training: frontline, intermediate, and advanced. From 2009-2018, CDC trained 129 field epidemiologists from Georgia, Armenia, Azerbaijan, and Ukraine through the Advanced FETP.
In 2021, CDC launched the Eastern Europe and South Caucasus Intermediate FETP with participants from Georgia, Armenia, Azerbaijan, Ukraine, and Moldova. CDC also supports the Frontline FETP in Georgia. Through FETP, CDC strengthens country workforce capacity to identify and stop outbreaks before they spread. Many graduates now hold public health leadership positions in their countries.
Emergency response
CDC works to strengthen the capacity of the Emergency Operations Center (EOC) in Georgia. Since 2020, CDC has trained responders in the Public Health Emergency Management system and in emergency management fundamentals.
During the COVID-19 pandemic, CDC supported the expansion of sequencing capacity to enhance national and global surveillance of COVID-19 variants. CDC also collaborated on key preparedness and response activities including:
- Diagnostic testing
- Disease surveillance
- Vaccine distribution
- Training public health professionals.
Other CDC supported emergency response activities include:
- Supporting NCDC to host the Public Health Emergency Management Fellowship, adapted from the Atlanta-based program to address the unique needs of the region.
- Assessing health communications organizational and functional capacity during emergency and peacetime settings through the establishment of a Joint Information Center.
- Established a regional-level EOC in Kutaisi, West Georgia in 2021.
Laboratory systems strengthening
CDC partners with Georgia's NCDC to increase laboratory and workforce capacities in quality management systems, project management, and disease surveillance.
CDC collaborates with the Lugar Center for Public Health Research (LCPHR) on:
- Proficiency testing and educational trainings on basic microbiology.
- Laboratory testing.
- Bacteria isolation methods.
Through CDC support, the LCPHR has obtained various international accreditations laboratory testing and quality assurance.
CDC also facilitates genome sequencing for routine disease surveillance and detection of foodborne disease outbreaks.
Data modernization
CDC supports public health data system modernization. This work includes development and implementation of a national Laboratory Information Management System (LIMS), wastewater, viral hepatitis, and antimicrobial resistance surveillance data systems.
Data modernization efforts are critical to connect human and animal health with food safety and environmental health. These efforts help to rapidly identify and contain disease outbreaks across the country. Georgia's laboratories and LIMS are critical assets to the country's Global Health Security Agenda goals, One Health approach, and outbreak response.
Pandemic respiratory threats
Respiratory viruses remain one of the greatest threats to global health security. CDC works to strengthen Georgia's capacity to prevent the spread of diseases with epidemic and pandemic potential.
CDC has supported Georgia to:
- Train nearly 500 public health professionals during the COVID-19 pandemic in infection prevention and control protocols, laboratory diagnostics, and contact tracing.
- Develop and implement integrated surveillance for influenza-like illnesses and severe acute respiratory infections.
- Develop and implement wastewater surveillance for detecting SARS-CoV-2 and other viruses.
- Support expanded genomic sequencing capacity and reporting to the Global Initiative on Sharing All Influenza Data.
Viral hepatitis elimination
Georgia launched the world's first national hepatitis C elimination program in 2015. The program offers free testing and treatment to all citizens and is a global model for hepatitis elimination. In 2021, Georgia achieved reduction in chronic hepatitis C prevalence by 67%. More than 98% of people who completed chronic hepatitis C treatment were cured. In 2022, Georgia was designated a World Health Organization Collaborating Center for Viral Hepatitis Elimination.
CDC has supported the following activities:
- Genomic research of the hepatitis C virus.
- Development of the 2016-2020 and 2021-2025 strategic plan for hepatitis C elimination.
- Implementing nationwide nucleic acid testing on all blood donations that are part of the Blood Safety Program.
Zoonotic diseases
CDC implements a multisectoral One Health approach with partners to:
- Develop disease control guidelines.
- Strengthen surveillance and response capabilities for priority zoonotic diseases.
- Enhance genomic sequencing capacity.
CDC collaborates with Georgia's Ministry of Environmental Protection and Agriculture of Georgia and NCDC to:
- Build capacity for laboratory diagnostics, including whole genome sequencing.
- Conduct surveillance surveys on priority zoonotic pathogens.
- Respond to zoonotic, foodborne, waterborne, and enteric diseases outbreaks.
Key achievements
- 18 laboratories now participate in the CDC-supported hepatitis C External Quality Assurance (EQA) program
- 5 countries now participate in the Eastern Europe and Central Asia Intermediate FETP, which launched in 2021
- Georgia eliminated mother-to-child transmission of hepatitis B virus (HBV) and achieved the European regional HBV control goal
- Georgia achieved reduction in chronic hepatitis C prevalence by 67% and more than 98% of people who completed chronic hepatitis C treatment were cured
- Georgia was designated a World Health Organization Collaborating Center for Viral Hepatitis Elimination in 2023
- Georgia developed a National Antimicrobial Resistance (AMR) Surveillance Protocol in 2023 that was approved by the government
- Georgia developed and implemented a wastewater surveillance protocol for detecting viruses and initiated regular collection of wastewater as part of the pilot test for SARS-CoV-2 detection
- The LCPHR is internationally accredited to serve as an EQA provider for AMR detection in Georgia and across the region
- 25 laboratories of the Georgian AMR network now participate in the CDC-supported EQA program
- 25 laboratories of the Georgian AMR network now participate in the CDC-supported EQA program
Success story spotlight
Bird flu surveillance takes flight
The small country of Georgia is famous among researchers for sitting at the intersection of three major flyways used by wildfowl during migration: the Black Sea, Central Asian, and East Asian. This makes it a critical hub for surveillance of avian influenza, also known as bird flu.
Thanks to an innovative partnership between public health experts at CDC Georgia and academic experts from the University of Cambridge and Ilia State University, Georgia’s Ministry of Environmental Protection and Agriculture has successfully developed the capacity to conduct surveillance and genomic sequencing of bird flu viruses.
Academic partners brought knowledge, contacts, relationships, and research that combined seamlessly with CDC’s technical expertise, training, and local staff to make a significant impact on bird flu surveillance in Georgia. Using a One Health approach, these capacities help address a gap in global bird flu surveillance, protecting the world from emerging animal-to-human diseases.