European project SCORCH kick-off meeting Supportive Risk Awareness and Communication to Reduce impact of Cross-Border Heatwaves Heidelberg University, Germany, March 27-29 , 2019 Environmental Health Challenges and Priorities for Georgia Nia Giuashvili MD, MPH National Center for Disease Control and Public Health, Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia დაავადებათა კონტროლისა და საზოგადოებრივი ჯანმრთელობის ეროვნული ცენტრი Georgian National Center for Diseases Control and Public Health www.ncdc.ge
NCDC is a central public health and research institution under the authority of Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs Established in 1996 on the basis of CDC / Atlanta Functional Structure 1937 Establishment of the Anti-Plague Station in Georgia 1992 Research Center of Especially Dangerous Pathogens ( EDPs ) 1996 National Center for Disease Control 2004- As a result of large-scale reorganization: Integration of 2007 Medical Statistics Center and Public Health Department 2013 Integration of R. Lugar Center for Public Health Research National Center for Disease Control & Public Health www.ncdc.ge
NCDC Strategic Priorities Decrease of Morbidity, Disability and Mortality caused by Communicable Diseases and Non-Communicable Diseases Assessment and correction of environmental hazards and behavioral risk-factors for improvement of health in population Development of applied and fundamental bio-medical and bio- technological scientific research potential Strengthen preparedness capacities for rapid and effective response to the public health threats Develop electronic information systems National Center for Disease Control & Public Health www.ncdc.ge
Non-Laboratory Part of NCDC Medical Statistics Environmental State Public Surveillance of Surveillance of Non- Health Health Programs: Communicable communicable - Early Disease Detection and Public Health Diseases: Diseases: Screening Preparedness and - Epidemiological Surveillance Response - VPD - CVD - Immunization - Blood Safety - Diarrheal - Cancer Quality Control - TB Management - Vector borne - Diabetes - HIV/AIDS Management - Respiratory - CRD - Maternal and Child Health - Zoonotic - Risk- factors GF Programs - Prevention of - Parasitic - Health promotion Occupational Diseases - Hepatitis /STI/HIV/ TB - Tobacco Control - Health Promotion Strengthening - HCV Screening International Collaboration Training Center National Center for Disease Control & Public Health www.ncdc.ge
R. Lugar Center for Public Health Research Accreditation & Certification – NCDC / Lugar Center Virology , , Molecular Bio-safety and Biology and EDP Department Genomic Department 3 Labs accredited by WHO Molecular Bio-Safety - Polio Epidemiology / Division Genomics Influenza - - Measles/Rubella Influenza and National Respiratory Repository Viruses Lab 5 Labs Connected to WHO Polio and other Lab Network with EQA EDP Lab Entero viruses lab - Rota - Invasive Zoo-Entomology Meningitis Cell Culture Lab Lab - Malaria - Salmonelosis General Serology Lab – Bacteriology Lab - AMR HCV Research Subunit Vivarium Sample Receiving group National Center for Disease Control and www.ncdc.ge Public Health
Surveillance System Under “One Health” Concept 194 sites: Human / Veterinary 2 sites Human sites: 90 Veterinary sites: 102 Population based surveillance: 72 diseases/conditions are reported through surveillance sys tem Two types of notification: urgent and aggregated Urgent – 52 diseases/conditions Reporting and epi investigation is performed by PHC worker s Syndromes under surveillance: Sentinel surveillance : AFP - ILI /SARI Diarrheal diseases - Rotovirus Food poisoning - Invasive meningitis National Center for Disease Control & Public Health www.ncdc.ge
National Immunization Program Achievements Vaccination coverage Vaccination Schedule Immunization program budget, Gel 25.000.000 22.400.000 17.926.000 20.000.000 16.205.000 15.000.000 11.174.000 10.000.000 5.943.000 4.431.000 2.751.000 5.000.000 0 2012 2013 2014 2015 2016 2017 2018 დაავადებათა კონტროლისა და საზოგადოებრივი დაავადებათა კონტროლისა და საზოგადოებრივი National Center for Disease Control and Public Health National Center for Disease Control & Public Health www.ncdc.ge National Center for Disease Control & Public Health www.ncdc.ge www.ncdc.ge www.ncdc.ge www.ncdc.ge ჯანმრთელობის ეროვნული ცენტრი ჯანმრთელობის ეროვნული ცენტრი
Hepatitis C Elimination Program in Georgia Goal Elimination of HCV by ensuring prevention, diagnostics and treatment of the disease Targets Initiated treatment 50 000 90-95-95 Completed treatment 44 000 By 2020 90% of people living with HCV are diagnosed Overall cure rate - 98.2% (April 2018) 95% of those diagnosed are treated 95% of those treated are cured დაავადებათა კონტროლისა და საზოგადოებრივი დაავადებათა კონტროლისა და საზოგადოებრივი National Center for Disease Control & Public Health www.ncdc.ge www.ncdc.ge www.ncdc.ge ჯანმრთელობის ეროვნული ცენტრი ჯანმრთელობის ეროვნული ცენტრი
Establishment of new Public Health Preparedness and Emergency Preparedness Response Division in 2016; and Response The revision of Epidemics, Pandemics and Biological Incidents Response Plan Updating/Developing disease specific plans; Public health preparedness and response study tour to CDC-Atlanta The Public Health Emergency Management (PHEM) Fellowship at CDC NCDC was designated as the national IHR Focal Point; WHO IHR was fully implemented in 2012; 24/7 Duty Officer System is established; GHSA has become a new vision for Georgia since 2014: Real-Time Surveillance - as a leading country National Laboratory System – as the contributing country GHSA IHR Zoonotic Diseases – as the contributing country As Georgia is active in contribution to Regional Disease Surveillance, it is chairing The Biosurveillance Network of the Silk Road (BNSR); National Center for Disease Control and Public Health www.ncdc.ge
WHO CDC / Atlanta DTRA UNFPA WRAIR UNICEF NIH USAID WB NCDC FAO / OIE EU GAVI ALLIANCE Principal Recipient of GFTAM Grants Universities, Research Centers, Public Health institutions: University of Florida, University of Maryland, Emory University, Johns Hopkins University, North Arizona University, Bundeswehr Institute of Microbiology, University of Oslo, The Italian National Institute of Health, German Environment Agency, Public Health England etc. National Center for Disease Control & Public Health www.ncdc.ge
Georgia. 2012. Disease Burden and Deaths Attributable to the environment Source: WHO Global Health Observatory data repository 400000 352203 350000 21% 295626 25% 300000 250000 DALYs Deaths 200000 150000 100000 38740 17838 12362 11660 50000 530 172 0 22% DALYs WHO Global 23%Deaths დაავადებათა კონტროლისა და საზოგადოებრივი ჯანმრთელობის ეროვნული ცენტრი Georgian National Center for Diseases Control and Public Health www.ncdc.ge
Air Pollution and Health SDG indicator 3.9.1.: Mortality rate attributed to household and ambient air pollution. Georgia.2016 Lower respiratory 6845 SDG 3.9.1. 14 7 7 Index/per infections Deaths 100 000 259 Trachea, bronchus, 205 54 lung cancers Ischemic heart 4092 2086 2006 disease 1886 Stroke 884 1002 Global 94.8 WHO ER 60.8 3489 595 3356 COPD 288 307 Georgia 184.0 Source: WHO World Health Statistics 2016Georgia 184. 184.0 დაავადებათა კონტროლისა და საზოგადოებრივი ჯანმრთელობის ეროვნული ცენტრი Georgian National Center for Diseases Control and Public Health www.ncdc.ge
Water and Sanitation Burden of disease attributable to water, sanitation and hygiene, for the year 2016. WHO. Georgia 7 4 3 WSH Deaths Total (95%CI) - Diarrhea Total WSH 2 0-4 years DALYs (95%CI) Regulation of water 1436 consumption represents one of major challenges not only for water supply system and sanitation, but also for effective environmental activities and 0-4 sustainable develop- years ment . 744 691 557 Source: WHO/UNICEF Joint Monitoring Programme estimated trends on water coverage for Georgia Source: WHO (PHE). BoD_WSH_2016_Georgia.pdf დაავადებათა კონტროლისა და საზოგადოებრივი ჯანმრთელობის ეროვნული ცენტრი Georgian National Center for Diseases Control and Public Health www.ncdc.ge
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