DOCSLIB.ORG

PWID and HCV Infection

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
PWID and HCV Infection TRANSLATING SCIENCE TO END HIV IN EASTERN EUROPE AND CENTRAL ASIA AIDS 2018 POST-CONFERENCE SYMPOSIUM Georgia, 20 June 2019 www.iasociety.org Panel discussion: HIV, Tuberculosis and Hepatitis - The path forward for prevention and treatment: which way forward for an integrated approach? Progress towards eliminating hepatitis C in Georgia: overcoming challenges through decentralization of services George Kamkamidze, MD, PhD, MS Head of Research Department, Health Research Union (HRU), Tbilisi, Georgia www.hru.ge www.iasociety.org HCV Treatment Sites within Elimination Program, January 31, 2019 (Total=40) Total of 40 treatment sites: • 32 specialty clinics • 8 primary care centers 3 sites Zugdidi Senaki Kutaisi Poti Ozurgeti 1 site Khashuri Gori Lanchkhuti Telavi Kobuleti 1 site Akhaltsikhe Gurjaani Tbilisi Batumi 1 site Rustavi 3 sites Akhalkalaki 1 site 155 physicians (ID specialists, gastroenterologist, primary care specialists ) Treatment Protocols April 2015 – March 2016 Sofosbuvir (SOF) IFN-containing and IFN-free SOF regimens recommended based on various clinical scenarios (genotype, cirrhosis, previous treatment experience) Since March 2016 Ledipasvir/Sofosbuvir (LDV/SOF) LDV/SOF is recommended in all genotypes Evidence supporting this recommendation included: - High prevalence of 2k/1b recombinant in Georgia - Results of some trials and observational studies indicating that LDV/SOF could be more effective that SOF alone Since December 2018 Velpatasvir/Sofosbuvir (VEL/SOF) RBV-containing and RBV-free regimens recommended based on cirrhosis and previous treatment experience Georgia Hepatitis C Elimination Program Care Cascade, April 28, 2015 – January 31, 2019 Positive Anti- HCV Test (Total)* 108.747 73.4% HCV Confirmatory Testing 79.819 85.2% HCV Confirmed Chronic Infection 68.010 80.7% Completed Work-up (Enrolled) 54.858 99.6% Case Reviewed by Committee 54.649 99.9% Authorized to Begin Treatment 54.589 97.8% Initiated HCV Treatment 53.393 93.4% Completed Treatment 49.853 94.6% Eligible for SVR 47.162 75.1% Tested for SVR 35.427 98.2% Cured 34.805 Patients initiating treatment, Georgia HCV elimination program, April 2015 – January 2019 5000 60000 4500 50000 4000 3500 40000 3000 2500 30000 2000 Patients Initiating Patients Initiating TreatmentperMonth 20000 Cumulative Patients Initiated Treatment 1500 1000 10000 500 0 0 Month of Treatment Initiation Patients Initiating Treatment Cumulative Initiated Treatment PWID and HCV infection PWID are a major source of the burden of HCV in the country as documented by the national HCV sero-survey conducted in 2015 Recent modeling indicates that priority treatment of PWID is needed to reach the elimination goals Milestones of HCV treatment integration initiative with HR services April, 2016 • Meeting on integration of HCV treatment with harm reduction services – during EASL meeting, Barcelona June, 2016 • Meeting of ECHO and CDC team with civil society representatives and NCDC at HRU/NEOLAB to discuss HCV treatment integration with HR services • TAG recommendations December 2017 • First meeting on HCV treatment decentralization March 2018 • The session on integrating HCV treatment with HR services at the 5th National Hepatitis C Elimination Workshop HCV treatment decentralization MOH Decentralization working group Harm Reduction Primary Health Care group group Concerns related to integrating HCV treatment with HR services • Unwillingness of HR center personnel • Low trust among patients and preference to be treated at specialized clinics • Quality of treatment and poorer outcome Study to evaluate barriers of integrated care Funded by CDC/TEPHINET • KAP survey of OST/NSP personnel on HCV care integration to evaluate readiness of health personnel to provide HCV care at OST/NSP sites. • Qualitative evaluation of HCV treatment integration to understand barriers and challenges of HCV integrated care • Patient satisfaction survey • Chart review form for patients enrolled in integrated care services 13 Patient satisfaction survey Question Answer % Is the location of medical facility convenient for you? Yes 93.3 How satisfactory are the conditions (building, waiting Good 97.9 space, sanitary conditions) at the medical facility? Are you satisfied with the attitude towards you from your Yes 98 doctor? Are you satisfied with the attitude towards you from the Yes 98 nurses? 14 Patient satisfaction survey Have you received comprehensive information about hepatitis C Yes 98% treatment and side effects? Do you think that your confidentiality is protected during HCV treatment? Yes 96.2% Do you think that it’s convenient to receive HCV treatment and Yes 98% methadone substitution therapy at the same clinic? In general, how would you assess HCV treatment services at this facility? Very Good 93.5% Will you recommend your family member/relative/friend (if interested) Yes 100% to be enrolled in National HCV Elimination Program? 15 Provider attitude to HCV treatment integrated services (IS) (N=81) Question Answer % Do you believe HCV treatment should be Yes 98 integrated with HR services Do you believe your institution has enough Yes 82.8 administrative resources for IS? Do you believe your institution has appropriate Yes 68.8 infrastructure for IS? Willing to have IS at their institution Yes 98 Simplified Algorithm of pre-treatment diagnostics Simplified Treatment Monitoring Algorithm Pilot project Integration of HCV treatment with harm reduction services Funded by CDC Goal and Objectives The goal of this project is to integrate HCV treatment with harm reduction services at four OST/NSP sites in different regions of Georgia Objective 1 To provide three NSP sites with security equipment to meet the MOH requirements to the facility for enrollment in HCV treatment Objective 2 To train personnel of NSP/OST sites enrolled in HCV treatment Objective 3 To introduce simplified testing algorithm among patients treated at harm reduction sites Objective 4 To monitor diagnostic and treatment process and to establish ECHO teleconsultations with the Hub Activities Facilitate enrollment in treatment program for 4 sites with different services: 3 sites (in Tbilisi, Zugdidi and Batumi) having on-site RNA testing (FIND study site, arm 1) One private OST site (using suboxone) with low linkage to HCV care rate Simplified regulation • This project needed regulatory changes from MOH to make possible treatment integration at HR centers • The basic security measures (camera, security system, lockers) on site • Physician on site (contracted) • Simplified diagnostic and monitoring algorithm • Contract with elimination program provider clinic 22 Outcomes of pilot project • Overall referral rate of patients from HR center to specialized clinics – 24% • Integration of hepatitis C care with HR services is likely feasible and it is highly acceptable for personnel providing HR services. • Based on experience of pilot sites, 4 new HR sites are selected for enrollment into HCV integrated treatment Challenges during the implementation of pilot project • The treatment integration process took longer than previously expected and planned. • The MOH regulatory agency requested multiple re-arrangements at HR sites to meet regulations for treatment integration. • Because these sites were not operating as medical facilities before HCV treatment was introduced, starting treatment process was challenging and several steps of adjustments were needed to meet all requirements. • Cases of personnel replacement and retraining needed • Lessons learned during this process will be very important for further enrollment of the new HR sites in HCV treatment program. Hepatitis C treatment outcome among people with history of drug use • Initial concerns among medical personnel and policy makers that PWID would have poor treatment compliance that would lead to poorer outcomes. • Study estimating RVR and SVR rates among patients reporting injecting drugs compared to those without a history of injection drug use (data from clinic Neolab) Comparison of the two study groups • Of the 4091 patients in the HCV elimination program by the time of analysis, 1775 (43.4%) had history of injecting drugs. • The two study groups were comparable in age and fibrosis stage. • Among PWID only 0.7% were females compared to 27.1% of females among non-PWID (p<0.0001). • Genotype 3 predominated among PWID (43.2%) vs. non-PWID (34.8%, p<0.001). • RVR was higher in PWID (97.3%) vs non-PWID (95.0%, p<0.01). • SVR rates were comparable (96.0% vs 95.0%, p=0.24) Comparison of two study groups Conclusion Treatment outcomes among PWID were similar to patients without history of drug use, suggesting that treatment adherence may be sufficiently similar to achieve reasonably comparable clinical outcomes. Barriers and Facilitators to Enrollment in HCV Treatment Program among PWIDs FUNDED BY MDM AND CDC 27 www.iasociety.org Methods “Linked to care” individual was defined as: – Having positive anti-HCV screening and RNA/Core antigen test in elimination database “Lost to follow-up” was defined as: – Not having HCV RNA or Core antigen test in the elimination database at 90th day from being screened anti-HCV positive Stratified sample of PWID having positive HCV antibody test between August 1, 2017 and January 31, 2018 and tested for HCV RNA/cAg Sample Size • The stratification was done by Georgian Harm Reduction Network (GHRN) • Proportional to size samples for lost to follow up and linked to care PWID were selected from each HR site • 13 HR centers located in 10 cities were participating
Load more

Recommended publications
  • Tour to Georgia 10 Days /9 Nights
    TOUR TO GEORGIA 10 DAYS /9 NIGHTS Day 1: Arrival at Tbilisi Meeting at the airport, transfer to the hotel. Free time. Overnight at the hotel in Tbilisi. Day 2. Tbilisi (B/L/-) Breakfast at the hotel. Tour of the historic part of the city, which begins with a visit to the Metekhi Temple, which is one of the most famous monuments in Tbilisi. This temple was honored in the 13th century, on the very edge of the stony shore of the Kura and the former fortress and residence of the Georgian kings. The first Georgian martyr, Queen Shushanika Ranskaya, was buried under the arches of the Metekhi temple. Inspection of the Tbilisi sulfur baths, which are built in the style of classical oriental architecture. These are low, squat buildings, covered with semicircular domes with large glass openings in the center, serving as windows that illuminate the interior, as the baths themselves are below ground level. In the old days, people here not only bathed, but also talked, lingering until dawn, and the city matchmakers arranged special days on special days. In the baths gave dinner parties, concluded trade deals. Walk on the square Maidan, which was the main shopping area of the city and along small streets known under the common name "Sharden". Narikala Fortress, which is the most ancient monument, a kind of "soul and heart of the city." The date of construction of the fortress is called approximately IV century AD, so it stands from the foundation of the city itself. Later, the fortress was expanded and completed several times.
    [Show full text]
  • Economic Prosperity Initiative
    USAID/GEORGIA DO2: Inclusive and Sustainable Economic Growth October 1, 2011 – September 31, 2012 Gagra Municipal (regional) Infrastructure Development (MID) ABKHAZIA # Municipality Region Project Title Gudauta Rehabilitation of Roads 1 Mtskheta 3.852 km; 11 streets : Mtskheta- : Mtanee Rehabilitation of Roads SOKHUMI : : 1$Mestia : 2 Dushet 2.240 km; 7 streets :: : ::: Rehabilitation of Pushkin Gulripshi : 3 Gori street 0.92 km : Chazhashi B l a c k S e a :%, Rehabilitaion of Gorijvari : 4 Gori Shida Kartli road 1.45 km : Lentekhi Rehabilitation of Nationwide Projects: Ochamchire SAMEGRELO- 5 Kareli Sagholasheni-Dvani 12 km : Highway - DCA Basisbank ZEMO SVANETI RACHA-LECHKHUMI rehabilitaiosn Roads in Oni Etseri - DCA Bank Republic Lia*#*# 6 Oni 2.452 km, 5 streets *#Sachino : KVEMO SVANETI Stepantsminda - DCA Alliance Group 1$ Gali *#Mukhuri Tsageri Shatili %, Racha- *#1$ Tsalenjikha Abari Rehabilitation of Headwork Khvanchkara #0#0 Lechkhumi - DCA Crystal Obuji*#*# *#Khabume # 7 Oni of Drinking Water on Oni for Nakipu 0 Likheti 3 400 individuals - Black Sea Regional Transmission ZUGDIDI1$ *# Chkhorotsku1$*# ]^!( Oni Planning Project (Phase 2) Chitatskaro 1$!( Letsurtsume Bareuli #0 - Georgia Education Management Project (EMP) Akhalkhibula AMBROLAURI %,Tsaishi ]^!( *#Lesichine Martvili - Georgia Primary Education Project (G-Pried) MTSKHETA- Khamiskuri%, Kheta Shua*#Zana 1$ - GNEWRC Partnership Program %, Khorshi Perevi SOUTH MTIANETI Khobi *# *#Eki Khoni Tskaltubo Khresili Tkibuli#0 #0 - HICD Plus #0 ]^1$ OSSETIA 1$ 1$!( Menji *#Dzveli
    [Show full text]
  • Evaluation of the Hepatitis C Care Cascade in the Country of Georgia: Monitoring Progress Towards Elimination
    IVHEM 2019. November 22-23, 2019, Amsterdam EVALUATION OF THE HEPATITIS C CARE CASCADE IN THE COUNTRY OF GEORGIA: MONITORING PROGRESS TOWARDS ELIMINATION Tengiz Tsertsvadze,1,2 Amiran Gamkrelidze,3 Nikoloz Chkhartishvili,1 Akaki Abutidze,1 Lali Sharvadze,2,4 Maia Butsashvili,5 David Metreveli,6 Lia Gvinjilia,7 Shaun Shadaker,8 Muazzam Nasrullah,8 Tamar Gabunia, 9 Ekaterine Adamia,9 Stefan Zeuzem,10 Nezam Afdhal,11 Sanjeev Arora,12 Karla Thornton,12 Francisco Averhoff8 1Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; 2Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia; 3National Center for Disease Control and Public Health, Tbilisi, Georgia; 4Hepatology clinic HEPA, Tbilisi, Georgia; 5Health Research Union, Tbilisi, Georgia; 6Medical Center Mrcheveli, Tbilisi, Georgia; 7CDC Foundation, Tbilisi, Georgia; 8Centers for Disease Control and Prevention, Division of Viral Hepatitis National Center for HIV, Hepatitis, STD&TB Prevention, Atlanta, USA; 9Ministry of IDPs, Labour, Health and Social Affairs of Georgia, Tbilisi, Georgia; 10Goethe University Hospital, Frankfurt, Germany; 11Beth Israel Deaconess Medical Center Liver Center, Boston, USA; 12University of New Mexico, Albuquerque, USA Infectious Diseases, AIDS and Clinical Immunology Research Center Disclosure No relevant financial relationship exists Infectious Diseases, AIDS and Clinical Immunology Research Center 12 COUNTRIES WORLDWIDE ON TRACK TO ELIMINATE HEPATITIS C INFECTION BY 2030 Georgia’s HCV elimination program builds on delivering
    [Show full text]
  • Assessment of Citizen Engagement Practices in the Municipalities of Batumi, Kutaisi and Akhaltsikhe
    Assessment of Citizen Engagement Practices in the Municipalities of Batumi, Kutaisi and Akhaltsikhe The assessment has been conducted by the Institute for Development of Freedom of Information (IDFI), within the framework of the project “New E-Governance Initiatives to meet OGP Commitments in Georgia”, funded by the Good Governance Initiative (GGI) in Georgia project of the United States Agency for International Development (USAID) and the Ministry of Foreign Affairs of Estonia. The study has been prepared by the Institute for Development of Freedom of Information (IDFI) and the opinions expressed herein do not necessarily reflect those of the United States Agency for International Development (USAID), the Good Governance Initiative (GGI) in Georgia project, the United States government or the Ministry of Foreign Affairs of Estonia. Author: Saba Buadze Editor: Levan Avalishvili Reviewed by: Mamuka Abuladze March 2017 Tbilisi 1 Contents Introduction ................................................................................................................................................... 3 General Context & Legal Framework ........................................................................................................... 4 Main Observations ..................................................................................................................................... 7 Public Participation Practices in Batumi .................................................................................................. 8 Public
    [Show full text]
  • Pdf | 18.24 Kb
    Current Humanitarian & Rehabilitative Programs in Samtskhe-Javakheti Compiled by OCHA with information provided by the respective agencies, March 2001 (version 1.1) ORGANISATION ACTIVITY LOCATION OF NUMBER OF TOTAL FUNDING TOTAL EXPECTED DONORS ACTIVITY BENEFICIARIES 2000 (US$) LEVEL 2001 (US$) BILATERAL DONORS USAID 1. Emergency loan Samtskhe- 1. 2,450 1. 150,000 1. 200,000 United States Agency program for drought- Javakheti 2. 2,000 farming 2. 249,983 2. Not available for International affected farmers households Development 2. Drought relief UN AGENCIES UNICEF 1. Introduction of the Georgia-wide 1. N/A 1. 40,000 Not available UNICEF, USAID, United Nations active learning 2. 186,000 2. 634,700 German Natcom Children’s Fund methodology 2. Immunization OCHA 1. Humanitarian advocacy Georgia-wide N/A 336,140 599,159 PRM United Nations Office 2. Facilitating co- Switzerland for the Coordination ordination of Humanitarian 3. Information exchange Affairs 4. Resource mobilization UNV 1. Confidence building Ninotsminda N/A 1. 1,500 Not confirmed Bridge funding United Nations 2. Regional rehabilitation 2. 2,000 Volunteers UN WFP Emergency food assistance Samtskhe-Javakheti 46,200 N/A 544,779 WFP donor countries World Food Program to drought-affected population INTERNATIONAL ORGANISATIONS International 1. Community 1. Borjomi 1. Georgia-wide 1. 438,353 N/A 1. USAID development for IDPs 2. Akhaltsikhe 8,000 2. 14,970 2. PRM Federation 2. Population Movement 3. Borjomi 2. Georgia-wide 3. 198,802 3. SDS International 3. Rehabilitation of water 4. Samtskhe- 2,500 4. N/A 4. WFP Federation of Red sanitation in collective Javakheti 3.
    [Show full text]
  • Ten-Year Development Plan for Georgian Gas Transmission Network 2018-2027
    Ten-Year Development Plan for Georgian Gas Transmission Network 2018-2027 October 2017 1 The document represents a 10-year Georgian gas transmission and related infrastructure development plan. It was prepared on the basis of 2016 and 2017 year editions of “10-Year Development Plan for Georgian Gas Transmission Infrastructure)’’, considering the actual situation of current period. The 10-year Gas Network Development Plan was discussed with the Georgian Gas Transportation Company, presented to the Ministry of Energy of Georgia, the Georgian National Energy Regulatory Commission and other stakeholders. Consultations regarding the information used in and information on the project implementation of the 10-year Gas Network Development Plan can be obtained from GOGC Strategic Planning and Projects Department. Head of the Department: Teimuraz Gochitashvili, Dr. Sci, professor, Tel: +(995 32) 2244040 (414); E-mail: [email protected] 2 Contents Abbreviations ...........................................................................................................................4 Executive summary ..................................................................................................................5 1. Introduction .....................................................................................................................7 1.1. General provisions............................................................................................................ 7 1.2. Formal and methodological basis for preparing the plan ..............................................
    [Show full text]
  • ADVISORY ASSISTANCE to the MINISTRY of ENERGY of GEORGIA “Power Trip”
    “Power Trip” Campaign ADVISORY ASSISTANCE TO THE MINISTRY OF ENERGY OF GEORGIA “Power Trip” Campaign The film “Power Trip” by Paul Devlin was broadcasted on the TV Channel Rustavi 2 and shown on three regional town hall meetings in: Kutaisi, Akhaltsikhe and Zugdidi. October 2005 This publication was produced for review by the United States Agency for International Development. It was prepared by CORE International, Inc. 1 Advisory Assistance to the Ministry of Energy of Georgia, Public Outreach Strategic Plan Implementation Success Story – “Power Trip” Campaign Activity Date: Summer-Fall, 2005 Contact By: P. Ballonoff, B. Tsirekidze CORE - “Advisory Assistant to the Ministry of Energy” a USAID Project Method: Regional Town Hall Meetings, dedicated to broadcast the film, produced by Paul Devlin “Power Trip”. CORE - “Advisory Assistant to the Ministry of Energy” a USAID Project, Organization/Company P. Ballonoff - Chief of Party Name: B. Tsirekidze – Communication and Public Participation Expert Address: 10 Lermontov Str. 0105 Tbilisi, Georgia Tel/Fax: + 995 32 439020/+995 32 439022 E-Mail: [email protected] Cooperation In terms of organization of regional broadcasting of the film, CORE cooperated with/Participant/Speaker: with following organization: Name: (i). Ministry of Energy of Georgia (ii). Head office and Akhaltsikhe regional representation of Liberty Institute; (iii). Head office and regional representations of UEDC; (iv). Local governments in Kutaisi and Zugdidi REPORT In the scope of “Power Trip” campaign, it was planned to broadcast the film “Power Trip” by Paul Devlin on TV Channel Rustavi 2 and at three specially organized regional town hall meetings in Kutaisi, Akhaltsikhe and Zugdidi.
    [Show full text]
  • GEORGIA Second Edition March 2010
    WHO DOES WHAT WHERE IN DISASTER RISK REDUCTION IN GEORGIA Second edition March 2010 Georgian National Committee of Disaster Risk Reduction & Environment Sustainable Development FOREWORD Georgia is a highly disaster-prone country, which frequently experiences natural hazards (e.g. earthquakes, floods, landslides, mudflows, avalanches, and drought) as well as man-made emergencies (e.g. industrial accidents and traffic accidents). Compounding factors such as demographic change, unplanned urbanization, poorly maintained infrastructure, lax enforcement of safety standards, socio-economic inequities, epidemics, environmental degradation and climate variability amplify the frequency and intensity of disasters and call for a proactive and multi-hazard approach. Disaster risk reduction is a cross-cutting and complex development issue. It requires political and legal commitment, public understanding, scientific knowledge, careful development planning, responsible enforcement of policies and legislation, people-centred early warning systems, and effective disaster preparedness and response mechanisms. Close collaboration of policy-makers, scientists, urban planners, engineers, architects, development workers and civil society representatives is a precondition for adopting a comprehensive approach and inventing adequate solutions. Multi-stakeholder and inter-agency platforms can help provide and mobilize knowledge, skills and resources required for mainstreaming disaster risk reduction into development policies, for coordination of planning and programmes,
    [Show full text]
  • Enhancing Capacity for Low Emission Development Strategies Beling by DISPLAY
    DISPLAY TRAINING In July, Green Building Council Georgia conducted training on Building Energy La- Quarterly Newsletter Enhancing Capacity For Low Emission Development Strategies beling by DISPLAY. The training included how to use the online tool designed and maintained by Energy Cities. Originally it was intended for use by municipalities – EC-LEDS Covenant of Mayors’ signatories--but now it has become a management instrument for other interested parties as well, including NGOs, ministries, and the private sec- Summer 2015 Clean Energy Program tor. Currently DISPLAY is used by more than 400 municipalities in 27 countries. It contributes to the implementation of European Building Performance Directives that will become mandatory for Georgia after Georgian legislation is harmonized with AMERICA DAYS 2015 European law, as per a recently signed Association Agreement. In addition to the EU directive, DISPLAY includes water efficiency and other recommendations that are From June 1 to 6 the U.S. Embassy celebrated not required, and was chosen by the EC-LEDS program from among other systems America Days to showcase American culture and of building labeling because of its wide coverage and its ease of use. It is accessible U.S.-supported programs in four Georgian cities - from any work station and has been adapted to Georgian climate data and lan- guage. - Zugdidi, Akhaltsikhe, Gori and Tbilisi. Organizing an Information Fair, the Embassy In August, GBC-Ge conducted a series of information meetings on DISPLAY for cities that are signatories to Covenant of Mayors and for those who are preparing Sus- showed visitors about assistance programs, edu- tainable Energy Action Plans (SEAP).
    [Show full text]
  • Realizing the Urban Potential in Georgia: National Urban Assessment
    REALIZING THE URBAN POTENTIAL IN GEORGIA National Urban Assessment ASIAN DEVELOPMENT BANK REALIZING THE URBAN POTENTIAL IN GEORGIA NATIONAL URBAN ASSESSMENT ASIAN DEVELOPMENT BANK Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) © 2016 Asian Development Bank 6 ADB Avenue, Mandaluyong City, 1550 Metro Manila, Philippines Tel +63 2 632 4444; Fax +63 2 636 2444 www.adb.org Some rights reserved. Published in 2016. Printed in the Philippines. ISBN 978-92-9257-352-2 (Print), 978-92-9257-353-9 (e-ISBN) Publication Stock No. RPT168254 Cataloging-In-Publication Data Asian Development Bank. Realizing the urban potential in Georgia—National urban assessment. Mandaluyong City, Philippines: Asian Development Bank, 2016. 1. Urban development.2. Georgia.3. National urban assessment, strategy, and road maps. I. Asian Development Bank. The views expressed in this publication are those of the authors and do not necessarily reflect the views and policies of the Asian Development Bank (ADB) or its Board of Governors or the governments they represent. ADB does not guarantee the accuracy of the data included in this publication and accepts no responsibility for any consequence of their use. This publication was finalized in November 2015 and statistical data used was from the National Statistics Office of Georgia as available at the time on http://www.geostat.ge The mention of specific companies or products of manufacturers does not imply that they are endorsed or recommended by ADB in preference to others of a similar nature that are not mentioned. By making any designation of or reference to a particular territory or geographic area, or by using the term “country” in this document, ADB does not intend to make any judgments as to the legal or other status of any territory or area.
    [Show full text]
  • Quarterly Progress Report Georgia Communities
    QUARTERLY PROGRESS REPORT GEORGIA COMMUNITIES EMPOWERED FOR LOCAL DECISION-MAKING APRIL TO JUNE 2005 Prepared for Prepared by William E. Krause The Urban Institute Georgia Communities Empowered for Local Decision-Making United States Agency for International Development Cooperative Agreement No. 114-A-00-04-00131-00 THE URBAN INSTITUTE 2100 M Street, NW Washington, DC 20037 (202) 833-7200 July 2005 www.urban.org UI Project 07755-000-00 TABLE OF CONTENTS I. Highlights ..............................................................................................................................................2 II. Progress of Major Activities...................................................................................................................3 III. Deliverables and Reports....................................................................................................................12 IV. Problems or Delays Affecting Performance ........................................................................................13 V. Work Planned for Next Reporting Period ............................................................................................13 VI. Specific Action Requested ..................................................................................................................15 QUARTERLY PROGRESS REPORT APRIL TO JUNE 2005 GEORGIA COMMUNITIES EMPOWERED FOR LOCAL DECISION-MAKING Cooperative Agreement No.: 114-A-00-04-00131-00 Date of Issuance: September 23, 2004 Amount Obligated: $5,000,000 Total Potential
    [Show full text]
  • Causes of War Prospects for Peace
    Georgian Orthodox Church Konrad-Adenauer-Stiftung CAUSES OF WAR PROS P E C TS FOR PEA C E Tbilisi, 2009 1 On December 2-3, 2008 the Holy Synod of the Georgian Orthodox Church and the Konrad-Adenauer-Stiftung held a scientific conference on the theme: Causes of War - Prospects for Peace. The main purpose of the conference was to show the essence of the existing conflicts in Georgia and to prepare objective scientific and information basis. This book is a collection of conference reports and discussion materials that on the request of the editorial board has been presented in article format. Publishers: Metropolitan Ananya Japaridze Katia Christina Plate Bidzina Lebanidze Nato Asatiani Editorial board: Archimandrite Adam (Akhaladze), Tamaz Beradze, Rozeta Gujejiani, Roland Topchishvili, Mariam Lordkipanidze, Lela Margiani, Tariel Putkaradze, Bezhan Khorava Reviewers: Zurab Tvalchrelidze Revaz Sherozia Giorgi Cheishvili Otar Janelidze Editorial board wishes to acknowledge the assistance of Irina Bibileishvili, Merab Gvazava, Nia Gogokhia, Ekaterine Dadiani, Zviad Kvilitaia, Giorgi Cheishvili, Kakhaber Tsulaia. ISBN 2345632456 Printed by CGS ltd 2 Preface by His Holiness and Beatitude Catholicos-Patriarch of All Georgia ILIA II; Opening Words to the Conference 5 Preface by Katja Christina Plate, Head of the Regional Office for Political Dialogue in the South Caucasus of the Konrad-Adenauer-Stiftung; Opening Words to the Conference 8 Abkhazia: Historical-Political and Ethnic Processes Tamaz Beradze, Konstantine Topuria, Bezhan Khorava - A
    [Show full text]