From: Tamar Gabunia
Sent: Tuesday, April 14, 2020 2:14 AM
To: Volkan Cetinkaya
Cc: Ketevan Goginashvili ; Lika Gamgebeli ; Iryna Postolovska ; nino_moroshkina@yahoo.com; Adrien Arnoux Dozol ; Ha Thi Hong Nguyen ; liluashvilibeqa@gmail.com; Ana Kvernadze ; n.gagua@mof.ge
Subject: RE: focal points for COVID-19 project

Dear Volkan

Many thanks for your e-mail and follow up. Please find my responses below:

• Would the Ministry consider using Bank Facilitated Procurement (BFP) among other alternative procurement options? Our procurement specialist Tanvir informed us about this opportunity, if the Ministry is interested in, we can share the BFP request.  For some critical equipment such as ventilators, we heard that waiting period is quite long.- Ministry is currently using a standard emergency procurement mechanism. I will discuss with our procurement team if they would be interested in switching to BFP.
• Is the government already contracting with private facilities to deliver COVID-19 services or are there plans to do so? During the first call, if we recall correctly, you told us that an assessment of ICU/ventilator capacity at private facilities showed that there was sufficient supply of ventilators in Georgia to meet even the high-infection scenarios. If there is indeed sufficient availability of ventilators and ICUs, perhaps it may not be necessary to purchase additional ventilators for the public sector. The situation may differ by region – for example, if there are fewer private facilities with ICU/ventilator capacity near Abkhazia, there is a strong justification for investing to equip Rukhi hospital. It would be great if we could have more information on this. Is the private sector willing to provide such services?- As you know 85% of inpatient capacity in Georgia is private. The number of ventilators in private sector facilities is around 1700. 60% of this capacity is utilized at a time for other health conditions. Private providers have been engaged in COVID treatment however critical cases are being transferred to selected public facilities in Tbilisi. Rukhi hospital is currently being prepared for operations and we hope this will happen within the next couple of days with most basic services. The bed shortage is most severe in Samegrelo region with only 15 infection disease beds in Zugdidi and a 100 beds referral hospital (Private) which continues general health service delivery (except COVID). We consider full equipment of Rukhi clinical very important and people with COVID may experience other health emergencies and the hospital should be fully equipped to address those needs. As for ICU equipment it is indeed very urgent.
• If the private sector will be involved in the COVID-19 response, will the government procure personal protective equipment (PPE) and other supplies/consumables and distribute them to private facilities or will private facilities do this on their own?- As there is a shortage of PPE on a global and local market, for the time being the ministry decided to procure PPEs centrally and distribute them to clinics which are identified as Fever or COVID clinics, other providers would also need to enhance IC measures and procure adequate amount of PPEs. Ministry will only be providing PPEs within the COVID program for selected private and public health facilities. If is decision is changed and providers are able to procure PPEs by themselves, PPE cost will be included into the service tariff to be covered by the government.
• Could you also please provide the total number of existing (fully equipped) ICU beds in the public and private sectors?- Attached you can find the list of health facilities „ხელოვნური სუნთქვის აპარატები“ with the number of ICU beds with ventilators. There is also the list of facilities which are or will be involved in COVID response. Sorry these are in Georgian language. I assume local office can help with translation.

With best regards

Tamar  

Dear Tamar,

I hope this email find you well!  Have you had a chance to discuss implementation arrangement and investment priorities during your meeting on Friday?

Could you please help us by answering a few questions regarding Georgia’s approach to working with the private sector for COVID-19?

• Would the Ministry consider using Bank Facilitated Procurement (BFP) among other alternative procurement options? Our procurement specialist Tanvir informed us about this opportunity, if the Ministry is interested in, we can share the BFP request.  For some critical equipment such as ventilators, we heard that waiting period is quite long.
• Is the government already contracting with private facilities to deliver COVID-19 services or are there plans to do so? During the first call, if we recall correctly, you told us that an assessment of ICU/ventilator capacity at private facilities showed that there was sufficient supply of ventilators in Georgia to meet even the high-infection scenarios. If there is indeed sufficient availability of ventilators and ICUs, perhaps it may not be necessary to purchase additional ventilators for the public sector. The situation may differ by region – for example, if there are fewer private facilities with ICU/ventilator capacity near Abkhazia, there is a strong justification for investing to equip Rukhi hospital. It would be great if we could have more information on this. Is the private sector willing to provide such services?
• If the private sector will be involved in the COVID-19 response, will the government procure personal protective equipment (PPE) and other supplies/consumables and distribute them to private facilities or will private facilities do this on their own?
• Could you also please provide the total number of existing (fully equipped) ICU beds in the public and private sectors?

[External]