Cooperation between Georgia and the USA in the field of public health and biomedical basic and applied sciences
(summary)

• The United States has supported Georgia for decades, during which Georgia has made significant progress and resilience in various fields. Cooperation in the field of health and life sciences development deserves special attention. Thanks to this support and assistance (for several decades), Georgia is now a leading country in the region in terms of surveillance and laboratory diagnostics capabilities, basic and applied biomedical research, trained personnel, etc.
• In partnership with the U.S. Government and donor organizations, Georgia is part of the Global Health Safety Program (GHSA) action Package: It is a leader in real-time surveillance with Norway and participates in a package of laboratory systems; a model country for hepatitis C elimination worldwide.; Georgia's achievements in the implementation of immunization, transmission of non-communicable and non-communicable diseases, especially in the research of dangerous infectious diseases, the development of high standards of biosafety and biosecurity, the implementation of guidelines for the prevention and control of infections; The development of scientific diplomacy; With the introduction of electronic surveillance systems and other areas.
• Georgia, and in particular the health and public health systems, has long-standing partnerships with such American institutions as the United States Agency for International Development (USAID), the National Institutes of Health (NIH) and related institutions: the National Institute of Allergy. and Infectious Diseases (NIIAD).), the National Cancer Institute (NCI), the Foundation for Civilian Research and Development (CRDF Global), the Biological Cooperation Program (BTEP), the US Centers for Disease Control and Prevention (CDC), the US Threat Reduction Agency (DTRA), the Walter Reed Institute for Military Studies (WRAIR), as well as leading American universities: Florida State University, University of Maryland, Emory University, Johns Hopkins University, University of Arizona, Los Alamos National Laboratory of the University of California, etc. )
• Thanks to the extensive technical and financial support of the U.S. government and the private sector, Georgian scientists and industry professionals were able to share their international experience through participation in short- and long-term trainings and conferences.
• The following are some of the outstanding achievements and successful results of cooperation within the framework of the above-mentioned cooperation:

In accordance with the principles of United Health, the United States Joint Biological Program (CBEP) was initiated in 2004, and with the direct assistance of DTRA, the foundation was laid for the construction of a High-level Biosafety Public Health Research Center (BSL 3) in Georgia, later named the U.S. Senator (CBEP). The name of one of the founders) - Richard Lugar and in 2013 merged with the National Center for Disease Control and Public Health and became its property as one of the integrated structural units. The Lugar Center includes 22 laboratories for the supervision of human and animal health throughout the country, of which 10 are under the jurisdiction of the Ministry of Refugees, Labor, Health and Social Protection from the Occupied Territories, and the remaining 12 are under the jurisdiction of the Ministry of Environment and Agriculture. The Lugar Center is the only BSL-3 laboratory in Georgia and the most powerful in the Caucasus and Central Asia region. Pathogens of infectious diseases, including especially dangerous pathogens, are stored in the DC National Repository of Bacteria and Viruses. The main objectives of the Lugar Center are: the safety of epidemiological and laboratory surveillance in the country; Rapid detection and confirmation of biological hazards; Participation in the package of laboratory systems of the Global Health Safety Program; Monitoring of reservoirs and transporters (zooentomological) in the country; Laboratory support for public health programs; Development of the potential of fundamental and applied biomedical research. The exclusive functions of the center include: diagnostics of especially dangerous pathogens, exotic and rare infections; Virological and molecular surveillance of influenza; Epidemiological surveillance of respiratory, diarrhoeal and enterovirus pathogens; Virological and molecular surveillance of polio; Epidemiological surveillance of rotavirus infections; Epidemiological surveillance of measles, measles and genotyping; Complete genome sequencing.
In the context of the COVID-19 pandemic, the Lugar Center plays one of the most important roles in terms of early detection and timely diagnosis of infection.

In 2015, with the support of the CDC, a hepatitis C and B serological study was conducted throughout Georgia, the main purpose of which was to determine the prevalence of hepatitis C among the population. The active infection, detected in about 150,000 people, formed the basis for the strategic planning of the Hepatitis C Eradication Program. With the support of the CDC and Gilead Sciences. Georgia has become an exemplary country in the world in terms of hepatitis C elimination. With the active support of the CDC, the State Program for the Elimination of Hepatitis C has been implemented since 2016, the goal of which is to examine 90% of those infected with hepatitis C by 2020, including the treatment of 95% and the cure of 95% of patients. the result of treatment. As part of the Hepatitis C Elimination Program, patients will receive expensive latest-generation medicines for free. The program covers research on screening, diagnosis, and monitoring of treatment.

Of the listed organizations, cooperation with the CDC should be particularly noted. In 1996, the CDC's structural and functional model was used to establish the Georgian National Center for Disease Control. To study infectious diseases and train Georgian epidemiologists, the CDC began its initial activities in Georgia in the mid-1990s, and in 2009 opened a representative office in Georgia, which conducted a number of important studies and programs for timely detection and response. and from the point of view of supervision. More than 70 epidemiologists, medical professionals, and veterinarians in Georgia have received professional training through the CDC's Field Epidemiology and Laboratory Training (FELTP) Program. It is the epidemiologists trained under this program who have played and continue to play an important role in improving epidemiological surveillance of COVID-19 and contact tracing.
The mission of the CDC in Georgia is to enhance the timely detection and response to epidemics at the institutional level through close collaboration with the Ministry of Labor, Health and Social Affairs and the National Center for Disease Control and Public Health.
The CDC provides technical support for various health risk factors through surveillance and human resource development. The CDC's activities in Georgia include the following areas: hepatitis, influenza, zoonotic, respiratory, diarrheal diseases, tuberculosis, nutrition, STDs, etc.

In May 2019, the National Center for Disease Control and Public Health was honored to host Robert Redfield, Director General of the U.S. Centers for Disease Control and Prevention (CDC), on an official visit to Georgia. The visit was historic because it was the first visit by such a high-ranking U.S. health official to Georgia. Mr. Redfield's visit was of particular importance for evaluating the results achieved by the CDC Director as part of the ongoing long-term successful partnership in public health between Georgia and the United States. During his meetings with senior Georgian government officials, Mr. Redfield highlighted Georgia's achievements in eliminating the hepatitis C virus, adhering to the principles of "general health" and improving monitoring systems for influenza and other diseases. For planning and hospitality, and also promised that he would definitely voice this in his country at various levels.

On November 6, 2019, a meeting was held between the leadership of the National Center for Disease Control and Public Health and a high-level delegation from the US CDC on future expanded activities with the CDC. At the meeting, the American side officially announced the decision of the head office in Atlanta to select Georgia as the country selected for the CDC Eurasian Platform and regional events starting in 2020.

The Water Reed Military Research Institute (WRAIR), a partner organization, and its structural component, the US Army Medical Research Unit (USAMRMC), also make a special contribution to strengthening the biomedicine sector. WRAIR's mandate promotes the provision of knowledge, technology, and facilities for biomedical research in partner countries.

WRAIR has been working at the Lugar Center since 2011 and collaborates to conduct joint research. Among the implemented scientific projects: research on current and emerging fever diseases; Laboratory diagnostic studies of antimicrobial resistance; New generation genomic sequencing projects; Molecular diagnostics of intestinal infections, etc.

Future plans for cooperation with 3 major US institutions (CDC, DTRA, WRAIR)

The CDC will support Lugar Center for the next 2 years to develop and improve COVID-19 combat capabilities.;
 Planning of activities to support the Lugar Center to enhance the role of the regional center: educational, biological and epidemiological surveillance, threat preparedness and response;
 Development of scientific diplomacy - promotion of science participation in international scientific conferences and symposiums and financial and technical support;
 Financing of scientific projects;