Sending a quick update of HCV treatment decentralization process in harm reduction centers, as this topic will be discussed at TAG meeting.

- All equipment was purchased in February-March and installed. 

- The SOPs and other required documents were prepared. 

- All 4 sites contracted primary care physicians.

- The application to start HCV treatment was submitted to MOH in April, 2019.

- In Summer one center (HR center "Hepa plus")  was visited by regulation department  team and some additional documents were requested, which were immediately submitted. - - No technical barriers were noted by the team. 

- No other sites were visited.

- After that this topic was discussed at State Committee meeting in September, where the new requirement was presented by the representative of MOH (Kakha Chkhartishvili) about having so called "laboratory doctor", which is not relevant (and in fact is not required when only rapid tests are done on site) and appropriate explanations were given by NCDC lab manager Maia Alkhazashvili to him. 

- After this no more advancements were made and we are expecting the further recommendations from regulatory department or visit to the same and/or remaining sites.

The project is ending this year and we still have 3 types of technical and clinical training to conduct for managers, medication release persons, physicians and nurses (including working with elimination program database) and also we have to conduct contentious assistance and monitoring during at least 3 months after we start the treatment (in real life even longer assistance is needed, as shown during the last pilot project). 

Accordingly, I will have to request no-cost extension of the project for 6 months, at least.   

Thank you

Maia