Equal access to health care services – Universal Health Coverage
Right to health is a fundamental part of human rights. Enjoyment of the highest attainable standard of physical and mental health is essential for building quality lives for everyone.
Universal health coverage (UHC) is crucial for achieving the Sustainable Development Goal 3 and is an important way to expand access to effective health-care services, reduce financial hardship during illness and improve health outcomes.
The Universal Health Care Program launched by the Government of Georgia in 2013 has led to a major expansion in population entitlement to publicly financed health services, from 29% to over 94% of the population.
The UHC reform has improved access to health care. Financial barriers have declined, mainly for outpatient visits and hospital care and therefore, utilization of health services has been increased. Until 2013, the number of outpatient visits did not exceed 2 visits per person annually; in 2013 the number of visits rose till 2.7 and in 2018 till 3.7 and exceeded the level recommended by the World Bank for developing countries.
In July 2017, the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health, and Social Affairs of Georgia introduced policies for further protection of poorer and sicker, persons with disabilities and retired people by expanding their benefit package and including medicines for major Non-Communicable Diseases – cardio-vascular, type 2 diabetes, obstructive pulmonary disease, thyroid conditions, which together with cancer account for more than 80% of the burden of disease in Georgia.
Hepatitis C Elimination Program in Georgia
Hepatitis C virus (HCV) infection is a major public health burden in many parts of the world, including Georgia. According to the population-based seroprevalence survey of 2015 an estimated 7.7% of Georgian population was living with hepatitis C virus (HCV) and the prevalence of active disease was 5.4%. Interferon-based treatment options were complex and poorly tolerated.
Recognizing the growing HCV burden, financial barriers for population to receive modern treatment regimens and expensive medications, the Government of Georgia stepped up its efforts to combat this extremely dangerous public health threat through elimination of Hepatitis C and started intensive negotiations with different stakeholders. As a result, in 2015, after fruitful collaboration with WHO, US Centers for Disease Control and Public Health, Pharmaceutical Company Gilead Science Int. an unprecedented HCV Elimination Program was launched.
Since the launch of the program, 1.7 million people were screened for Hepatitis C virus, more then 58 000 out of registered patients have started treatment with sofosbuvir, sofosburiv/ledipasvir-based treatment regimens and more than 54 000 patients completed treatment. SVR was achieved in 98% cases.
Through universal access to HCV diagnostics and treatment, HCV burden in Georgia is gradually being eliminated. The project itself is the best example of the successful public-private partnership.
To achieve the HCV elimination goal, Georgia set forth the following 2020 targets: a) identifying 90% of HCV-infected persons; b) treating 95% of people with chronic HCV infection; and c) curing 95% of persons treated of their HCV infection.
Reforms in the penitentiary system: No more torture and epidemic in Georgian jails
The core challenge for the new Georgian Government since October 2012 has been the legacy of politicised, repressive criminal justice system and an extremely poor human rights record it inherited. Systemic disregard of human rights by the state had a devastating effect on the penitentiary system.
The policy embraced by the Government is aimed at ensuring maximum protection of the rights of inmates, eradicate torture and inhuman treatment, improve imprisonment conditions and promote re-socialization/rehabilitation.
Both internal and external monitoring mechanisms have been strengthened and improved. The Public Defender and the members of the National Prevention Mechanism have unimpeded access to the penitentiary establishments and are provided with the right to take photos of inmates and their detention conditions to document potential abuses. The new rules on prisoners’ registration and photographing are adopted in line with the recommendations of Istanbul protocol.
The intensive efforts are taken to provide decent living conditions in the penitentiary system; some of the facilities are closed down due to inappropriate conditions; minimum living space per prisoner increased from 2 to 4 square meters. As a result of improved early conditional release mechanisms and the amendments introduced to the relevant legislation, the prison population reduced from 24 114 (as of December 2011) to 9 500.
Introduction of individual sentence planning and risk assessment mechanisms were main novelties in the basic reforms to ensure public safety, promote positive changes amongst the convicted inmates, assist inmates in the process of preparation for release and ultimately reduce the risk of reoffending.
The penitentiary healthcare service has significantly improved resulting in substantial decrease of Prison Mortality Rate. State programs for treatment of Hepatitis C and Tuberculosis are fully functioning; suicide prevention program is implemented in all penitentiary establishments.
The overall objective of the penitentiary system is to keep inmates physically and mentally in good state of health through engaging them in different activities. This policy is pursued to promote their readiness to get back to normal life with less risk of reoffending. Currently penitentiary system offers a wide range of VET programs, psycho-social therapy, general, and higher education through distance learning, also various employment opportunities.
Moreover, the platform – www.online.moc.gov.ge helps inmates to sell their handmade items online and get income directly to their bank accounts. Additionally, inmates in the release preparation establishment are granted the right to leave the facility during weekends and weekdays for work and/or study purpose.
Juvenile justice system has significantly improved after the adoption of the new Juvenile Justice Code. As a result, imprisonment of ‘children in conflict with the law’ has been extremely reduced. A new type of alternative non-custodial sentence “house arrest” has been enacted. Since January 1, 2018 the Ministry expanded the application of “house arrest” for adult convicts as well.
The Government of Georgia is committed to maintain this positive trend in human rights protection and now strives to become an exemplary for other nations.