1. NCD policy and programming in Georgia
Lela Sturua
Head, NCD Division/NCDC
WHO counterpart on NCDs

2. Geopolitical Context
Georgia is located at the geographical and political border of Europe and Asia
Population – 4 million

3. Structure and organization of prevention and care services and resources available
Ministry of Labour, Health and Social Affaires
National Center for Disease Control and Public Health
Primary Healthcare (public/private)
Hospital Sector (public/private)
Insurance companies
NGOs
Resources
State budget
International Donations

4. NCDs accounted for 94% of all deaths; CVD – 75%

5. Main achievements Legislation documents
Laws: on Healthcare; on Public Health; on Medical Insurance; on Prevention of Iodine and other Microelements & Vitamins Deficiency; on Tobacco Control; on Protection and Promotion of Natural Feeding of Children; etc.
Normative decrees
Strategic documents (Food based dietary guidelines dissemination package, Assessment of NCD Prevention and Control in Primary Health Care, etc.)
Establishing alliances and joint committees (ESAN, NFSI, WASH, etc.)
Public educational materials
Preventive practice guidelines
Professional education

6. Main achievements NCD Division at the NCDC
Surveys: WHO-STEP (2010); GNNS (2009); GeoRHS ( )
Breast cancer and cervical cancer screening programs
Flour/bread fortification
Salt is well iodized
Presidential program “equipping stadiums”; schools are equipped with sports inventory
First sketch of the Concept Paper on Prevention, Early Detection and Treatment of Most Prevalent Non-Communicable Diseases

7. Main challenges Lack of finances Main Diseases: IHD (42%); CVD (26%)
Main risk-factors: hypertension (49%), high cholesterol (23%), high BMI (17%)
Georgia belongs to TOP 5 WHO Member Countries with the highest mean blood pressure
No information available on salt consumption, etc.
Half of newly diagnosed cancer cases are on IV stage
Limited finances, adequate trained human resources and technical capacity
Lack of standard management guidelines, strategic documents
Inadequate advocacy & political commitment
Poor surveillance system

8. Main challenges
The proportion of 16 y. students who had tried cigarettes at the age of 13 or younger is 30% (10% started smoking at the age ≤9 years old)
On the last occasion 43% had alcohol at home and 27% at friend’s home
87%’s friend smokes; 86%’s friend drinks (ESPAD)
35% of healthcare professionals smoke
33% of adult population smokes (56%-man) (STEPS, 2010)
56% are overweight (man–58%); 25% - obese (women-28%)
35% of y. have 3 or more risk-factors (man-46%)
27% of y. have 3 or more risk-factors (man-39%)

9. Main challenges
NCD Risk Factors Survey, Georgia Recommendations Against Unhealthy Habits

10. Main lessons learnt over the last 5 years
Low Budget allocation
Lack of strategic documents
Cultural sensitive intervention
Advocacy & political commitment
Surveillance system

11. Plans for the next 12 months
2011 State programs
Cancer screening programs: breast cancer, cervical cancer, prostate cancer, colorectal cancer
CVD program; etc.
Cancer registry/stroke registry?
International donor funded projects
Concept Paper on Prevention, Early Detection and Treatment of Most Prevalent Non-Communicable Diseases
National strategy on NCDs
National HP strategy
Communication strategy
Strengthen partnerships