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Foundation of Center for Disease Control and Prevention in Abkhazia

1.    Foundation of Center for Disease Control and Prevention in Abkhazia, including monitoring of Avian Influenza, ASF, malaria, cholera
1.1.    Contact: Ramaz Mitaishvili                      
Proposed Center will cover Caucasus, including Armenia, Azerbaijan, Russia, as well as Black Sea area, including Turkey, Ukraine and other countries. We believe that foundation of Center for Disease Control and Prevention in cooperation with separatist self-proclaimed government and policies are needed to restore humanitarian assistance to the people in Abkhazia, but caution that new restrictions imposed by the separatists are making such efforts more difficult. Our personal relation with Abkhazian physicians makes us believe in success of this joint project. We and our families are well known in Abkhazia, because of our backgrounds. Our team is multilingual, and consists from top quality professionals.
1.2.    Background
There is a growing humanitarian crisis in Abkhazia. The ruling government’s policies have restricted nearly all aid and allowed serious infectious diseases to spread unchecked. With the global spread of bird flu, there is a fear that if a human form of H5N1 were to take hold in Abkhazia, it could potentially spread unchecked for weeks or months before anyone knew about it. Uncontrolled spread of any disease, especially an emerging disease like H5N1, poses a serious health threat to Abkhazia’s populous neighbors, like Russia (Sochi (host of Winter Olympics 2014 is just 20 miles away from Abkhazia), as well as the rest of the world. Separatist government policies in Abkhazia (that restrict public health and humanitarian aid have created an environment where AIDS, drug-resistant tuberculosis, malaria and bird flu (H5N1) are spreading unchecked, could pose a serious health threat to other nations and the world.

1.3.    Proposed Schedule
Center must be charged with the task to respond to bioterrorism, chemical terrorism and other public health emergencies, including outbreaks. The proposed center is a unique asset in the nation's growing preparedness for biological and chemical terrorism. Center must be linked linking of state and local public health laboratories, veterinary, agriculture, military, and water- and food-testing laboratories is unprecedented. Good practices in prevention and control programs must be shared with Abkhazian separatist regime.

Center Departments:
•    Agents, Diseases, & Other Threats
•    Bioterrorism
•    Monitoring & Detection. Recent Outbreaks & Incidents
•    Chemical Emergencies
•    Natural Disasters & Severe Weather
•    Radiation Emergencies
•    Mental Health
•    Lab Training & Education
All departments must be focused on preparation and planning
Because of limitation in financing in the beginning we will focus on specific needs: Bioterrorism, Monitoring & detection, recent outbreaks & incidents predominantly of Avian Influenza, TB, ASF, and malaria, Lab Training and Education.
1.4.    Command, control, and management

1.4.1. Command Structure

The PCDCP Director (or his/her designee) is responsible for officially activating the AISER’s Pandemic Influenza Response Plan during an influenza pandemic. The PCDCP Emergency Operations Plan (EOP) describes the AISER Incident Command System structure that will be implemented in the event of a public health emergency, including an influenza pandemic. In addition, the EOP outlines the procedures for activating and operating the PCDCP Intervention Resource. The PCDCP Director will decide when to activate this command system and/or the based on current information and recommendations from the Central Georgian Governments Health Officer and the State Epidemiologist and coordinates with appropriate health department in Abkhazian de-facto government.

1.4.2. Pandemic Influenza Working Group

PCDCP has designated a working group to oversee planning, response and mitigation efforts and ensure that this plan is developed, reviewed, and periodically revised. This group will develop this response plan and other materials related to a pandemic influenza response. During a pandemic response, this group will be responsible for developing recommendations and guidelines, particularly for the use of limited vaccine and antiviral supplies. The Working Group may need to be expanded to include other subject matter experts as a pandemic situation develops.

1.4.3. Pandemic Influenza Advisory Committee

Abkhazia Institute for Social and Economic Research has designated an Advisory Committee consisting of representatives from PCDCP and partnering Georgia and Abkhazian de-facto agencies.

1.5. Powers of the PCDCP in Abkhazia

1.5.1. Quarantine and Isolation

The PCDCP (proposed Center for Disease Control and Prevention), through the Director, or under his/her direction and supervision, has the power to establish, maintain and enforce isolation and quarantine, and in pursuance thereof, and for such purpose only, to exercise such physical control over property and over the persons of the people within this state as necessary for the protection of the public health. Any person who has been quarantined may appeal to the appropriate district court at any time for release from the quarantine.
1.5.2. Closing of Public Buildings and Events
The PCDCP has the authority to close theaters, schools and other public places, and to forbid gatherings of people when necessary to protect the public health.
1.5.3. Mandatory Vaccination
•    In most cases, the PCDCP does not have the authority to subject any person to any vaccination or medical treatment without the consent of that person. However, during a public health emergency, after consultation with Georgian Authorities, may subject a person to vaccination or medical treatment without consent in the following circumstances:
•    If the parent, legal guardian or other adult person authorized to consent to medical treatment of a minor child cannot be located and consulted and the vaccination of or medical treatment for the minor child is reasonably needed to protect the public health or protect the minor child from disease, death, disability or suffering;
•    If the person authorized to consent on behalf of an incompetent person cannot be located and consulted and the vaccination of or medical treatment for the incompetent person is reasonably needed to protect the public health or protect the incompetent person from disease, death, disability or suffering.
•    If a person withholds or refuses consent for himself, a minor or other incompetent when the vaccination or medical treatment is reasonably needed to protect the health of others from a disease carrying the risk of death or disability, then the person for whom the vaccination or medical treatment is refused may be quarantined by the PCDCP.
1.5.4. Liability
During a public health emergency any health care provider or other person who in good faith follows the instructions of the PCDCP is immune from any liability arising from complying with those instructions. This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton misconduct.
1.5.    Staff
1.6.    Business Preparedness
In the event of pandemic influenza, businesses will play a key role in protecting employees' health and safety as well as limiting the negative impact to the economy and society. Planning for pandemic influenza is critical. Companies that provide critical infrastructure services, such as power and telecommunications, also have a special responsibility to plan for continued operation in a crisis and should plan accordingly. As with any catastrophe, having a contingency plan is essential.
AISER have developed guidelines (in accordance to guidelines developed by United States Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC)), including a checklist, to assist businesses in planning for a pandemic outbreak as well as for other comparable catastrophes.

1.7.    Surveillance, processing, specimen handling and shipping
1.8.    Vaccine Delivery in Abkhazia
1.9.    Guidelines for Healthcare Facilities Management
1.10.    Individual and Family Preparedness, School Preparedness

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