Expanding Access to Affordable Medication in Georgia

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Despite reforms in Georgia’s healthcare sector over the last two decades, access to affordable medication has remained a top concern of citizens. A 2023 poll found that 68% of Georgians consider the cost of medicine the biggest issue for the healthcare sector. Civil Society Engagement Program (CSEP) in Georgia CSO grantee, Curatio International Foundation (CIF), evaluated recent government reforms to the pharmaceutical sector and how they have impacted Georgian households’ access to medications. After CIF shared their findings and policy recommendations for how to decrease the costs of medication for Georgians, the state’s universal health coverage program was expanded to offer full medication coverage for various chronic diseases. It also launched a web platform that allows Georgians to access information about drug prices, patient rights, state programs, and eligibility for medication-related subsidies.

Photo by Laura Rivera

Strengthening Georgia’s Legal Profession and Justice System

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EWMI is proud to support the Georgia Bar Association’s (GBA) “Strengthening Georgia’s Legal Profession and Justice System” project, a comprehensive, two-year capacity development and legal system outreach initiative. The GBA officially announced and launched the project on January 25, 2024 at an event attended by judges, members of the Prosecutor’s Office, representatives of international organizations, and leaders of civil society groups. This initiative, supported through the EWMI-implemented USAID Rule of Law Program (ROLP), will allow the GBA to continue development of its continuous legal education program, expand its bench-bar collaborations, support its Ethics Commission work, and develop a concept for Georgian lawyers to provide pro bono (free) legal assistance to those in need. 

In his welcoming comments, David Asatiani, GBA Chairman, expressed gratitude for the ongoing support and partnership of the USAID Rule of Law Program. He acknowledged the essential role USAID has played in GBA development over the years, sharing credit for many of GBA’s achievements. During the event, Tamta Devdariani, Head of the GBA’s Department of Analytical and Committee Activities, detailed many of the achievements of the 2022 – 2023 USAID-supported project that enhanced the organizational and analytical capabilities of the GBA’s thematic committees, organized bench-bar meetings, administered the qualification exam for lawyers in an objective and transparent manner, evaluated court case-loads, and suggested evaluation criteria for first and second instance court judge candidates.

In her opening remarks, Lisa Kovack, Acting Director of USAID/Georgia’s Office of Democracy, Rights, and Governance, emphasized USAID’s commitment to supporting the rule of law in Georgia. She shared her admiration for the progress GBA has made over the last decade. She expressed confidence that the Strengthening Georgia’s Legal Profession and Justice program will help continue GBA’s development and reinforce the rule of law in Georgia.

Increasing Access to Preschool Education in Georgia’s Remote Regions

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Georgian law mandates the universal right to early education for all Georgian residents, but research conducted by Civil Society Engagement Program (CSEP) in Georgia grantee, Center for Civic Activities (CCA), showed that for residents of mountainous and ethnic minority populated areas, this type of access proves to be the exception rather than the rule. CCA went door to door in more than 30 villages in these areas, engaging local activists and meeting with residents to help them advocate for their children’s right to early education. In many of these areas, CCA and the CSO Platform Salam helped locals use petitions — a first in the history of the municipalities — to assert their rights. After this campaign, the state announced in early 2023 that it would allocate 1.3 billion GEL for the renovation of 555 kindergartens and the construction of 330 new ones – including some in ethnic-minority populated villages that had previously lacked access to their own kindergarten.

Photo by Laura Rivera

Supporting Child-Friendly Justice in Georgia

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With the efforts of Rights Georgia and the support of the EWMI-implemented USAID Rule of Law Program in Georgia (ROLP), another precedent of child-friendly justice was established in the case of a minor child whose biological father initially evaded caregiving and responsibility.

The case involved a five-year-old child whose birth certificate lacked information about her father. The child’s biological father only assumed responsibility after paternity was established through a court-ordered medical examination, litigated by Rights Georgia. Seeking legal assistance, the child’s mother approached the organization, facing economic challenges that prevented her from independently conducting the necessary tests to determine the child’s paternity.

On February 13, 2023, Rights Georgia submitted a lawsuit to the Tbilisi City Court, requesting the establishment of paternity, amendments to the birth certificate, and the imposition of alimony. The legal battle highlighted the economic struggles faced by single mothers, especially when essential evidence such as DNA testing incurs substantial costs.

Despite the financial obstacles, the lawyers of Rights Georgia filed a petition on May 1, 2023, arguing that the alleged father should cover the expenses for the paternity examination. Through their efforts, Judge Maya Kutkhashvili of the Tbilisi City Court agreed that assigning the costs to the father was crucial for establishing paternity and ensuring the woman’s access to justice. The judge mandated a biological examination, and the defendant was directed to prepay the associated costs with the ruling of September 29, 2023.

This landmark case serves as a precedent in safeguarding the child’s best interests and upholding a high standard of child-friendly justice. Unfortunately, many single mothers face limitations in accessing justice due to the substantial costs associated with obtaining crucial evidence, especially DNA testing, leading them to forgo legal actions in numerous instances.

The Levan Samkharauli National Forensic Bureau confirmed the defendant’s biological fatherhood through a relevant report, with the costs for DNA testing being covered by the defendant. On December 18, 2023, Judge Maya Kutkhashvili partially granted the claim, recognizing the defendant as the child’s biological father. The necessity to change the birth certificate to indicate the defendant as the child’s father was established, and the defendant was ordered to pay alimony of 300 GEL (instead of the requested 550 GEL) from the moment of filing the lawsuit until the child reaches adulthood.

“I can’t put into words how emotional all of this is for me. This is the happiest day in my life since the birth of my child, as now I can demand providing my child with sufficient financial support and caregiving,” exclaimed the mother, expressing her joy upon receiving the results of the biological examination.

According to Rights Georgia, this case holds particular significance for access to justice for single mothers, demonstrating the possibility of making the presumed father prepay the expenses of DNA testing. It serves as an example that single mothers are not alone in seeking justice and managing childcare despite economic challenges.

Mobilizing Communities in Racha for Environmental Protection

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In May, the Center for Civic Activities (CCA) received a Rapid Response Grant from the EWMI-implemented USAID Civil Society Engagement Program (CSEP) in Georgia to mobilize citizens in Racha and protect the more than 100,000 hectares of the Racha-Lechkhumi forest that were auctioned off by the Georgian government in April. The auction, which had only one participant, resulted in a 49-year lease of the land for the purpose of developing a hunting farm.

In response to the lack of government transparency regarding the auction and its failure to engage impacted communities in the process, the Center for Civic Activities, in partnership with media portal Mountain News (mtisamebebi.ge), the Racha Community-Based Organization, and the Green Alternative, began an advocacy campaign to hold the government accountable for its decision. The campaign is also advocating for the establishment of a national park in Racha that includes the recently auctioned territory, a process that was initiated by the government more than 20 years ago and promised again most recently in 2019.

As part of its activities, the project team will hold a door-to-door campaign in 30 villages of Racha, informing locals about the terms of the Racha auction and the benefits of establishing a national park. In parallel, the Center for Civic Activities will conduct legislative work for the establishment of a national park and cooperate with members of parliament as well as interested local and international organizations. CCA is also in the process of initiating a court dispute to obtain public information related to the sale of the hunting license and will organize a press tour in Racha for national media outlets to ensure that citizens are informed about the issue and how it may impact them.

Expanding Women’s Labor Rights in Georgia

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Photo by: Mostafa Meraji

The Parliament of Georgia greatly expanded women’s labor rights via amendments to the Labor Code that were shaped by the guidance and expertise of the USAID-funded Promoting Rule of Law in Georgia Activity (PROLoG). Passed on September 29, 2020 after 18 months of discussions with different social partners and intense public and parliamentary debates, the Labor Code amendments promote gender equality in the workplace and provide new protections for all workers. 

The amendments expand protections for pregnant women and mothers, who could be denied the right to return to the same job and working conditions following maternity leave, child care leave, or leave due to adoption of a newborn under the previous version of the law. The amendments further support the professional development of women by requiring employers to consider participation in professional trainings or qualification upgrading courses as work time for which employees will be remunerated in cases where the employer has required the participation of the employee.

Under the amendments, the scope of prohibition of discrimination in employment and professional activities within labor and pre-contractual relations has been expanded as well, and will also apply to pre-contractual selection criteria and employment conditions and promotion on all levels of professional hierarchy regardless of the sphere of activity. The amendments also prohibit discrimination on the grounds of a health condition.

Protections for all workers are further strengthened by requiring written employment agreements for all employment relationships exceeding one month.

Most significantly, the amendments have established an effective enforcement mechanism to ensure compliance to the code. According to Dimitri Tskitishvili, Georgian Member of Parliament (MP), “as a result of the adoption of this amendment package, Georgia now has significantly improved legal standards for labor rights and a solid legal foundation to establish an independent and fully-pledged Labor Inspection.”

PROLoG became involved in the legislative reform efforts in 2018 when the Parliament’s Gender Equality Council (GEC) requested experts to advise on the drafting of a legislative package on women’s labor rights. PROLoG experts Anna Maisuradze and Zizi Chkhaidze collaborated with the GEC to draft a law and explanatory notes that later became part of Labor Code reforms. The draft law not only reflected European directives and international obligations, but also included recommendations prepared by PROLoG legal aid grantee NGOs based on strategic litigation in common courts.

The GEC supported an inclusive and participatory process to amend the Labor Code and, before the adoption of the legislative changes, PROLoG conducted several meetings with relevant stakeholders to discuss the existing practices and challenges in women’s pre-contractual and labor relations, as well as future prospects for reform. PROLoG’s experts also participated in discussions with the Ministry of Labor, Health, Social Affairs, MPs, and business sector representatives.

Following the passage of the amendments, Mr. Tskitishvili expressed his gratitude to USAID for its “continuous support and significant contribution in this very long and challenging journey to improve the labor rights and standards in Georgia for the benefit of the employees and economic prosperity of the country.” 

Photo by Laura Rivera

Improving Access to Justice for Marginalized Groups in Georgia

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Religious minorities living in the mountainous Adjara region of Georgia had the opportunity to seek legal advice on matters of violence and discrimination based on gender and religion thanks to a mobile legal clinic organized by the Human Rights Education and Monitoring Center (EMC). The two-day clinic was held on August 24-25 in the towns of Khulo and Ghorjomi and included a workshop for women in Khulo focused on women’s rights and domestic violence issues.

Religious and ethnic minorities in Georgia often face legal hurdles that limit their access to justice. With support from EWMI’s USAID-funded Promoting Rule of Law in Georgia Activity (PROLoG), EMC is working to strengthen the rights of religious and ethnic minorities in the Adjara region by addressing the discriminatory practices of state institutions. These discriminatory practices include the restriction of freedom of religion for minority religious groups, discrimination on religious and ethnic grounds in relations with the state and private persons, unequal treatment with regard to the recognition of property ownership and during the construction process, and the discriminatory indifference of police towards religious-based hate crimes.

EMC organized the mobile legal clinic to provide free legal aid and identify the key social and legal problems faced by the residents. The clinic was led by a group of lawyers from Tbilisi along with a locally-based lawyer who will be permanently stationed in the region to provide on-going legal consultations and litigation assistance. During the clinic meetings, residents of Khulo and Ghorjomi sought legal advice on matters of violence and discrimination based on gender and religion, as well as issues related to the registration of agricultural lands. In particular, the women who attended the meeting were interested in family law issues, such as the management of funds between spouses when they both are involved in agricultural activities and how alimony is determined in cases of divorce.

As part of the mobile legal clinic, 15 women in Khulo had the opportunity to participate in a workshop focused on women’s rights. They learned about the rights of domestic violence victims and existing protection mechanisms, and an EMC representative explained the importance of reporting violence to the police and provided information about shelters for situations in which  victims might not have a safe place to go.

The discussions held during the two-day clinic highlighted existing challenges in the region, including the lack of access to resources and services. The residents of high mountainous Adjara often have to travel two or three hours to the city of Batumi to access necessary public services which is both a logistical and financial burden for the local population.

Access to justice requires a justice system that is responsive to the needs and rights of all citizens, as well as a citizenry that is informed and able to seek the protection of their rights under the law. EMC’s work will help to ensure that the religious minorities of Adjara are not forgotten and strengthen their ability to seek justice should they face violence or discrimination based on their gender or religion.

Amplifying Women’s Voices

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Women of Georgia published 15 new stories that hit a record number of over one million viewers and brought over 3,000 new followers to the official Facebook page.

For over three years, EWMI’s Advancing CSO Capacities and Engaging Society for Sustainability (ACCESS) project has supported an online platform, Women of Georgia, created to raise awareness about gender inequalities and promote open discussion of issues affecting women in Georgia. Featuring real stories of women from various backgrounds, these stories have become an important voice for many women.  In the past two months, Women of Georgia has published 15 new stories that combined hit a record number of over one million total views and brought over 3,000 new followers to the official Facebook page, bringing the total to over 78,800 followers. Moreover, many of these stories were quickly picked up by national TV channels and social media sites, stirring intense debates and, in some cases, first-time conversations on women’s struggles in Georgia.

EWMI ACCESS also supported the creation of the Women of Georgia website, that collects all the published stories in Georgian and English languages.

ACCESS is funded by the US Agency for International Development (USAID). 

Protecting the Rights of a Child

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Photo by Sven Brandsma

On July 7, the Tbilisi City Court decided a case litigated by EWMI grantee, Partnership for Human Rights (PHR). Through a EWMI PROLoG-supported project, “Strengthening Child Access to Justice in Georgia,” PHR provides legal aid to children and their guardians in cases where there is a violation of the rights of a child. In this particular case, PHR was protecting the rights of a child that was placed in a COVID-19 quarantine zone despite having a suitable place for self-isolation with the parent.

On June 27, the family returned to Georgia from the U.S. and was taken to a quarantine zone. According to the government’s regulation, instead of quarantine, which lacks adequate living conditions for a child, the child should have been placed in self-isolation. The family requested to be transferred to their home arguing that they had a suitable alternative, the quarantine zone did not provide appropriate nutritional support for the child, and the child’s psychological well-being was at risk, but their request was rejected without any basis.

With the help of PHR, the family was able to address the Tbilisi City Court. On July 7, the court heard the case, and, taking into account the best interest of the child, granted PHR’s request, and the family was transferred to self-isolation. PHR was pleased with this outcome and continues to protect the human rights of children and other vulnerable groups through legal assistance. 

Supporting Civic Action to Address the COVID-19 Crisis in Georgia

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CSOs play a vital role in Georgia.

In order to respond to the COVID-19 crisis in a timely manner, EWMI’s Advancing CSO Capacities and Engaging Society for Sustainability (ACCESS) Project in Georgia promptly announced the Rapid Response Grants (RRG) program for Georgian Civil Society Organizations (CSOs), civil movements and citizen groups. The program deploys flexible resources to these groups to take civic action to minimize the spread of infection and address the crisis caused by the pandemic. Response to the program has been very positive, and grants have already been awarded to several grantees.

Quick access to funds allows grantees to address the needs of vulnerable populations throughout Georgia. In the town of Sighnaghi, about 30% of residents are over the age of 65 and are at a higher risk of developing severe complications from COVID-19. These residents have been advised to stay home and practice strict social distancing. For many of them, self-isolation will equal loneliness. With RRG funds, the Civic Initiatives’ Knowledge Café project will support this population by developing a database of elderly citizens living alone in the Sighnaghi municipality; reaching out to them to identify and address their needs; providing them with essential food and medical products; and organizing stress management and relief. To further support this effort, the Knowledge Café also raised funds from 513 local citizens through crowd funding. The Roma community is one of the most marginalized and under-represented communities in Georgia and are especially vulnerable during this pandemic. Roma have a limited access to private housing, social welfare, health care, and education. Inability to speak Georgian creates additional barriers for their integration into the Georgian society. The Ajara Democratic Development Center used its grant funds to launch a hotline for the Roma community living in the Ajara region to help inform them about the COVID-19 risks and prevention measures.

People with underlying health issues are at increased risk for infection, severe illness, and poorer outcomes from COVID-19. With their health in mind, EWMI ACCESS Rapid Response grantee, Identoba Youth, began information- and awareness-raising campaigns on COVID-19 for HIV positive and at-risk groups in Batumi. The organization developed and published a protocol with detailed guidance on what is COVID-19, how it is transmitted, what precautions to take, and how to access necessary health services. Identoba Youth has also started providing individual consultations on the COVID-19-related social and medical issues to the target group members.  Another grantee, the Winner Women’s Club launched a Facebook challenge campaign in which the Club members – cancer patient and survivor women – share their personal experiences during the COVID-19 stay-at-home order. This activity is part of the Winner Women’s Club effort to support the physical and mental well-being of cancer patient women during COVID-19 and beyond. Rapid Response Grantee Europa Donna Georgia will also use funds to support cancer patients, as well as their families, caregivers, and larger oncology community during the COVID-19 crisis. The grantee will develop infographics and videos about cancer and COVID-19 and facilitate discussion and Q&A via website, social media, and webinar with experts. Rapid Response Grantee Xenon is experienced in working with individuals with substance dependence, which is a high-risk group for COVID-19 transmission and complications. Xenon will use the RRG funds to facilitate a training webinar for Harm Reduction Program staff on COVID-19 issues, develop and distribute print materials and also distribute information by phone call to raise awareness among individuals with substance dependence about COVID-19 and how to avoid contracting it, and to provide personal protection equipment to individuals with substance dependence.

EWMI ACCESS Rapid Response Grants are also being used to ensure that the citizens of Georgia receive accurate and important public health information. Giorgi Beria, the Head of the New Vision University Training Center and National Expert of Education Quality Development, began organizing trainings for front-line medical personnel in targeted health facilities (these facilities have been designated as first, second, and third tier recipients of COVID-19 patients). Training agenda and materials for the targeted health care facilities are based on the national protocol and guidelines and WHO’s and NCDC’s recommendations, and have been vetted by the Regional Public Health Center under the Georgian Ministry of Health. The first three trainings covered 58 nurses, assistant nurses, and doctors from the Kutaisi Clinic L.G. Another Rapid Response Grantee Mirian Jugheli has built up a website cataloging different types of products and services available online in Georgia to ease adherence to the stay-at-home regulations. It includes a section debunking disinformation about COVID-19 and pointing visitors to reliable information. The Rapid Response Grantee Salam received funds to publish new informative posters in Azerbaijani language to raise awareness about COVID-19 prevention measures. The first poster explains the importance of physical distancing and how to maintain it. Another poster explains the importance of regular hand washing and provides detailed instructions on how to do it properly.

The COVID-19 outbreak has caused fear, stress, anxiety and grief among many Georgian citizens, including children. EWMI ACCESS awarded the New Thinking Institute a grant that enabled them to prepare and publish a new animated children’s story in Azerbaijani language to help young children in Kvemo Kartli and other parts of the country cope with the stay-at-home order. This is the fourth animated story by the New Thinking Institute during the pandemic. The stories are based on Azerbaijani fairy tales.

EWMI ACCESS is funded by the US Agency for International Development (USAID).