EWMI Judicial Independence and Legal Empowerment Project (JILEP) grantees, the Georgian Young Lawyers’ Association (GYLA) and Transparency International Georgia (TI) presented the findings of their most recent court monitoring efforts on April 2, 2013. In GYLA’s case, their findings covered the period July to December 2012; TI’s reporting covered the period June to October 2012. While GYLA and TI found that the courts generally followed the procedures prescribed by law, they noted that the courts continued to show a clear preference for the prosecution in criminal cases and for the state party in administrative cases.
They found this preference was especially evident in cases where political interests were involved. While the groups reported a slightly positive trend towards objectivity and professionalism by the courts, the results were not substantially different than what the groups reported six months ago. The only truly significant change observed in the behavior of the courts, was in cases involving former government officials charged with crimes by the new government. In these cases, the courts were substantially more lenient toward the defendants in terms of imposing bail and pretrial detention than they had been with any other category of defendant in the past. Judicial representatives attended the April 2nd event and provided their views of the reports’ findings. They expressed their general support for the monitoring efforts but suggested that the reports did not provide a complete picture of what was happening in the courts.
GIA’s research and advocacy, funded by EWMI, contributed to policy reforms aimed at making prescription drugs in Georgia more affordable.
Healthcare expenses in Georgia have risen steeply over the last decade. By 2009, they constituted an average of 35% of household income, with 60% of these health expenditures going toward prescription drugs. However, little data exists in Georgia to guide the formation of pharmaceutical policies that would make prescription drugs more affordable.
To fill this information gap, EWMI provided the Georgian Insurance Association (GIA) with a grant to survey Georgian physicians, households, and insurance companies to investigate the reasons for rising drug costs in Georgia.
One of GIA’s most important findings was that physicians rarely consider cost effectiveness when prescribing medicines. Only 4% of prescriptions are for generic brands, even though doctors’ attitudes toward generics are generally positive and the price of generics is approximately one-third that of brand name products. The fact that generics are not widely available in Georgia compounds the problem.
The study also found that doctors in Georgia prescribe a relatively high number of drugs per patient visit (2.9 on average), compared to internationally accepted standards (2.0). This means that people could be paying for drugs they don’t need.
Through EWMI’s Policy, Advocacy, and Civil Society Development Project in Georgia (G-PAC) Mentorship Program, Professor John Hall of Arizona State University provided advice to GIA on how best to present its results and recommendations. With Professor Hall’s input, GIA developed a policy paper based on its research and analysis of existing policies. GIA’s paper presented a number of policy options that included controlling the prices of brand name drugs, providing incentives for the increased distribution of generics, developing preferred drug lists, creating guidelines for prescription practices, and regulating drug promotion efforts for brand name drugs.
GIA then conducted an advocacy campaign to raise public awareness about the implications of unnecessary prescriptions, including holding presentations and discussions for the media and the public and appearing on TV and radio talk shows to discuss the issue. GIA’s research and public awareness efforts have contributed to a series of reforms, including a quadrupling of insurance benefits for 900,000 people covered under a new government health insurance program and new regulations establishing a list of approved brand name and generic drugs, and new requirements that pharmacies have adequate supplies of all drugs on the list and that they dispense the drugs as prescribed.
The Ministry of Labor, Health, and Social Assistance (MoLHSA), insurance companies, and medical service providers also collaborated on a list of prescription protocols for doctors, which took effect on January 1, 2013. Additionally, MoLHSA is developing an electronic prescription management system that will require all prescriptions to be registered and subject to audit by the end of 2012.
EWMI funded GIA’s project through G-PAC’s Think Tank Support Grant (TTSG) Program.
GBA General Assembly (Prosecutor General Archil Kbilashvili- front row, second from left)
On December 8, the Georgian Bar Association (GBA) held its annual General Assembly. By the end of the meeting, the Assembly had adopted long awaited amendments to the Professional Ethics Code of Lawyers and the GBA’s Disciplinary Responsibility By-laws. These amendments were drafted over the course of last year by a working group of GBA members and with the technical assistance of EWMI’s Judicial Independence and Legal Empowerment Project (JILEP) and its experts, Professor James Moliterno of Washington and Lee University School of Law, USA, and Mr. Jim McCauley of the Virginia State Bar. The General Assembly discussion on the amendments lasted for nearly three hours; they ultimately adopted the amendments by a 234 to 5 vote.
During the Assembly, Georgia’s new Prosecutor General (and former GBA Ethics Committee member) Archil Kbilashvili, spoke to the membership about the need to reform the plea bargaining system, and forms of possible cooperation between his office and the GBA. He indicated his interest in giving GBA members access to the library of the General Prosecutor’s Office and signing some type of memorandum of cooperation with the GBA. Also during the meeting, Eka Gasitashvili, Chairman of Ethics Committee, and Zviad Kordzadze, Chairman of CLE Committee, reported on their committees’ work and mentioned their appreciation for assistance received from JILEP.
