Former Georgian health minister's critical post deleted few hours later

Former health minister of Georgia, Zurab Azarashvili, posted a lengthy reflection on his two-year term on social media, discussing the systemic challenges and “business interests of influential groups” he faced. However, the post was deleted hours later.

Key points from Azarashvili’s post:

• He described his tenure as filled with stress, pressure, and protests, with decisions that were principled, bold, and risky, aiming to address long-standing inequalities in the healthcare system. He credited the success of reforms to teamwork, high state responsibility, and strong political support from [former prime minister] Irakli Garibashvili.
• He discussed the implementation of a clinic payment system that established base treatment tariffs, a goal of previous ministers for 30 years, which was launched in his first year. The system aimed to expose dishonest practices and led to significant protests, as it reduced the excessive profit margins of individuals who were exploiting the healthcare budget and negatively impacting people’s health and lives.
• His ministry introduced reference prices for medications, setting price caps to save the population hundreds of millions of lari and help reduce inflation in the country.

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● With the opening of the Turkish market, the implementation of reference prices, and the direct procurement of oncological drugs from manufacturers, we manage to save 400 million lari [about $150.3 million] every year. Reference pricing allowed us to completely remove the annual limit for citizens needing continuous medications, starting from 2024. Thanks to the reform, 350 thousand citizens with chronic diseases can receive medicines for free from the state throughout the year.

● As part of the patient safety project, the ministry monitors the prescription of excessive antibiotics, psychotropic, and unnecessary drugs in real-time to save funds. To address this issue, work has begun on the so-called Sunshine project, according to the best world practices, under which pharmaceutical companies will be limited in marketing activities in clinics, and every lari paid by pharmaceutical companies to doctors will be declared in the relevant state system.

● Thousands of unregistered oncological drugs of dubious origin were detected being imported. Unfortunately, likely, no less than 60 oncologists are involved in this scheme. Based on based on medical certificates issued by the doctors, applications for funding in millions of lari were submitted to both the ministry and the municipalities, while oncological patients were prescribed drugs of unknown origin.

● An appropriate interim discussion on this matter has already taken place at the professional council, and the case materials have been transferred to law enforcement structures. It is precisely for these and other valid reasons that it is not possible to cancel the established oncology limit per patient, and early oncology diagnostics only begin in a pilot mode in state clinics.

● There was significant dissatisfaction with the treatment of children with cancer. After several meetings with parents, we decided to implement a program for treating children abroad. Since last August, in three countries of the world – Spain, Israel, and Turkey – in seven multi-profile clinics of international standard, we provide comprehensive services for pediatric oncology. More than 60 children have already benefited from it.

● Drug and medical device trials in the country were completely unregulated, which has been rectified according to international standards. The decision to conduct trials is made by an interdepartmental commission based on the submitted documentation.

● There was a massive protest against the law restricting surrogacy, which we have already submitted for discussion in parliament and which should protect the national interests of all Georgians.

● Regulations for the import of medical devices into the country according to international standards have been prepared and may be submitted to the government and then to parliament in the coming days. This law will address the problem of the circulation of substandard medical devices and materials in the country.

● Of course, strengthening the role of state clinics, including the Tbilisi republican clinic, was our main priority. Over the past 20 years, a number of conclusions or assessments about the lack of prospects for the clinic building have been made, but, like other major reforms in the system, this one has not started yet. Accordingly, no one has reached the mark in February to which we brought the project.

“All our decisions were aimed at achieving long-term results for the country, not at one-day PR activities. I always thought about how much strength, how much truth is behind our decisions when, despite the business interests of influential groups, I retained my post for two years, and today I left it with dignity and pride,” wrote Azarashvili.

“The dismissed health minister has ended the Georgian dream’s healthcare policy” – comment

“The now-dismissed health minister has put an end to the Georgian dream’s healthcare policy – his confession turned out to be scandalous and made the confrontation between the former and the new prime ministers obvious,” wrote Georgian parliament member Roman Gotsiridze on social media.

According to Gotsiridze, Azarashvili effectively declared the nine-year period preceding his appointment as criminal.

“Times that were before me will never repeat,” writes the former minister in his farewell statement, linking his dismissal to the interests of powerful “business groups.”

His assessment could have been accurate, if not for the fact that the demolition of the Republican hospital, the creation of a small clinic in its backyard, and the sale of the rest of the territory for construction were in the interest of these “influential groups.” Even now, nothing has changed, which he himself lobbied for. If Garibashvili said to first demolish the hospital and then build a new one, Kobakhidze says to first build a new one and then demolish the old one. Both approaches involve the construction of buildings on the vacated territories, pumping millions of Lari into the pockets of so-called investors at the expense of ignoring the interests of the city turned into [total] collapse,” Gotsiridze wrote.

Post by the former health minister of Georgia