One would think that good health is a public good, and therefore a functioning healthcare system should be accessible to all, at least in theory. This is the idea which lies behind healthcare systems in different European countries. But it appears that in an EU Association Agreement this principle can be sacrificed, behind closed doors, to give the new associate’s politicians the chance to do private deals with little accountability.
Georgian open news sources have said that the Georgian government has signed a long-term agreement with the international advisory group Global Alliance for Health and Social Compact (GAHSH) which will bring that country’s healthcare system into line with European standards, or so it is claimed.
The Healthcare Ministry maintains that the company’s aim is “to provide quality healthcare, pricing and availability through new, innovative methods”. One of the basic principles behind these will be “reduction of healthcare costs with absolute adherence to European medical standards”.
This is genuine issue in Georgia, where price and supply cartels have long dominated healthcare services. But is this agreement really going to address such problems?
European standards in general are supposed to promote democracy, transparency and good practice. A look at the company involved in this agreement might make one wonder if these standards will ever be adhered to.
For a start, why does it call itself “global”? It has based in the UK and has offices in Ukraine, Georgia, England and France, a rather small portion of the globe even when all put together. Its website, consists of stock photos, rather than images of the company actually doing anything, meaningless headlines and equally meaningless accompanying narrative. It looks like a website made in a hurry because an application required one.
For example, if the company really has 300 staff, can’t it show us a photo of the place where they work? Or are all the staff field workers in Ukraine, working from their laptops in hotel rooms? All we know at this time is that they will be based in Kiev, Tbilisi and other locations, including Moldova.
One would expect a national government, even that of a small, developing nation, as Georgia, to employ a respected company, one with some sort of proven track record to undertake work on behalf of its populace. The Global Alliance has only existed for seven months, has never filed any accounts and seems to have had practically no clients during that time.
It is run by Christopher Davey, born 1991. What track record does a 23-year-old have? And why is the listed Company Secretary, who performs a vital compliance function, not an actual person but “Paifang Nominees Ltd”, a firm of accountants? How will this company ever be able to show compliance with European standards when the Company’s Secretary isn’t even human?
Yet this company is now “out-of-the-blue” responsible for steering all medical programmes and processes in Georgia. There are many genuine healthcare companies in Europe, run by medical professionals with actual track records. The track record of previous “health reformers” in Georgia is now well-known – after pocketing the proceeds on serious contract corruption for several years, they have now been given the same jobs in Ukraine, when they are not Ukrainian nationals and have never been elected by anyone. Does the new Georgian government elected to end corruption actually want to entrench it further, and play with people’s lives in the process?
The Devil we don’t know
In a recent article Sergo Chikhladze, MD, PhD, a Georgian health expert, raises similar concerns. Chikhladze studied at the Russian Academy of Medical Sciences in Moscow and later in the US, where he focused on monitoring and evaluation issues in order to develop and implement comprehensive M & E plans and systems for health programmes in Georgia. He has also practiced in the country for many years in various roles, and might therefore be presumed to know rather more about Georgian healthcare than Global Alliance does.
The Global Alliance is very reminiscent of previous donor supported projects, such as the USAID funded CoReform Health Project a few years ago, which were not as they seemed. The agreement with Georgia was signed by Georgia’s Minister of Labour, Health and Social Affairs Davit Sergeenko and GAHSH coordinator Jean-Elie Malkin. Malkin was previously Senior Advisor to the UNAIDS Executive Director and the Director of the UNAIDS Regional Support Team for Eastern Europe and Central Asia, both of which were ‘front’ projects for illegal payments.
As a result of all this, investigative reporters are discussing how this company could possibly have won this contract. But they are not doing so in print, because in spite of all the promises the present Georgian government made when it was elected it would still be dangerous for locals to break the story, and more than jobs and future careers are at risk.
It has previously been reported that all those who have said they were willing to contradict the official version of the death of Zurab Zhvania, the former Prime Minister, are mysteriously dying off, one by one. There is evidence that the same is happening to people who delve too deeply into this story, although it is unclear who these deaths can be attributed to.
Health Minister Sergeenko is so highly-appreciated that Georgian President Margvelashvili has awarded him the Saint George’s Order for his personal contribution to introducing successful healthcare reforms and his high level of professionalism. Only around 100 people have ever received the St. George’s Order, including former U.S. President George W. Bush, Senator John McCain, former President of Lithuania Valdas Adamkus, former President of Poland Lech Kaczynski and former Ukrainian President Viktor Yushchenko.
Is it likely that such an individual would appoint a fly-by-night company to take charge of Georgia’s healthcare system without at least explaining his choice? All the signs point to external forces, whose business it is not, using Georgia’s sick and vulnerable as a means of furthering their own ambitions – or rather, using Georgia’s EU aspirations to launder money and people through “development work”, as has happened so often before.
As one Western-educated Public Health Official, originally from Tbilisi, recently wrote:
“I can only worry about my people. The question is who is behind this robbery? I’m so disappointed with our authorities in the Health Ministry. At the beginning of the new political changes they promised a slow, “step by step” process [transfer to a modern system] and what do we have now? The problem of our people is that they trust the “Golden West” without thoroughly checking the backgrounds of the contractors and without simultaneous consulting other companies. SUPERFICIALITY is the main sickness of my people [Georgians] and I am very upset to say so. Unfortunately they have superficial education, superficial understanding and a superficial approach to problem solving.”
This is hardly the first time trusting the “Golden West” has endangered the health of Georgians. The most notorious example is the Richard E. Lugar Centre for Public Health, long claimed not to exist, which has spent years allegedly researching the emergence of bacteria and other biological agents in Georgia’s livestock. In order to conduct its alleged research it would have to inject animals with these deadly bacteria and virus to see how they were affected by them, and more importantly, how people who ate the meat or came in contact when they were introduced into the food chain would be affected by them.
Georgia is still waiting to see some outcomes from this research, like papers or new medicines. Such was the public disquiet about its activities that this well-guarded facility was taken over by the present Georgian government soon after it was elected. Nevertheless the US Department of Defense maintains that it still controls it, its work is still top secret and those who stray too close are assaulted in the street by its staff and others associated with it. All of this is somewhat unusual, at least, for a medical facility. But it comes from the West, so the people are obliged to accept that all this must be then be alright, really!
Now a new company with unknown personnel, no documented track record, no accounts and no clients, has been suddenly selected to bring Georgia’s healthcare system into line with Western standards. Health Minister Sergeenko says he has been seeking an appropriate company to do this work for over a year. Global Alliance was only formed 7 months ago. Are we to believe that no reputable company, with a track record, accounts and clients, had been identified before Global Alliance was even founded? If not, is this not outrageous incompetence?
Proof of the pudding
This deal is not about healthcare. Like many before it, it is about how far a country will go to join the EU. How many pockets is it happy to line? How many times will it blindly follow the EU’s will regardless of the consequences? How much is it prepared to do under the table for its friends?
One recent example of the same thing was the enormous plane full of supplies for ISIS, sent from the US, which clogged up Tbilisi Airport as soon as the EU Association Agreement was signed. Now a company which could never win a tender is being paid to endanger lives, because someone wants it. As we are told this company has been appointed to bring Georgia in line with EU standards, it is the EU which has insisted this happen.
Maybe Georgia will pass this gross initiation ceremony and be prepared to replace domestic corruption with the EU and international variety. Whether this is the action of any responsible government is another matter, and what threats and promises were actually made to force this deal on Georgia needs to be fully investigated.
Henry Kamens, columnist, expert on Central Asia and Caucasus, exclusively for the online magazine “New Eastern Outlook”.