In August 2004, the Defense Threat Reduction Agency broke ground on the outskirts of Tbilisi, Georgia, to begin construction of a facility that would be known as the Central Public Health Reference Laboratory. Through a collaboration between the U.S. Department of Defense, the U.S. Army Medical Research and Materiel Command, and the Georgian Ministry of Defense, the 8,000-square meter state-of-the-art facility with 2,551 square meters of BSL-2 and -3 laboratory space was officially opened in March 2011, and it will serve as the hub of a proposed research campus to be maintained by the Georgian government.

"The goal of the U.S. DoD and GoG is to address the threat of infectious diseases at the source with approaches that utilize modern technological developments applied from the rapidly expanding knowledge base in public and animal health. This collaborative effort is meant to reduce the impact of these threats to local communities, the region, and the world," said Lt. Col. Jamie Blow, director of Overseas Operations for Walter Reed Army Institute of Research, which is a subcommand of the USAMRMC.

As the lead DoD organization in charge of medical research, the USAMRMC was tasked to establish a new medical research unit at the CPHRL. This tasking was further delegated to WRAIR for development of the initial Implementation Plan for the facility. With subject-matter expertise in areas such as pathogen research, biosecurity, biosurety, and facility operations and maintenance, the USAMRMC will help to train Georgian scientists working at the lab, and it will also serve in an advisory capacity to support the Georgian government in its public health initiatives.

"When fully operational, the CPHRL will be a state of the art, internationally-certified central reference laboratory and a repository for infectious disease agents unique to the region. The laboratory is a joint human and veterinary public health facility, both with BSL-2 and BSL-3 laboratory capabilities, and separate pathogen repositories. The staff at the Georgian facility will be trained to perform diagnostic and confirmatory laboratory tests, epidemiological data analysis, and database management for national human and animal health authorities. It will be the regional focus of the work of the U.S. DoD Threat Agent Detection and Response program, and programs of other international disease surveillance and cooperative research partners. In addition to laboratories, the facility will include office space and host training functions to promote state-of-the-art infectious disease detection and research. The CPHRL is the central component of the overall network of capabilities the U.S. DoD Cooperative Threat Reduction Agency is developing to assist the region in concert with the Georgian Government and international agencies," said Blow.

"At this time, DTRA is in the process of fine-tuning the facility to ensure that all of its systems work properly in order to guarantee that it will meet both U.S. and international standards for operations in containment," she said. "By late 2012 or early 2013, it should be fully functional."

Blow said that Col. Arthur Lyons, the WRAIR lead in Georgia, and Dr. Mikeljon Nikolich, who is the WRAIR Science Advisor to Georgia, were critical to this effort. In addition, other scientific and support personnel provided critical input to both DTRA and the Georgians on this effort, and their extensive experience is critical to the success of this new Georgian facility.

"We see ourselves as long-term partners who can help the Georgians improve their own scientific and operational capabilities," said Blow. "This is not a U.S. Army facility, it is a Georgian facility, and we really want this lab to be very successful for the Georgians."

"The U.S. Army's goal in this is as a partner, collaborator, and as an advisor," she said. "We do not run other governments' laboratories."

Recently, Blow invited a group of seven Georgian employees from the CPHRL to visit WRAIR and the USAMRMC laboratories at Fort Detrick, Md. The group spent 6 days at WRAIR touring the facility and meeting with administrative sections to understand how a large research facility conducts business and supports science. In addition, the group was also able to tour the U.S. Army Medical Research Institute of Infectious Diseases, which is highly regarded for its top-level biological research facilities and science personnel.

Vakhtang Berishvili, CPHRL deputy director, said he was very impressed with the people and labs he toured with the group.

"Of course, the CPHRL building is much smaller, but all of the systems are basically the same," he said. "So, I have been learning much, and I am very focused on observing everything I can to make sure our lab in Georgia is where it should be [operationally]."

"The WRAIR facility was very interesting and well kept," Eka Khabazi, CPHRL biosafety officer said. "Besides the tour, I reviewed many logistics functions, and I spent time with a gentleman at WRAIR who showed me business plans that will help me in my role at the CPHRL."

Khabazi has been learning about the day-to-day safety issues within the lab in anticipation of its being fully operational by the start of 2013.

When speaking of their new laboratory, the Georgian team displays a great deal of enthusiasm.

"We have plenty of evidence that the Georgians are feeling a great sense of ownership, and that they are committed to the success of the CPHRL," said Maj. Gen. James K. Gilman, USAMRMC commander.

Looking ahead, the Georgian government plans to move its National Center for Disease Control (which is equivalent to the U.S. Center for Disease Control in Atlanta, Ga.) onto the campus. Its primary mission is public health, which includes the avoidance of epidemics and outbreaks of diseases that can be otherwise controlled with proper research, planning, and preparation.

As for the U.S. Army, it anticipates being a tenant in the Georgia facility and establishing a new Medical Research Unit within the CPHRL.

"The mission of WRAIR is to establish a new medical-research unit in the Georgia lab," said Blow. "A smaller unit will be there full-time to partner with the Georgians."

Blow certainly speaks from experience, as the U.S. Army's partnerships with the governments of both Thailand and Kenya have proven very successful with regard to overseas research units. WRAIR has a long history of overseas medical research units. The U.S. Army and the Royal Thai Army have been in partnership in the Armed Forces Research Institute of Medical Science located in Bangkok, Thailand, which has been in existence for 51 years. Similarly, the U.S. Army has partnered with the Kenyan Medical Research Institute for over 40 years in Kenya.

"These two medical research units have been critical in the development of products to protect both the Warfighter and also public health," said Blow. "Recently, these two units have been involved in development and testing of malaria and HIV vaccines that are the first to show any efficacy."

Within the new facility, WRAIR intends to conduct research in wound infection, bacteriophage, and vector borne diseases, as well as enteric diseases, which include bacterial causes such as E. coli, salmonella, and shigella, and viral pathogens such as rotavirus and norovirus.

Regarding the new lab in Georgia, Gilman said, "We [the USAMRMC] have been a significant factor in helping to develop a long-term friendship in a part of the world where we still need to have some friends. Lt. Col. Jamie Blow is the person that is most responsible for that."