As soon as the Republic of Georgia’s National Center for Disease Control and Public Health (NCDC) sounded an alarm about a cluster of unusual pneumonia cases in Wuhan, China, Prime Minister Giorgi Gakharia’s government set its pandemic response into motion.  It was early January 2020, and there was still no hard evidence that the infection had spread across borders, but the country’s health leaders were wary. As outbreaks of the virus, identified as COVID-19, began to appear in other countries, the government quickly created a multisectoral coordination council chaired by the prime minister and then adopted a number of emergency response measures. Working with a network of local public health centers, the NCDC launched a communications blitz, with scientists and physicians at the forefront. The public health campaign encouraged compliance with stringent—and unpopular—lockdown measures. Through the first half of 2020, the weekly number of new cases remained low, even as infections surged in many high-income industrial countries. But it was too early for a victory lap. Pressure grew to open up resort centers during July and August in an economy heavily dependent on tourism. During September, October, and November the number of new cases per day climbed sharply, driven mainly by expansion of the outbreak in Adjara, a vacation destination. Compared to most European countries, the incidence of disease remained low, however, and the number of new infections later plummeted, approaching initial levels by March 2021. This case study highlights how a small, middle-income country with a privatized and decentralized health-care system initially succeeded in its pandemic response, struggled with sharp reversals, and then brought the infection rate close to earlier levels prior to vaccine distribution.

Tyler McBrien drafted this case study based on interviews conducted with Nona Tsotseria, MD, PhD, in January and February 2021. Case published June 2021. This case study was supported by the United Nations Development Programme Crisis Bureau as part of a series on center-of-government coordination of the pandemic response.

The views expressed in this publication are those of the author(s) and do not necessarily represent those of the United Nations, including UNDP, or the UN Member States.

In 2002, Lithuania was struggling to defeat corruption, which had flourished during the Soviet occupation. Once viewed as the key to survival in an administered economy, offering gifts for services had become an accepted social norm. More than a decade after Lithuania regained independence, polling showed that although 77% of Lithuanians considered this form of corruption a problem, few were willing to change behaviors they saw as practical. The country’s recently created anti-corruption agency, the Special Investigation Service, faced the challenge of changing those social expectations. It decided to focus on a new generation of Lithuanians. The Modern Didactics Center, an educational nongovernmental organization, and a dedicated group of teachers stepped in to help the agency work toward the ambitious goal of changing the attitudes of students across the country. The group experimented with a variety of educational approaches both in and outside the classroom, including a curriculum that integrated anti-corruption elements into standard subjects and projects that encouraged students to become local activists. Despite resistance from educators that limited the program’s scale, the effort developed new approaches that illuminated the ethical and practical downsides of corruption for students across the country.

Maya Gainer drafted this case based on interviews conducted in Vilnius, Mažeikiai, and Anykščiai, Lithuania, during February 2015. Case published June 2015.

In 2006, incoming Mexican president Felipe Calderón had to work quickly to deliver on ambitious campaign promises that included improving infrastructure and confronting organized crime. Limited by his country’s constitution to one six-year term, Calderón, a hands-on manager, sought to ensure coordination and follow-through among members of his Cabinet by creating a strong Office of the Presidency. At first, he appointed Juan Camilo Mouriño, a close aide and political adviser, to head a centralized office that combined political and policy responsibilities in his chief-of-staff role. Later, Calderón moved Mouriño to the Cabinet, shifting political responsibilities out of the office, flattening the structure, and assuming more-direct management responsibility than he had exercised as president earlier. Mouriño’s untimely death later the same year coincided with twin crises that tested the office and the presidency. Although Calderón’s tenure demonstrated successful planning and coordination, his experience also illustrated the limitations of an organizational structure that relied too heavily on the chief executive’s participation.

Robert Joyce drafted this case study based on interviews conducted in Mexico City in January 2015. Case published in June, 2015.