Substantial NATO Georgia Package

Tiflis - The Substantial NATO-Georgia Package (SNGP) strengthens Georgia´s defense and interoperability with NATO. A key focus is military medicine, supported by the Multinational Medical Coordination Centre – Europe, enhancing training, mobile Role 2 capabilities, and operational readiness in a complex security environment. 

The current global and regional security challenges require an increased level of multidomain and multilevel cooperation, between all interested actors. The partnership between NATO and Georgia has become a central element of Western stability efforts in the Black Sea region. At the heart of this cooperation is the Substantial NATO-Georgia Package (SNGP), a comprehensive instrument aimed at strengthening defence capabilities, institutions, and interoperability. 

The SNGP was established in 2014 at the NATO Summit in Wales 2014. Against the backdrop of rising tensions with Russia, the Alliance sent a clear signal: Georgia will continue to get stabilization support in the long term and for a more closely integration into the Euro-Atlantic structures. Since then, the package has served as a central framework for reforms, education, training, and capability development.

From Theory to Practice: A Multidimensional Approach

Organisationally, the SNGP is a Defence Capacity Building package led by NATO’s International Staff and is implemented by NATO and Georgian local authorities. Its goal is to support the interagency effort for increasing Georgia`s defense capacity and resilience, gradual alignment of the Georgian Armed Forces with NATO standards and strengthen their ability to operate alongside the Alliance`s members and other partners.
Its financing is hybrid, consisting of contributions from individual NATO member states and project-related funding. One relevant example of practical implementation is the Joint Training and Evaluation Centre (JTEC) which enables joint exercises and evaluations promoting interoperability. 
The SNGP encompasses numerous development areas, including command and control, logistics, cyber defence, and military training. One area that has proven especially dynamic and strategically relevant in recent years is military medicine.
This ensures both long-term reform processes and includes material and technical support – for example, equipment for training centres, mobile medical modules and infrastructure development. Therefore, the SNGP functions as the overarching instrument for developing military medical capabilities, including Role 2 capabilities in four army brigades.

Military Medicine as a key capability for Operational Readiness

The changing security situation in the Black Sea region has significantly increased the need for rapidly deployable, interoperable medical capabilities. 
A central role is played by the Multinational Medical Coordination Centre – Europe (MMCC-E), based in Koblenz. This unique multinational unit serves as a coordination platform for military medical cooperation in Europe. It links national medical services, harmonises standards, and enhances joint crisis and operational response capabilities.
Within the SNGP, a military medical capacity development initiative was included, now considered one of the most advanced components of the program.
The MMCC-E ensures that the developed medical capabilities are sustainable and NATO-compatible by bringing together multinational expertise, standardising procedures, and providing continuous guidance for planning and implementation.

The Military Medical Initiative within the SNGP

The initiative pursues three core objectives:

1. Professionalisation of Medical Personnel
   Military medical personnel are trained in accordance with international standards, covering core areas such as Tactical Combat Casualty Care (TCCC), emergency surgery and operational logistics. However, conventional training alone is no longer sufficient. Increasingly, the focus is on combining diverse training methods, such as move-build-treat-move methods and changing locations of Role2F during Exercises, to better reflect the complexity of real-world scenarios.
   A key hub for this integrated approach is the Military Medical Training School in Krtsanisi, near Tbilisi (Figure 1). It serves as a central platform for a variety of training modules, including trauma management, emergency room procedures and role-specific preparation. 
   In addition, personnel participate in NATO courses covering areas such as CBRN defense, medical evaluation and pre-hospital care. Comprehensive trauma management, including Damage Control Resuscitation (DCR), is also an established component of the training framework. The overarching objective is clear: to develop a robust and versatile pool of highly qualified medical personnel capable of operating effectively across a broad spectrum of missions.
2. Development of Mobile Medical Capabilities
   Central to this objective is the Role 2 Forward, a highly mobile and rapidly deployable facility for surgical first intervention, diagnostics, and stabilisation. (Figure 2)
   It includes:
   • Triage and initial stabilisation module;
   • Mobile surgery unit;
   • Basic laboratory, portable ultrasound, X-ray;
   • Short-term patient admission/observation areas;
   • Preparation for casualty and medical evacuation (CASEVAC/MEDEVAC);
   • Capacities: Initial assessments for 20 to 30 patients non-surgical care per day; 2 to 4 surgical emergencies per day;
   • Personnel: Surgeons, anaesthesiologists, emergency and intensive care physicians and nurses, diagnostics, medical logistics and command team.
   • Tent modules, trucks for transportation ready for deployment within a few hours.
3. Interoperability with NATO partners
   The objective is to further strengthen interoperability of Role 2 units with NATO Partners by implementing standard procedures, ensuring compatible communication systems and documentation, and increasing participation in joint exercises. In this context, the ambition is for each Infantry Brigade to be supported by its own Role 2 Forward capability.
   The goal is to achieve:
   • Common medical operational capabilities;
   • Independent operational military medical capabilities from the brigades;
   • Quick reaction in crises situations;
   • Standardised training and logistics systems

Contribution of Germany and the Netherlands

Germany and the Netherlands have, in close cooperation over several years, assumed technical leadership of the SNGP medical initiative. As non-resident members, Germany and Netherlands are supporting the Georgian Defence Forces in training, the introduction of modular medical facilities and the development of operational readiness concepts. Close cooperation with the SNGP Leadership in Tblisi and the Georgian Ministry of Defence (Figure 3) was crucial for coordinated requirement assessments, standardised training plans, and the successful development of Role 2 capabilities. This strong cooperation and significant involvement of the Georgian Medical Service represent a key reason for the initiative’s current advanced stage of development.

Conclusion: A Model for Modern Security Policy
The SNGP exemplifies a new form of security cooperation: long-term, multidimensional, and partnership-driven. The military medical initiative, particularly the development of Role 2 capabilities, demonstrates how concrete, operationally relevant capabilities can be developed. 
Thanks to the involvement of MMCC-E, the medical component of the SNGP is ensured to not only succeed but to remain fully NATO-compatible. For Georgia, this represents a significant strengthening of defence and crisis response capabilities. For NATO, the SNGP is a strategic instrument to promote regional stability while sustainably deepening partnerships.
In an increasingly complex security environment, it becomes clear: the capacity to save lives effectively is critical for modern defense.