site.btaMedics Discuss Draft of Bulgaria's National Brain Health Plan

A draft of a national plan for brain health was the focus of a roundtable discussion titled “National Plan for Brain Health – Strategic Framework and Expert Solutions.” The event was organized by the Brain Health Council in partnership with the Bulgarian Medical Association and the Sofia Medical University.

One in three Europeans suffers from a disease or condition related to impaired brain or nervous system function, said Prof. Nikolay Gabrovski, founder of the Brain Health Council. Speaking to journalists, he emphasized that “there is no health without brain health,” underlining the serious financial dimensions of the problem.

The plan sets clear priorities across neurology, psychiatry, and neurosurgery for the next five years, including public awareness, patient access to health care, scientific development, and international cooperation. According to Prof. Gabrovski, the implementation costs range between BGN 50 and BGN 200 million annually, depending on the scope of the program. However, further discussions with the Ministry of Health and the National Health Insurance Fund (NHIF) are needed to determine what can be realistically funded.

The draft plan includes the creation of two types of healthcare facilities and Prof. Gabrovski explained that instead of closing hospitals, a transformation model could be applied.

The first type are rehabilitation and recovery hospitals for patients who have undergone surgery or completed acute treatment but still require specialized recovery and care. The second type are long-term care facilities designed for patients with lasting impairments, including those in vegetative state, with severe strokes, brain trauma, cognitive dysfunctions, dementia, and more.

Currently, the burden of care for such patients falls heavily on families, which often leads to their isolation from social life, Prof. Gabrovski added.

The goal of the plan is a comprehensive approach: prevention, accurate diagnosis, integrated treatment, and successful reintegration of patients into society, he added.

One pressing issue is the lack of a clinical pathway for financing the treatment of transient ischemic attacks (TIAs) by the National Health Insurance Fund, said Acad. Ivan Milanov, President of the Bulgarian Neurological Society. He expressed hope that such a pathway would be developed and adopted soon. It would allow better statistical distinction between strokes and TIAs—an important step, given that Bulgaria is frequently cited among the top countries in stroke incidence.

He also noted that some neurological diseases are still missing from the list of conditions for which the NHIF reimburses medication.

Prof. Dimitar Maslarov, co-founder of the Brain Health Council and head of the Neurology Clinic at the St. John the Baptist University Hospital in Sofia, said that ischemic strokes could be reduced by 20% over the next decade with improved care and prevention. Since January 2025 alone, 36,000 strokes have been reported, affecting about 32,000 unique patients—a sign that recurrence is common. That is a strong evidence of a need for ongoing patient care even after the first incident.

Prof. Georgi Onchev, Vice President of the Bulgarian Psychiatric Association, stated that the association’s proposals span nearly all mental disorders, with a strong emphasis on finding long-awaited biomarkers for primary psychiatric illnesses. This would mark a major step forward in psychiatric research and diagnosis.

At the opening of the discussion, Health Minister Silvi Kirilov emphasized the importance of creating a sustainable framework for brain health in Bulgaria. "It is important to recognize the need for coordinated action—with all relevant institutions—to create a sustainable framework for brain health. I am confident that today’s decisions will become tomorrow’s real actions," he added.