Bulgarian counterintelligence, the State Agency for National Security (SANS), has recognized the deepening crisis in the country’s healthcare system as a “significant process creating risks” for national security.
According to a report by SANS, which Euractiv reviewed, the agency highlights four key healthcare scenarios that pose a serious threat to Bulgaria’s stability.
These include the possibility of new epidemics arising from population migration from conflict regions and low vaccination rates, the exacerbation of antimicrobial resistance (AMR) due to widespread antibiotic use, the growing shortage of medical personnel, particularly in public and municipal hospitals, and periodic shortages of essential and expensive medications.
This unprecedented assessment places healthcare at the forefront of Bulgaria’s national security concerns, reflecting growing worries about the system’s ability to respond to public health threats.
The report mentions the rise of AMR, which is largely caused by excessive and improper antibiotic use. SANS notes that AMR significantly limits the ability to treat infections, posing a considerable threat to public health and the resilience of the healthcare system. The agency also points to the “growing shortage of medical personnel, particularly in public and municipal hospitals.” This shortage exacerbates existing inequalities in access to healthcare, especially in small towns and rural areas, and weakens the overall capacity of the national healthcare system.
The SANS report also highlights the periodic shortage of critically important and expensive medications on the market. Key factors contributing to these shortages include supply chain issues, the spread of parallel exports, and increased domestic demand, all of which jeopardize the provision of medical care and could further intensify the healthcare crisis in the event of an emergency.
The report stresses the need for urgent and coordinated measures across all government sectors to address these risks.
The Bulgarian Medical Association (BMA) has called for an increase in healthcare insurance contributions, warning that the country’s healthcare system is on the brink of collapse, with hospitals across the country halting basic services, including maternity and pediatric departments.
The BMA criticized the constant underfunding of the healthcare sector, noting that Bulgaria allocates the smallest share of GDP to healthcare among EU member states and has the lowest healthcare insurance contributions.
Among additional measures proposed by the BMA are reforms in the education and training of nurses and midwives to make these professions more attractive, as well as providing students with opportunities to actively participate in clinical work during their studies.
The BMA also called for further development of support mechanisms for hospitals that are the only medical service providers in their municipalities, with the goal of reducing their dependence on patient numbers and ensuring their financial stability.
Given the threat that the current wave of closures could expand, leaving entire regions without basic medical services, the BMA has urged the government to take immediate action to ensure the stability of the healthcare system.
