On October 20, 2025 at a round table organized by the Brain Health Council Foundation in partnership with the Bulgarian Medical Association and the Sofia Medical Association, the draft National Plan for Brain Diseases in the Republic of Bulgaria (2026–2030) was presented and discussed. The document outlines a long-term program for building a comprehensive, sustainable, and high-tech system for prevention, early diagnosis, effective treatment, rehabilitation, and social support for people with brain diseases.
“The National Plan for Brain Diseases provides for the inclusion and interaction of all stakeholders. We see that a sustainable framework for brain health care is being created in our country. I am convinced that today’s expert decisions will turn into real actions tomorrow,” said Minister of Health Assoc. Prof. Silvi Kirilov, welcoming the guests at the round table. The governor of the National Health Insurance Fund, Assoc. Prof. Petko Stefanovski, expressed his concern about this significant medical and social problem and emphasized that the institution’s goal is to support affected people by helping them regain their confidence and fully realize their potential in society.
Brain health is one of the most underestimated topics in the healthcare system, even though these diseases are the leading cause of disability and the second leading cause of death worldwide. According to data from The Lancet Neurology from 2024, by 2021, more than 3 billion people, or 43% of the world’s population, suffered from brain-related diseases. In Europe, 179 million people are affected, and the associated costs exceed €800 billion per year – more than the combined costs of cancer, cardiovascular disease, and diabetes.
According to the Brain Health Atlas (2021), stroke, neurological and mental disorders have the greatest impact on health in Bulgaria. In 2022, over 1.2 million cases of brain disorders were registered in Bulgaria, resulting in more than 33,000 deaths. Stroke is the cause of nearly 16% of all deaths in the country. “Caring for brain health is no longer just a medical issue—it is a moral, social, and economic necessity. Investing in brain health is an investment in human capital and the future of Bulgaria,” said Prof. Nikolay Gabrovsky, Chairman of the Brain Health Council Foundation and moderator of the round table.
The National Plan for Brain Diseases (2026–2030) offers a strategic response to one of the greatest health challenges of the 21st century and is fully in line with the efforts of the World Health Organization and the European Brain Council for integrated policies. The document covers five strategic areas:
Science, Data, and Innovation;
Access and Quality of Care;
Integration and Coordination of Activities;
Public awareness and social support; and
Policies and sustainability.
The plan provides for the establishment of a national monitoring system and digital infrastructure, the introduction of telemedicine and the use of artificial intelligence, as well as the creation of national registries for brain diseases. The focus is on investing not only in technology but also in people—doctors and healthcare professionals through continuing education, as well as the creation of specialized structures for aftercare and long-term care. Telemedicine and digital solutions will shorten the path to a specialist, remove geographical barriers, and speed up timely treatment.
The first part of the forum was devoted to proposals from leading scientific and professional organizations. Acad. Ivan Milanov, Chairman of the Bulgarian Society of Neurology, and Prof. Dimitar Maslarov, Board Member of the Brain Health Council Foundation, presented measures for the development of a network of centers for diagnosis, acute treatment, and rehabilitation after stroke and other brain injuries. Prof. Georgi Onchev, Deputy Chair of the Bulgarian Psychiatric Association, emphasized the integration of mental health into general medical practice and the elimination of stigma. Prof. Nikolay Gabrovski presented the proposals of the Bulgarian Society of Neurosurgery aimed at improving emergency neurosurgical care, creating modern rehabilitation programs, and reorienting hospital structures toward follow-up care and intensive rehabilitation. Arkadi Sharkov, health economist and Board Member s of the Brain Health Council Foundation, said that in 2024, brain diseases led to over 800,000 years of life with disability (DALY), which represents about one-third of the total burden of disease in Bulgaria. The economic impact is estimated at approximately €1.2 billion in losses per year, highlighting the need for better prevention, early diagnosis, and access to quality treatment. The Chairman of the Bulgarian Medical Association, Dr. Nikolay Branzalov, emphasized that the topic is of utmost importance not only for public health, but also for patients and the medical community as a whole. He expressed confidence that the efforts of leading specialists in this field will lay the foundations for a modern and effective national approach that will combine scientific potential, clinical experience, and policies for the prevention and treatment of brain diseases.
Dr. Asen Medjidiev, Chairman of the Sofia Medical Association (SMA), noted that the Association has nearly 100 neurosurgeons, 400 neurologists, and about 200 psychiatrists as members, which is proof of the organization’s high expert potential in the field of brain health. “This is not the only reason why the SMA supports this forum—the shared experience and expertise of the participants will outline effective solutions and strategies that will undoubtedly improve the treatment and care of patients with brain diseases,” said Dr. Medjidiev.
The experts outlined the systemic challenges: chronic underfunding and uneven distribution of resources, low public awareness and stigma, lack of integration between health and social services, shortage of doctors and especially healthcare specialists, and an aging population, which increases the incidence of dementia. Better use of European resources and networks, targeted educational programs, strong inter-institutional coordination, political support, and sustainable funding based on responsibility and accountability were identified as key levers for change.
“The National Brain Health Plan is not just a document with recommendations, but a real tool for action – with a clear path, measurable goals and a vision for change. It is an invitation to all institutions, non-governmental organizations, professionals, and citizens to become part of the common cause for better brain health,” emphasized Prof. Nikolay Gabrovsky.
The second panel of the round table was dedicated to scientific achievements and innovations in the field of brain health.
Prof. Dimitar Maslarov presented the topic “Modern thrombolytic treatment in acute ischemic stroke,” emphasizing that timely thrombolytic therapy in the first hours greatly increases the chances of recovery. Prof. Nikolay Gabrovsky spoke about robotization and artificial intelligence in neurosurgery, focusing on technologies that increase the precision and safety of procedures. Prof. Tsvetalina Tankova addressed the topic of “Brain Health and Obesity,” emphasizing the link between metabolic disorders, insulin resistance, and cognitive decline, and emphasized the importance of weight and blood sugar levels not only for cardiovascular disease but also for brain health and dementia prevention.