site.btaRenowned Neurologist Calls for Preparing National Plan for Brain Health

Addressing a round table "Brain diseases - challenges and solutions" in Sofia on Wednesday, Prof. Nikolai Gabrovski, chairman of the Brain Health Council Foundation, said that it is time to develop a national plan for brain health. He is the organizer of the forum, attended by neurosurgeons, neurologists, financial and health experts.

According to Prof. Gabrovski, 180 million people in Europe are living with brain diseases, but there are probably more as there are clinical conditions that cannot be defined as a disease. Brain diseases continue to be one of the leading causes of disability and mortality, the doctor added.

“The problems now and ten years ago are almost the same - there are nearly 800 neurologists in the country, they are not in good financial conditions as clinical pathways are very underfunded, and there are no people willing to specialize in neurology,” said Acad. Ivan Milanov, director of the Multiprofile Hospital for Active Treatment in Neurology and Psychiatry “St. Naum”. He added that neurologists have received support, but the situation is changing very slowly. “Neurological diseases are a very serious problem. In recent years, many therapies have been developed for diseases that were not curable, but we forget the more elementary diseases such as chronic migraine, a scourge for women over 50,” he said.

Prof. Georgi Onchev, deputy chairman of the Bulgarian Psychiatric Association, pointed out that brain health is multifaceted and depends on bodily health. One of the reasons for the high growth of brain diseases is the increase in cases of mental disorders in rich countries. According to him, this is related to a better lifestyle which lowers the frustration threshold. Another reason is the use of drugs, which leads to an increase in the incidence of mental illness, he said. Parallel to this growth, the investment in mental health remains nil, he stressed, adding that Bulgaria has a strategy for mental health until 2030, but "nothing of what is planned is related to translation and implementation in actual clinical practice." The first national concept in Bulgaria dates back to 1976, but real investment in psychiatric services is non-existent, Prof. Onchev said.

Prof. Radka Kaneva, manager of the Centre for Molecular Medicine, said the problem is not only related to the treatment of brain diseases, but also to genetic diagnostics for all inherited diseases. For example, genetic testing for the elderly is not reimbursed. According to her, there has been progress in genetic diagnosis for children in Bulgaria and there are opportunities to build an infrastructure in this country to allow genetic and genomic testing. “What we are missing is effort, funding and support from the Ministry of Health,” she stressed, adding that the lack of a database is an obstacle to the development of modern, evidence-based medical science.

Investments in healthcare should be smart - in prophylaxis and prevention, in early diagnosis, in patient care, said Deyan Denev, director of the Association of Research-based Pharmaceutical Manufacturers in Bulgaria (ARPharM). In his words, investments should be made on the basis of strategic documents, implemented in practice.

Evgeni Tassovski, executive director of the Bulgarian Generic Pharmaceutical Association (BGPharmA), pointed to the importance of political will to implement necessary changes, and added that Bulgaria needs to catch up with other countries in terms of the level of health spending as a share of GDP.

The Ministry of Health welcomes the establishment of a brain health council, and it has priorities united in a strategy until 2030, where mental health is also covered, said Deputy Health Minister Dr. Petko Stefanovski. Under the Recovery and Resilience Plan, more than BGN 84 million is earmarked for six state hospitals, where modern centres for endovascular treatment of cerebrovascular diseases will be established, he added.