The World Health Organization, founded in 1946, defines “the highest possible standard of healthcare as a fundamental right of every human being.”
The right to healthcare is regulated by a series of international documents, including the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, the Convention on the Elimination of All Forms of Discrimination Against Women, and the European Social Charter.
The Constitution of the Republic of Bulgaria also explicitly states that “citizens have a right to health insurance guaranteeing them affordable medical care,” as well as “a healthy environment conducive to wellbeing in accordance with established standards and regulations.”
The right to healthcare concerns not only healthcare services, but also the conditions that determine our wellbeing.
Recognizing access to adequate medical care without any form of discrimination as a human right creates a legal obligation for the state to ensure timely and acceptable care, as well as to guarantee fundamental health needs such as safe drinking water, sewage, food, housing, health-related information, and education.
Among the member states of the European Union, Bulgaria faces some of the most serious challenges in exercising the right to healthcare. Despite the overall improvement in this realm over the last two decades, our country is advancing slowly. As a result, it still lags behind other member states according to average EU health indicators and differs drastically from countries where citizens enjoy the highest-quality healthcare.
For certain groups in Bulgarian society, the right to health care is significantly reduced compared to other groups of Bulgarian or EU citizens. Most often, these are people in positions of vulnerability—members of marginalized groups, disabled individuals, those in closed institutions, women, children, etc.
BHC’s work is primarily aimed at groups whose right to healthcare is violated more frequently or to a more serious degree than that of other members of society. BHC was the first organization to detail human rights violations in specialized institutions and psychiatric hospitals, attracting local and international attention. We then took legal action to protect individuals residing in these facilities, which brought an end to arbitrary placement for involuntary psychiatric treatment. Following several legal battles, the right of individuals placed under interdiction to fight for their freedom in court was also successfully reformed.
The organization also has decades-long experience (dating back to 1995) in monitoring specialized institutions for children
. The most striking violations concerned the discovery of preventable child deaths in homes for disabled children
, which had resulted from neglect and a lack of medical services and other care. As of today, the conditions in residential facilities for children have been optimized thanks to a series of reforms, though they still lag far behind the established goals.
The other domain where our country has continuously failed in its obligation to meet required standards is access to healthcare for persons deprived of liberty. Members of the Roma community also continue to face significant obstacles, which in their case includes not only access to medical services, but also access to living conditions conducive to a higher standard of health and wellbeing.
Over the last few years, BHC has also directed its efforts towards legal and monitoring initiatives related to the rights of childbearing women
. In 2017, BHC conducted a study
which found existing institutionalized segregation of Roma women in maternity wards in 96.3% of hospitals in the country. Over the last three years, our organization has participated in a coalition which actively advocates to improve the quality of maternity care, particularly access to medical services for uninsured pregnant women.
One of the most well-known movements related to the right to healthcare is the 2012 campaign
to provide reimbursed medical devices and medication for patients with a rare disease known as epidermolysis bullosa. BHC, along with two partner organizations, worked to add the disease to the list of treatments financed by the National Health Insurance Fund.
Moreover, it is worth noting that approximately 600 stillborn babies
are born in Bulgaria every year. It is difficult to imagine that until 2015, bereaved parents did not have the right to cremate or bury their children. This policy was changed following a three-year campaign
initiated in 2012 by BHC and the “Poppies for Mary” Foundation.
Over the last two years, the subject of “healthcare” became especially relevant in light of the COVID-19 pandemic. In the context of myriad local, national, and cross-border restrictions, it became necessary to entirely revaluate our understanding of human rights. On one hand, the concept of human rights received heightened attention. On the other, we witnessed a number of misinterpretations and distorted applications in the protection of human rights in the context of the pandemic. This encouraged BHC to not only pay special attention to the healthcare dimension of each of the other domains it monitors in its Annual Report on Human Rights in Bulgaria, but also to include a special chapter in the 2020 and 2021 editions dedicated to the right to healthcare.